George Carty
Quality Assurance Specialist
Jacksonville
Summary
Results-oriented Quality Assurance Specialist with extensive experience in healthcare operations and clinical quality improvement. Expertise in clinical auditing, medical record abstraction, and managing projects to enhance HEDIS performance and ensure NCQA compliance. Proficient in implementing PDSA cycles and conducting advanced data analysis to address gaps and drive operational success.
Overview
9
9
years of professional experience
Work History
Quality Assurance Specialist
FIRSTSOURCE HEALTHPLANS & HEALTHCARE
04.2021 - 11.2025
- Analyzed HEDIS-adjacent clinical data using advanced Excel tools, identifying trends and performance gaps that informed targeted quality improvements and enhanced care metrics.
- Directed clinical over-read and coaching sessions for associates to improve quality audit accuracy and ensure adherence to HEDIS Hybrid Operations protocols.
- Conducted rigorous medical record abstraction and quality audits to identify non-compliant records, ensuring clinical accuracy across high-volume review cycles.
- Conducted medical record abstraction and quality audits to identify non-compliant records, ensuring clinical accuracy during high-volume review cycles.
- Analyzed HEDIS-adjacent clinical data with advanced Excel tools, identifying trends and performance gaps that led to targeted quality improvements and increased care metrics.
Quality Assurance Specialist
BROADPATH HEALTHCARE SOLUTIONS
11.2016 - 02.2021
- Orchestrated support and clinical over-read for under-performing agents, enhancing accuracy in medical record abstraction.
- Analyzed service delivery performance metrics and tracked SLAs to ensure alignment with contractual quality indicators and HEDIS reporting requirements.
- Managed quality assessment databases to maintain clinical integrity and support large-scale HEDIS data trending and reporting.
- Managed quality assessment databases to ensure clinical integrity and facilitate HEDIS data trending and reporting.
- Leveraged Microsoft Office Suite and Visio to streamline documentation for HEDIS Hybrid Operations and improve the precision of quality audits.
- Utilized Microsoft Office Suite and Visio to streamline documentation for HEDIS Hybrid Operations, enhancing precision of quality audits.
- Orchestrated individual support and clinical over-read for under-performing agents to boost accuracy in medical record abstraction processes.
Education
Bachelor of Arts - Accounting
UNIVERSITY OF PHOENIX
JACKSONVILLE, FLHigh School Diploma -
CHARLOTTE AMALIE HIGH SCHOOL
St. Thomas U.S.V.I.Skills
- Quality Control
- Quality control
Clinical compliance
Quality Project Oversight
Continuous Quality Enhancement
Performance improvement
Data analysis
Cross-functional Collaboration
Timeline
Quality Assurance Specialist
FIRSTSOURCE HEALTHPLANS & HEALTHCARE
04.2021 - 11.2025
Quality Assurance Specialist
BROADPATH HEALTHCARE SOLUTIONS
11.2016 - 02.2021
Bachelor of Arts - Accounting
UNIVERSITY OF PHOENIX
High School Diploma -
CHARLOTTE AMALIE HIGH SCHOOL