Heather Long
Nurse
Danville,KY
Summary
Experienced HEDIS nurse with 20+ years of management experience.
Overview
22
22
years of professional experience
Work History
HEDIS Abstractor (Seasonal)
Outcomes
06.2012 - 09.2014
Office Manager (LPN)
Gentiva Home Health
06.2012 - 09.2014
Unit Manager
Stanford Crossing
Stanford, KY
05.2025 - Current
- Assisted in development and implementation of policies, procedures, and regulations for unit operations.
- Handled complaints from patients and families and immediately took steps for quick resolution and to prevent reoccurrence.
- Promoted patient independence by establishing patient care goals and taught and counseled patients, friends and family about medications and self-care skills.
- Met with nursing staff and support personnel to plan services, programs and activities.
- Maintained adequate stock of medications, supplies and equipment to meet patient needs.
- Oversaw RNs, LPNs, nursing aides, medical clerks and support staff and performed staffing scheduling duties.
- Coordinated nursing with other services to promote continuity of total regimen of care.
- Established and maintained effective communication with staff, physicians and community organizations to promote high quality patient care.
Clinical Quality Manager
Optum Healthcare
06.2023 - 08.2025
- Prepared training material for the HEDIS Season
- Led the training team on Change healthcare University.
- Trained Optum staff on CAO (Clinical Auditing Portal) tool.
- Developed and implementing improvements for the CAO tool.
- Ran reports such as doc size, IRR score, M/X/I score.
- Tracked and trended for improving the quality scores.
- Sent emails out for abstractors that needed coaching and had 1:1 calls to improve quality.
- Alignment of team calls weekly.
- Convenience audits
- Medical Record Review Validation (MRRV) Audits
- Helped with Integrated In-Home and In- Office Assessment Program (IOA) training material.
- Completed IOA training email blasts to help improve quality.
PRN Nurse
Stanford Rehab Facility
03.2023 - 02.2024
- Staff Nurse
HEDIS Manager
Change Healthcare
01.2015 - 06.2023
- Prepared training material for the HEDIS Season
- Developed and implementing improvements for the CAO tool.
- Client engagement/Service Request tickets
- Managed on the average thirty -60 abstractors during HEDIS.
- Ran reports such as doc size, IRR score, M/X/I score.
- Kept up with trends for improving the quality scores.
- Sent emails out for abstractors that needed coaching and had 1:1 calls to improve quality.
- Had weekly calls with QA to go over any issues found.
- Performed Convenience audits.
- Performed MMRV Audits
Coder
Outcomes
09.2014 - 01.2015
- Coding charts
- HEDIS Abstractor/HEDIS Trainer
Document Processing Manager
Outcomes
01.2004 - 06.2010
Education
Coding courses
American Academy of Professional Coders (AAPC)
12.2014
Licensed Practical Nurse -
Bluegrass Community and Technical College
05.2012
Skills
- Licensed Practical Nurse
- Certified Coder
- HEDIS Hybrid Abstraction
- Goal Oriented
- HEDIS Hybrid Oversight
- Effective communication
- Leadership Skills
- Excel
- Management
- Microsoft Word
Timeline
Unit Manager
Stanford Crossing
05.2025 - Current
Clinical Quality Manager
Optum Healthcare
06.2023 - 08.2025
PRN Nurse
Stanford Rehab Facility
03.2023 - 02.2024
HEDIS Manager
Change Healthcare
01.2015 - 06.2023
Coder
Outcomes
09.2014 - 01.2015
HEDIS Abstractor (Seasonal)
Outcomes
06.2012 - 09.2014
Office Manager (LPN)
Gentiva Home Health
06.2012 - 09.2014
Document Processing Manager
Outcomes
01.2004 - 06.2010
Coding courses
American Academy of Professional Coders (AAPC)
Licensed Practical Nurse -
Bluegrass Community and Technical College