Edna "Denise" Davis
Lumberton,NC
Summary
Goal driven, reliable, highly skilled healthcare career professional with more than 33 years of experience. Known for excellent communication and teamwork abilities, with a commitment to achieving company goals and delivering exceptional service.
Accustomed to the integration of new healthcare delivery systems, restructuring of work and an increasing complex regulatory environment.
Overview
34
34
years of professional experience
Work History
Nurse Consultant
Office Of Inspector General-Healthcare Inspections
Fayetteville, NC
10.2021 - Current
- Carried out various functions within the Office of Inspector General, which included inspecting specific healthcare issues, conducting quality reviews of medical center operations and healthcare-related processes, evaluating nationwide healthcare programs, and offering clinical consultations. These efforts were aimed at strengthening the Veterans Health Administration’s (VHA’s) healthcare services and other missions, with the goal of enhancing patient care programs and preventing fraud, waste, and abuse.
- Evaluated the clinical practice guidelines of the Veterans Health Administration (VHA) to determine their effectiveness in improving patient care and reducing inappropriate variations in treatment. Confirmed that the VHA facility's clinical practice guidelines were evidence-based, incorporated patient input, and included explicit criteria to ensure internal validity.
- Inspected, analyzed, and evaluated both quantitative and qualitative clinical information gathered during the inspection process by individual team members.
- Recognized critical areas for advancement in quality care initiatives aligning with major departmental priorities and Congressional focus.
- Utilized the Corrective and Preventive Actions (CAPA) methodology, offering a clear framework for identifying and addressing nonconformities to prevent their recurrence.
Surgical Scheduler/Implant Coordinator
Fayetteville VA Medical Center
Fayetteville, NC
06.2017 - 10.2021
- Coordinated multiple internal and external phases of the development of the FVAMC Master Surgery Schedule daily. This is a complex process requiring an in-depth review of requests, alignment of procedure times based on historical case statistics, assignment of rooms, coordination of requests for equipment and supplies with Sterile Processing and Distribution (SPD), Prosthetics for implants, and interfacing with required ancillary support departments.
- Facilitated surgical scheduling for Fayetteville VA Coastal Health Care System and Womack Army Medical Center joint initiative.
- Assumed responsibility for the coordination of surgical implant devices as they relate to pre-surgical and post-surgical requests. Collaborated with Logistics and Prosthetics Services regarding the tracking of, and receipt of, the implant at the medical center from the vendor.
- Acted as liaison between surgeons, anesthesiologists, nurses and other medical staff regarding surgical schedules.
- Achieved cost-savings by developing functional solutions to problems.
- Conducted testing of software and systems to ensure quality and reliability.
- Utilized various software and tools to streamline processes and optimize performance.
Quality Manager/Risk Manager
Southeastern Health Physician Services
Lumberton, NC
01.2013 - 06.2017
- Responsible and accountable for the ongoing development, implementation, and coordination of physician network quality and population health initiatives, with the aim of enhancing the quality of patient care and outcomes in the physician network, including, but not limited to, 93 providers and 34 multi-specialty clinics. Directed management of governmental and third-party payer health care quality measures, resulting in three years of positive payment adjustments and over $1,000,000.00 in incentive payments.
- Participated in all aspects of quality review, data abstraction, and data entry to ensure monitoring and compliance with regulatory and accreditation requirements and standards specific to NCQA PCMH (Patient-Centered Medical Home).
- Provided leadership in developing best practices for continuous improvement initiatives across all departments.
- Served as a Subject Matter Expert, playing a critical role in the success of the Epic implementation, acting as a bridge between technology and operations. Epic is an integrated software that connects hospitals, clinics, post-acute care, health plans, and more. In addition, Epic's software provides tools that support better patient outcomes and reduce healthcare costs.
- Developed SOPs outlining quality control policies and procedures.
- Prepared reports summarizing findings from inspections, tests, investigations and other QA activities for senior management review.
- Established quality KPIs and reported on performance to senior management, highlighting achievements and areas for improvement.
- Managed internal audit program, identifying non-conformances and leading corrective action plans.
Regulatory Compliance Coordinator
Southeastern Regional Medical Center
Lumberton, NC
10.2008 - 12.2012
- Participated in meetings with external auditors, regulators or government officials when required.
- Drafted compliance documents such as reports, guidelines, training materials and policies.
- Oversaw full audit lifecycle according to organizational protocol, generating progress and closing reports for leadership and clients.
- Reviewed existing policies, procedures and practices for adherence to regulatory standards.
- Executed successful compliance monitoring and risk assessment programs.
- Created educational programs related to regulatory compliance topics for employees.
- Monitored changes in relevant legislation and advised management on necessary actions.
- Utilized various software and tools to streamline processes and optimize performance.
- Updated and maintained databases with current information.
- Prepared reports summarizing audit results, findings and recommendations for senior management review.
- Consulted with providers on clinical best practices, and served as project manager for all process improvements and regulatory initiatives.
- Tracked completion of corrective action plans following identified non-compliances.
- Developed and implemented internal processes to ensure compliance with applicable regulations and laws.
Care Management/Utilization Management Nurse
Southeastern Regional Medical Center
Lumberton, NC
12.2004 - 12.2008
- Assessed the appropriateness of medical services and procedures based on clinical documentation and criteria.
- Utilized evidence-based guidelines to support utilization review decisions and recommendations.
- Performed quality assurance audits on completed utilization review cases.
- Reviewed and updated utilization review criteria and guidelines to reflect current standards of practice.
- Liaised between patients, healthcare providers, and insurance companies to clarify coverage and authorize services.
- Monitored treatment progress by reviewing medical records, lab results, physician notes.
- Adhered to evidence-based standards when making decisions regarding resource utilization.
- Maintained up-to-date knowledge of changes in healthcare regulations, policies, and evidence-based practices.
- Communicated regularly with physicians and providers regarding appropriateness of care delivery within established parameters.
- Provided feedback to healthcare providers on clinical documentation improvement to support utilization review.
- Utilized computerized Resource and Patient Management System (RPMS) and Electronic Health Record (EHR) system.
- Coordinated with external agencies such as home health agencies or skilled nursing facilities regarding patient placement needs.
- Monitored patient admissions and discharges to optimize care coordination and resource utilization.
Assistant Unit Manager- Operating Room
Southeastern Regional Medical Center
Lumberton, NC
01.1998 - 11.2004
- Utilized various software and tools to streamline processes and optimize performance.
- Coordinated ongoing educational objectives to enhance staff competencies in safety, quality, and core measures.
- Analyzed unit performance metrics, identifying trends and areas for improvement.
- Developed and maintained budgets for the unit, closely monitoring expenses.
- Oversaw daily operations of unit, ensuring efficiency and compliance with company policies.
- Built work schedules and staff assignments, taking workload, space and equipment availability into consideration.
- Prepared and presented reports on unit performance, challenges, and achievements to senior management.
- Analyzed financial reports to identify areas of potential cost savings or increased profitability.
- Conducted periodic reviews of processes and procedures to improve efficiency.
- Stocked medical supplies, medications, and equipment to maintain essential items for unit.
- Assisted with the recruitment, selection and training of new staff members.
- Negotiated contracts with vendors and suppliers, optimizing costs and resources.
Circulating Nurse/Scrub Nurse- Operating Room
Southeastern Regional Medical Center
Lumberton, NC
06.1991 - 01.1998
- Prepared operating room for patient procedures and assisted with clean up after procedures.
- Monitored fluid balance levels throughout surgery, adjusting accordingly when needed.
- Administered conscious sedation medications per protocol guidelines.
- Participated in multidisciplinary team meetings to discuss patient progress, treatment plans, and other relevant topics related to patient care.
- Collected, labeled and processed patient specimens carefully and accurately for testing.
- Managed inventory of medical supplies within the operating room setting.
- Organized supplies for each procedure ensuring that necessary equipment was available when needed.
- Ensured proper positioning of patients on the operating table before beginning surgical procedure.
- Responded quickly in emergency situations while maintaining composure under pressure.
- Stocked clinical workstations and procedure rooms with necessary supplies.
- Collaborated with anesthesiologists and surgeons during operative procedures.
- Completed day-to-day duties accurately and efficiently.
Education
Bachelor of Science - Nursing
University of North Carolina At Wilmington
Wilmington, NC05-2012
Associate of Applied Science - Nursing
Southeastern Community College
Whiteville, NC05-1991
Timeline
Nurse Consultant
Office Of Inspector General-Healthcare Inspections
10.2021 - Current
Surgical Scheduler/Implant Coordinator
Fayetteville VA Medical Center
06.2017 - 10.2021
Quality Manager/Risk Manager
Southeastern Health Physician Services
01.2013 - 06.2017
Regulatory Compliance Coordinator
Southeastern Regional Medical Center
10.2008 - 12.2012
Care Management/Utilization Management Nurse
Southeastern Regional Medical Center
12.2004 - 12.2008
Assistant Unit Manager- Operating Room
Southeastern Regional Medical Center
01.1998 - 11.2004
Circulating Nurse/Scrub Nurse- Operating Room
Southeastern Regional Medical Center
06.1991 - 01.1998
Bachelor of Science - Nursing
University of North Carolina At Wilmington
Associate of Applied Science - Nursing
Southeastern Community College
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