Dawn Loeffler
Middleport,NY
Summary
Reliable Manager demonstrating high level of ownership and initiative. Possessing exceptional work ethic and desire to go above and beyond to exceed company expectations. Offering knack for building productive working relationships. Successful in fast-paced, deadline-driven environments to manage goals and team development. History of thriving in team-oriented environments.
Hardworking and motivated professional with several years of experience and record of success in industry. Solid history balancing team performance, customer service targets and business objectives. Dedicated to working closely with employees to maximize productivity and optimize procedures. Decisive leader with good planning and organizational skills.
Overview
20
20
years of professional experience
10
10
years of post-secondary education
Work History
Manager of Quality Programs
Children’s Health Home of Upstate New York
Rochester, NY
01.2018 - Current
- Responsible for developing and leading quality.
- Develop and implement a Quality Management Program addressing areas including but not limited to; chart audit process, gaps in care, utilization management, documentation compliance, NYS Health Home Performance Metrics, Medicaid Managed Care Plan expectations, and more
- Promotes quality in clinical practice by collaborating in the development of policy and procedures
- Oversee Medicaid Managed Care Plan’s outcome expectations and alignment of care management activities with HEDIS, QARR, and other measures as defined by the Managed Care Plan in preparation for value-based payment models
- Collaborate with Medicaid Managed Care Plans
- Work with network providers to drive care management improvement while educating on measures, performance, and the care management model
- Lead the Clinical Quality Workgroup
- Develop key performance indicators to identify gaps and successes with network providers
- Participate on case reviews as needed
- Identify training needs and secure subject matter experts to provide trainings to network providers
- Provide direction and oversight to business associates performing quality tasks
- Analyze data and report information to identify the need for change, minimize risk, and ensure effectiveness of quality improvement
- Design a reporting structure to inform CEO of network provider performance
- Assists in development and implementation of any performance improvement plans required by governing bodies or managed care plans
- Work closely with state agency partners to ensure all stakeholder expectations are addressed as it relates to quality of care management services
Director of Quality Management
Niagara Falls Memorial Medical Center
Niagara Falls, NY
01.2018 - 12.2018
- Responsible for developing and leading quality.
- Quality improvement and performance improvement leadership.
- Risk management.
- Manages utilization review team.
- Participates and when required chairs committees around quality metrics and performance improvement.
- Assists quality initiatives with primary care practices.
Project Manager Primary Transformation Healthcare Reform
Saratoga Hospital Primary Medical Group
Saratoga, NY
01.2017 - 12.2018
- Leads the primary care teams in transformation for Patient Centered Medical Home, CPC Plus and other medical/healthcare incentives.
- Coordinates will essential clinical and administrative staff to implement new process and policies developed to meet required standards.
- Writes policies and procedures aligning the primary care offices with the necessary requirements.
- Meets regularly with medical leadership to inform of progress, barriers etc. regarding progress towards meeting the requirements to receive accreditation.
- Established eight patient advisory councils.
- Worked with each primary care office in establishing a quality improvement committee.
- Responsible for additional programs such as APC (Advanced Primary Care), EPC (Enhanced Primary Care), DSRIP, and Patient Centered Medical Home.
Performance Management Coordinator
Capital District Physicians Health Plan
Albany, NY
01.2015 - 12.2016
- Assisted offices improve quality, patient satisfaction, and healthcare cost reduction to align with established goals.
- Collaborated with other internal departments i.e. Quality, Contracting, Provider Relations, Medicare Chronic Conditions etc., to provide provider offices necessary education / information.
- Served as mediator between CDPHP and Enhanced Primary Care (EPC) accounts to aid in a fast response or assist in their need.
- Identified areas of opportunity for each EPC account, provided reports supporting information to present to account while helping to establish strategic plan to move toward goals while identifying barriers and addressing them.
- Helped to re-develop Sales Force team reporting template to provide ease of use for coordinator while continuing to capture necessary information required at a management level.
Practice Administrator
Community Care Physicians
Clifton Park, NY
01.2014 - 12.2015
- Managed, maintained all daily functions of both offices.
- Establish solid workflows to allow for a smooth office operation.
- Increased staffing and identified right person for the right job to promote employee satisfaction and job performance.
- Empowered staff by assigning high level job functions; increased communication amongst staff and providers.
Practice Manager
Community Care Physicians
Clifton Park, NY
01.2013 - 12.2014
- Scheduled all office activities including staff and provider schedules.
- Managed day-to-day operations of all reception, medical records and nursing staff.
- Initiated Medical Home, Meaningful Use, HEDIS and other government and insurance incentives to acquire better patient care / control of chronic diseases.
- Promoted excellent customer service.
- Improved workflows / processes to promote timeliness and improve overall patient care.
Performance Improvement Manager
Hudson Headwaters Health Network
Queensbury, NY
01.2010 - 12.2013
- Implemented day-to-day Network Quality.
- Investigated all events, incidents, complaints and compliments.
- Reported quarterly to Network Quality Committee, Board of Directors trends / performance improvement in these areas.
- Promoted incentive based programs, assisted Network in achieving monetary incentive goals.
- Chairs Network Clinical Quality Committee and four sub-work groups.
- Established, implemented Patient Advocacy Council in accordance with Hudson Headwaters and PCMH guidelines, requirements, and vision.
Health Center Administrator
Hudson Headwaters Health Network
Queensbury, NY
01.2009 - 12.2010
- Complete oversight of the healthcare facility; entire front office staff supervision, staffing, day to day operations, health center budgets preparation for front office and assistance with nursing.
- Assumed assistance with nursing supervision when applicable.
- Worked closely with lead physician to obtain optimal customer service and health care to patients and their families.
Health Center Manager
Hudson Headwaters Health Network
Queensbury, NY
01.2007 - 12.2009
- Responsible for entire front office staff supervision, staffing, day to day operations, health center budgets preparation for front office.
- Scheduled, prepared agendas, performed team meetings, staff and front office meetings.
- Worked side by side on health center issues with the lead physician and nurse manager.
Reimbursement Director
O2 Solutions
Saratoga Springs, NY
01.2006 - 12.2007
- Oversight of 3 billing staff members and 3 customer service staff.
- Performed hiring, counseling and termination of staff as required.
- Worked closely with CEO, Investors, and CFO.
- Provided company financial projections from billing and accounts receivables.
Education
Master of Science - Health Administration
Sage Colleges
Albany, NY 09.2014 - 09.2017
Bachelor of Science - Business Administration
SUNY Empire State College
Saratoga Springs, NY 05.2010 - 04.2014
Associate of Science - Business
SUNY Empire State College
Saratoga Springs, NY 09.2007 - 04.2010
Skills
- 20 Years of Supervisory & Management
- Practice Management
- Customer Service
- Accounts receivables
- Reimbursement
- Patient Centered Medical Home
- HEDIS
- DME, Primary Care, Pediatric Care, Health Home management
- Quality Program development and oversight
- Quality and Risk/Compliance Management
- Recruitment, Interviewing, Hiring, Training, Management
- Proficient with Microsoft Office, several EMR platforms
Timeline
Manager of Quality Programs
Children’s Health Home of Upstate New York
01.2018 - Current
Director of Quality Management
Niagara Falls Memorial Medical Center
01.2018 - 12.2018
Project Manager Primary Transformation Healthcare Reform
Saratoga Hospital Primary Medical Group
01.2017 - 12.2018
Performance Management Coordinator
Capital District Physicians Health Plan
01.2015 - 12.2016
Master of Science - Health Administration
Sage Colleges
09.2014 - 09.2017
Practice Administrator
Community Care Physicians
01.2014 - 12.2015
Practice Manager
Community Care Physicians
01.2013 - 12.2014
Bachelor of Science - Business Administration
SUNY Empire State College
05.2010 - 04.2014
Performance Improvement Manager
Hudson Headwaters Health Network
01.2010 - 12.2013
Health Center Administrator
Hudson Headwaters Health Network
01.2009 - 12.2010
Associate of Science - Business
SUNY Empire State College
09.2007 - 04.2010
Health Center Manager
Hudson Headwaters Health Network
01.2007 - 12.2009
Reimbursement Director
O2 Solutions
01.2006 - 12.2007