Heather Karovic
Follansbee,WV
Summary
Dedicated nursing professional with extensive experience in regulatory compliance, risk management, and policy development, complemented by a strong background in quality improvement, operations and supervisory roles. Proven ability to foster team collaboration and drive continuous process enhancements across multiple locations. Adept at navigating metrics, value-based payment models, population health strategies, and ACO initiatives to optimize patient care and operational efficiency.
Overview
33
33
years of professional experience
Work History
Director of Compliance and Risk
CHANGE, Inc.
Weirton, WV
05.2022 - Current
- Lead compliance audits to ensure adherence to regulatory standards and internal policies.
- Developed and implemented risk management strategies to mitigate potential compliance violations.
- Collaborate with cross-functional teams to integrate compliance requirements into operational processes and to implement risk management strategies.
- Prepare and present comprehensive reports to upper management and audit team, covering issues and recommendations.
- Evaluate organizational policies, enhancing overall governance and risk mitigation efforts.
- Streamline reporting processes, ensuring accurate documentation of risk assessments and responses.
- Skilled at working independently and collaboratively in a team environment.
- Demonstrates strong organizational and time management skills while managing multiple projects.
DIRECTOR OF CLINICAL SERVICES
Change, Inc. (FQHC)
Weirton, WV
09.2015 - 11.2021
- Delivered team leadership and development of quality reports and maintained engaged and productive quality improvement program
- Direct day-to-day clinical oversight of health center staff at 10 locations serving 15,000 patients annually
- Direct day-to-day clinical oversight of multiple specialties within health center, including, Dental, Vision, Women's Health, Behavioral Health, Substance Abuse, Pediatrics, Family Practice and Medical Records
- Managed patient complaints, incidents and adverse events
- Interviewing, hiring and firing of staff
- Maintained integrity of medical records and other administrative and operational data.
- Managed entire application processes for health center certifications with National Committee for Quality Assurance (NCQA) Patient-Centered Medical Home (PCMH).
- Managed agency's compliance with CMS driven quality efforts such as Merit-based Incentive Payment System (MIPS) and Meaningful Use (MU)
- Assessed government driven metrics and adjusted operational plans to uphold quality standards.
- Defined protocols, quality assurance initiatives and clinic policies and procedures.
- Assisted in development of the credentialing and training of clinical staff
- Prepared for, and regular held, care team and quality care meetings
- Efficient in data mining, data mapping and data driven performance
QUALITY CARE MANAGER
Change, Inc. (FQHC)
Weirton, WV
09.2010 - 11.2021
- Developed and maintained overall Quality Improvement program
- Worked with administration to define quality metrics and outcome reporting processes
- Developed and maintained Peer Review processes
- Developed and maintained Chart Review processes
- Developed and maintained Targeted Chart Review processes
- Handled internal review of malpractice claims
- Conducted 340b compliance status reviews
- Developed Care Teams and monitored their overall performance as it related to quality metrics, care gap closure and coordination of care
- Worked with insurers on care gap lists and goals for annual quality compliance
- NCQA Patient Centered Medical Home Accreditation
- Government reporting compliance
REGISTERED NURSE CLINICAL LIAISON
Valley Hospice
Rayland, OH
04.2007 - 09.2010
- Part of Access Team at Valley Hospice
- Conducted Consults with Patient and/or Families to explain palliative care options available to them in times of terminal illness
- Performed inpatient hospice admissions either in hospice unit, local hospital unit or nursing homes
- When not conducting above, educating community members and attending community events share levels of care hospice can offer
- Calling on physician offices as part of hospice liaison marketing effort
REGISTERED NURSE -CLINICAL MANAGER PRIMARY CARE
James Vodvarka, DO
Steubenville, OH
07.1998 - 03.2007
- Implemented successful healthcare program through professionalism, quality of care, medical teaching and patient satisfaction.
- Communicated with patients, ensuring that medical information was kept private.
- Communicating with patients regarding normal and abnormal test results and sharing doctor 's direction for their care
- Defined testing protocols, quality assurance initiatives and clinic policies and procedures.
- Roomed patients, vitals, medical histories, medication lists, injections and all manner of in-office CLIA-Waived testing
- Assisted with in-office procedures
- All manners of referral process and prior authorizations
- Workers Compensation
- In-office site audits/visits from insurers
REGISTERED NURSE-TELEMETRY
Weirton Medical Center
Weirton, WV
01.1998 - 07.1998
- Administered medications via oral, IV and intramuscular injections and monitored responses.
- Managed care from admission to discharge.
- Provided direct patient care, stabilized patients and determined next course of action.
- Telemetry
- Implemented medication and IV administration, catheter insertion and airway management
- Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process and management and lifestyle options
REGISTERED NURSE- CRITICAL CARE
Ohio Valley Hospital
Steubenville, OH
01.1993 - 01.1998
- Administered medications to treat patients' symptoms and address underlying disease progression.
- Administered medications via oral, IV and intramuscular injections and monitored responses.
- Provided direct patient care, stabilized patients and determined next course of action.
- Operated critical care equipment to keep patients stable and promote recovery.
Education
Nursing Diploma - Associated College Credits
Ohio Valley Hospital School of Nursing
Steubenville12.1992
Bachelor of Science - Nursing
University of Cincinnati
Cincinnati, OH12-2024
Skills
- Risk management and mitigation
- Data-driven quality improvement
- Strategic goal formulation
- Cross-functional collaboration
- Regulatory compliance oversight
- Analytical investigation skills
- Accreditation management
- Team management oversight
- Project management coordination
Timeline
Director of Compliance and Risk
CHANGE, Inc.
05.2022 - Current
DIRECTOR OF CLINICAL SERVICES
Change, Inc. (FQHC)
09.2015 - 11.2021
QUALITY CARE MANAGER
Change, Inc. (FQHC)
09.2010 - 11.2021
REGISTERED NURSE CLINICAL LIAISON
Valley Hospice
04.2007 - 09.2010
REGISTERED NURSE -CLINICAL MANAGER PRIMARY CARE
James Vodvarka, DO
07.1998 - 03.2007
REGISTERED NURSE-TELEMETRY
Weirton Medical Center
01.1998 - 07.1998
REGISTERED NURSE- CRITICAL CARE
Ohio Valley Hospital
01.1993 - 01.1998
Nursing Diploma - Associated College Credits
Ohio Valley Hospital School of Nursing
Bachelor of Science - Nursing
University of Cincinnati