Darla Schaben
Grimes,Iowa
Summary
Collaborative leader with dedication to partnering with coworkers to promote engaged, empowering work culture. Documented strengths in building and maintaining relationships with diverse range of stakeholders in dynamic, fast-paced settings. Population health management experience with focus on NCQA quality and performance for Medicaid, Commercial and Medicare lines of business. History of achieving exceptional results in quality management, and implementation of innovative programs.
Overview
34
34
years of professional experience
1
1
Certification
Work History
Senior Clinical Transformation Manager
UHC Clinical Services
03.2017 - Current
- Accountable for successful deployment of Clinical Support program at ACO level for Medicaid, Medicare, and Commercial lines of business, including but not limited to, quality management, utilization management and risk adjustment by introducing and educating ACOs on value/use of reporting tools, patient registries and delivery of reports in all lines of business
- Recommended and implemented practical business process solutions, working directly with stakeholders to drive customer expansion and increase revenue generation.
- Applied principles of change management, organizational design and business process improvement to stimulate customer interest and attract untapped demographics.
- Regularly facilitated efficient, effective practice improvement meetings with practice to monitor, present, and discuss progress on clinical action plan and achievement in milestones
- Designed ACO clinical action plans
- HEDIS STARS action plans including Patient Experience and implement appropriate performance improvement initiatives to assist ACO in achieving contractually required transformation milestones
- Used utilization data to analyze key cost, and quality data to provide direction for quality contractual requirements and overall population health management.
Senior Clinical Practice Consultant
United Healthcare Community and State
01.2016 - 03.2017
- Accountable for successful deployment of Clinical Support program at practice level, including but not limited to, introducing, and educating practices on value/use of reporting tools and delivery of reports
- Supported practice in ensuring accurate attribution and provider rosters
- Regularly facilitated efficient, effective practice improvement meetings with practice to monitor, present, and discussed progress on transformation action plan and achievement in milestones
- Monitored monthly and quarterly HEDIS and EPSDT performance reports of assigned practices
- Based on performance analysis, developed strategies for improvement that includes specific outcomes and metrics to monitor progress to goal; provided feedback and made recommendations for improvement.
- Improved workflow automation to reduce wasted time and resources.
- Guided staff in clinical best practices and evidence-based methods
Quality Improvement Advisor
Regional Provider Network
11.2015 - 01.2016
- Clinic assessments and implementation of PCMH and Compass Practice Transformation
- Network initiative in development of comprehensive quality improvement strategies.
- Developed quality improvement plans, policies and operational guidelines.
Medical Home Nursing Supervisor
Nebraska Methodist Physicians Clinics
04.2014 - 10.2015
- Hiring and supervising 32 Health Coaches in 20 PCMH clinics, analyzing STARS performance data, and implementing processes for improvement and requirements of programs which include but not limited to NCQA diabetes and heart/stroke recognition, recertification of NCQA Medical Home and managed quality measures of payer contracts
- Developed policies and procedures to have continuity of care throughout health system.
- Followed all HIPAA rules and regulations regarding patient confidentiality
Health Coach
Nebraska Methodist Physicians Clinics
04.2013 - 04.2014
- Implemented the processes of HEDIS, STARS, ACO, NCQA, & PCMH requirements for Medicaid, Medicare, and Commercial lines of business at the clinic level.
- Assisted patients in finding new ways to inspire healthier habits.
Registered Nurse/License Practical Nurse
Cass County Health Systems
02.2009 - 04.2013
- Served as RN/LPN on medical/surgical unit at rural access hospital
- Actively participated in development and implementation of individual treatment plans for patients with broad range of medical and surgical issues
- Ensured that physicians’ orders were effectively carried out.
- Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
- Administered medications via oral, IV, and intramuscular injections and monitored responses.
Logistics Clerk
Iowa National Guard
08.1989 - 05.1991
- Handled high-volume paperwork and collaborated with administrators to resolve invoicing problems.
- Verified transactions and entered information into databases and reports.
Education
Bachelor of Science - Nursing
Northwest Missouri State University
Maryville, Missouri12.2014
Registered Nurse, State of Iowa -
Iowa Western Community College
Council Bluffs, Iowa12.2012
Skills
- Quality Improvement
- Risk Adjustment Knowledge
- Time Management
- Effective Communication
- NCQA Accreditation Experience
- Data Analysis
- Employee Coaching and Mentoring
- Team Management
- Meeting Deadlines
- Team Meetings
- Customer Satisfaction
Certification
- Certified Risk Coder, AAPC - July 2023
Timeline
Senior Clinical Transformation Manager
UHC Clinical Services
03.2017 - Current
Senior Clinical Practice Consultant
United Healthcare Community and State
01.2016 - 03.2017
Quality Improvement Advisor
Regional Provider Network
11.2015 - 01.2016
Medical Home Nursing Supervisor
Nebraska Methodist Physicians Clinics
04.2014 - 10.2015
Health Coach
Nebraska Methodist Physicians Clinics
04.2013 - 04.2014
Registered Nurse/License Practical Nurse
Cass County Health Systems
02.2009 - 04.2013
Logistics Clerk
Iowa National Guard
08.1989 - 05.1991
Bachelor of Science - Nursing
Northwest Missouri State University
Registered Nurse, State of Iowa -
Iowa Western Community College
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