Caroline Deblasio
Morristown,NJ
Summary
Health professional with extensive experience in coordinating healthcare payor programs and initiatives. Skilled in managing multidisciplinary teams, streamlining processes, and implementing effective health strategies. Known for strong collaboration, adaptability, and consistently delivering measurable results. Knowledge of health education and preventive care strategies to promote community well-being.
Overview
7
7
years of professional experience
Work History
Population Health Manager
Englewood Hospital
06.2022 - Current
- Manage eight payer quality programs across the physician network, ensuring compliance, performance tracking, and successful care gap closure.
- Collect, analyze, and manage complex datasets from payers and internal systems to support quality reporting and improvement initiatives.
- Supervise Quality Assistants and other team members to meet reporting requirements and drive high performance across all programs.
- Lead ACO Quality Metrics Reporting (GPRO) and oversee additional CMS and state initiatives, including Primary Care First.
- Collaborate with IT to ensure timely, accurate, and complete data acquisition for payer submissions.
- Leverage Excel (pivot tables, VLOOKUP) to efficiently abstract, manipulate, and report on large data sets.
- Develop and implement quality improvement initiatives to enhance patient care delivery and outcomes.
- Produce detailed quality metric reports for senior leadership, enabling informed, data-driven decision-making.
Administrative Coordinator
New Jersey Perinatal Associates
01.2022 - 06.2022
- Manage and generate various reports for senior management, incorporating best practices and supporting ad hoc projects as assigned.
- Obtain, review, and complete provider credentialing applications, ensuring accuracy and maintaining strict confidentiality of sensitive information.
- Prepare and submit provider data in online credentialing systems, including CAQH and payer portals.
- Maintain up-to-date records of provider licenses, DEA registrations, and malpractice coverage; coordinate renewals as needed.
- Develop and distribute monthly reports analyzing revenue trends and key practice performance metrics.
- Recruit, screen, and credential qualified prospective employees in accordance with organizational standards and regulatory requirements.
Quality Improvement Specialist
Robert Wood Johnson
03.2021 - 01.2022
- Supported the Quality Management Program by identifying performance improvement opportunities related to HEDIS and STARS measures.
- Conducted meetings with network physicians to review individual program performance and share best practices for closing care gaps and improving quality scores.
- Acted as a liaison between payers and the health system to enhance overall quality performance and foster collaboration.
- Performed detailed EMR data abstraction to identify and close quality gaps, supporting compliance and performance goals.
Customer Service Specialist
Montefiore Medical Center
08.2019 - 03.2021
- One on one communication with patients, hospital staff, and visitors in a polite and helpful manner
- Meet with patients and their families to discuss their complaints and grievances; documenting all details in MIDAS and determining what the proper resolution should be
- Receive calls from patients about needs or issues as well as rounding to units to advocate on their behalf
- Investigate all complaints and grievances and direct them to the appropriate medical and administrative staff members
- Complete patient interviews to identify problems relating to the medical staff to provide a patient centered care experience
- Work with unit leaders and staff to assign and assure follow-up action is taken quickly to resolve issues
Orthopedic Department- Administrative Intern
Mercy Medical Center
01.2019 - 05.2019
- Register patients in EPIC prior to their clinic visits
- Use EPIC to verify patient coverage, check in patients, and schedule appointments
- Answer phone calls for physicians and document accordingly
- Sit at greeter desk during clinic and provide patients with information
- Attend executive level meetings to have a better understanding of healthcare administration
Education
Bachelor of Science - Health Care Management, Minor: Business Administration
Towson University
Towson, MD05.2019
Skills
- Expertise in EPIC systems
- Electronic medical records proficiency
- Healthcare data analysis
- HEDIS reporting
- Excel proficiency
- Proficient in Word
- Presentation design
Timeline
Population Health Manager
Englewood Hospital
06.2022 - Current
Administrative Coordinator
New Jersey Perinatal Associates
01.2022 - 06.2022
Quality Improvement Specialist
Robert Wood Johnson
03.2021 - 01.2022
Customer Service Specialist
Montefiore Medical Center
08.2019 - 03.2021
Orthopedic Department- Administrative Intern
Mercy Medical Center
01.2019 - 05.2019
Bachelor of Science - Health Care Management, Minor: Business Administration
Towson University
Leadership and Volunteer Experience
- Active Member in the Iota Delta Chapter of Zeta Tau Alpha
- Tigertown, raising over $400,000 with other chapters for pediatric cancer March 2019
- American Cancer Society, Making Strides Walk, Towson MD October 2018
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