Erick A. Aquino
Redlands,CA
Summary
Quality improvement professional with proven track record of enhancing operational processes and driving impactful changes. Valued for strong focus on team collaboration and achieving consistent results. Known for adaptability and reliability, with expertise in process optimization and data analysis. Experienced with driving quality improvement initiatives that enhance operational efficiency and effectiveness. Knowledge of team collaboration and continuous improvement methodologies.
Adept at leading cross-functional teams to achieve significant results, adaptable to evolving organizational needs. Skilled in project management and implementing best practices.
Overview
13
13
years of professional experience
Work History
Director of Quality Improvement
LaSalle Medical Associates
01.2020 - Current
- Responsible for developing and implementing programs and initiatives that improve quality outcomes for over 130,000 southern California managed care lives
- Bolstered operational excellence through close collaboration with senior leadership in developing long-term strategic plans related to quality improvement initiatives.
- Coordinated cross-functional teams to develop, implement, and maintain a comprehensive quality management system for the entire Southern California network
- Implement robust corrective action systems at the Health Plan and Provider group level that enabled swift identification of root causes behind recurring care gaps leading to increased HEDIS scores year over year
- Develop strategic work plans for over 80 primary care providers that lead to improvement for multiple health plans quality measures
- Achieved significant cost savings by identifying inefficiencies within existing claims and utilization processes and introducing data-driven optimizations.
- Spearheaded the development of an integrated quality management platform, centralizing all key metrics and driving data-driven decision-making processes across the organization.
- Collaborated with stakeholders at various levels to incorporate patient, provider and health plans feedback into new initiative development processes, ensuring alignment with all parties
Provider Engagement Quality Manager
LaSalle Medical Associates
01.2018 - 01.2020
- Responsible for developing, implementing and managing programs and initiatives that improve quality outcomes for over 400,000 managed care lives across the state of California
- Develop statewide work plans that track and monitor quality improvement for multiple health plans and contracted primary care providers
- Cultivate and maintain effective working relationships with primary care providers, health plan partners and contracted vendors
- Managed and archived quality documentation and participated in internal and external quality audits.
- Mentored and encouraged employees to strive for excellence while fostering professional growth.
- Provided training to employees on best practices in quality management, fostering a culture of excellence within the organization.
- Streamlined production processes by identifying areas for improvement and implementing corrective actions.
- Wrote and implemented new rework procedures to standardize processes and streamline workflow.
- Led continuous improvement initiatives by actively seeking opportunities for process optimization and cost reduction.
Quality Improvement Care Navigator Manager
SynerMed/Inland Valleys IPA
01.2016 - 01.2018
- Responsible for implementing quality improvement activities and provider office coaching
- Promoted a positive work environment among peers by remaining approachable, supportive, and flexible when collaborating on shared tasks.
- Streamlined healthcare services by effectively collaborating with interdisciplinary teams.
- Updated knowledge on industry best practices regularly by attending professional conferences and participating in continuing education opportunities.
- Establishing and maintaining relationships with primary care provider, health plan partners, and quality partners
- Provide clinical resources and share best practices with provider network
- Develop workflows for primary care providers to help increase IHEP and Molina Medi-Cal quality measures
- Identified potential barriers to care, implementing tailored solutions to improve outcomes.
Regional Care Navigator Lead
Synermed
01.2014 - 01.2016
- Develop workflows for primary care providers to help increase LACare, Anthem Blue Cross, Care 1st, and Molina Medi-Cal quality measures
- Utilized Microsoft Word to edit, create and save confidential documents.
- Maintained confidential health information according to state and federal regulations.
- Monitored progress towards identified goals, adjusting care plans as needed based on evolving circumstances.
- Leading quality team in outreach activities
- Educated member on gaps in care and assisted with scheduling provider appointments.
- Providing care gap reports to providers
- Establishing and maintaining relationships with primary care provider
Quality Care Navigator
SynerMed
01.2012 - 01.2014
- Conducting patient care calls
- Responsible mail merge of patient letters
- Providing patient education about preventative care
- Providing care gap reports to providers
- Establishing and maintaining relationships with primary care provider
- Implementing workflows for primary care providers to help increase LACare, Anthem Blue Cross, Care 1st, and Molina Medi-Cal quality measures
- Stay update with each plan partner quality programs
Education
Licensed Vocational Nursing - Nursing
Pacific College
Cosa Mesa12-2014
Skills
- Process improvement expertise
- Documentation management
- Corrective action planning
- Process mapping
- Six sigma principles
- Managing operations and efficiency
- Customer relationship management
- Reliability
- Excellent communication
- Adaptability and flexibility
- Employee Training and development
- Professionalism
- Complex Problem-solving
- Strategic planning
Accomplishments
Incentives - Under my leadership in my current roll over the past 7 years, my departments efforts have led to over $10 million dollars in P4P/HEDIS performance efforts.
Department Recognition - Under my leardership in my current role over the past 7 years, my department has been recognized best ranked IPA for quality results by a Plan Partners and has consistently ranked among the top 5 best performers.
Emergency Room Avoidance - Developed and established a program that led to 20% reduction in patient ER usage
Emergency Room Utilization Reduction in Cost - Developed and established a program that iver the course of 1 year was able to reduce ER utilization cost by 9% from previous year.
Controlling Blood Pressure - Collaborated with Plan Partner to develop a program that reached HPL for 2 lines of business
Languages
English
Native or Bilingual
Spanish
Native or Bilingual
Timeline
Director of Quality Improvement
LaSalle Medical Associates
01.2020 - Current
Provider Engagement Quality Manager
LaSalle Medical Associates
01.2018 - 01.2020
Quality Improvement Care Navigator Manager
SynerMed/Inland Valleys IPA
01.2016 - 01.2018
Regional Care Navigator Lead
Synermed
01.2014 - 01.2016
Quality Care Navigator
SynerMed
01.2012 - 01.2014
Licensed Vocational Nursing - Nursing
Pacific College
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