Jennifer K Carney, RN
Staunton,VA
Summary
Organized and motivated Quality Improvement Specialist RN with extensive experience in a managed care setting, including Utilization/Case Management, regulatory accreditation, and leadership. Proficient with program, policy, and procedure development. Able to manage heavy workload in a remote environment utilizing time management strategies. Experienced with implementation of NCQA standards, processes, clinical documentation, audit preparation and case file presentations.
Overview
20
20
years of professional experience
Work History
RN Care Management Quality Improvement Specialist
Paramount Healthcare
Toledo, OH
10.2019 - Current
- Served as the subject matter expert related to best practices and regulatory requirements.
- Provided training materials to staff members on regulatory guidelines and procedures.
- Analyzed data collected during audits to identify areas needing improvement and provided recommendations for corrective action plans.
- Submitted documentation to regulatory agencies.
- Organized and facilitated procedure reviews with department heads.
- Provided support during audits by compiling requested documents and answering questions regarding procedure compliance.
- Identified and implemented quality initiatives for performance improvement.
- Performed ad hoc analyses as needed by management to inform decision making.
- Worked closely with IT teams to design systems capable of accurately capturing desired metrics information.
- Proficient with program, policy and procedure development, as well as audit preparation, to ensure NCQA and Ohio Department of Medicaid compliance.
- Succeeded in exclusively remote work environment
Clinical Coordinator/Case Manager/ClinicalCharge Nurse
Ohio Health Riverside Hospital
Columbus, OH
08.2010 - 10.2019
- Facilitated communication between patients, family members, physicians, other healthcare providers, insurance companies.
- Collaborated with multi-disciplinary staff to improve overall patient care and response times.
- Assessed staffing needs on an ongoing basis to ensure adequate coverage of clinical services.
- Conducted patient assessments to evaluate needs and develop individualized plans of care.
- Coordinated with nurse manager to develop programs targeting nurse education, overall departmental competencies, individual performance, patient safety and service-related issues.
- Coordinated patient referrals to appropriate medical facilities and practitioners.
- Communicated with patients with compassion while keeping medical information private.
- Counseled clients on available resources within the community that could help meet their needs.
- Participated in regular team meetings and in-house training sessions to boost group effectiveness.
Education
Associate of Science - Nursing
Columbus State Community College
Columbus, OHBachelor of Arts - Psychology
Ohio University
Athens, OHSkills
- Quality Improvement
- Strategic Planning
- Staff Education and Training
- Electronic Health Records Management
- Data Collection
- Case Management
- NCQA Regulatory Compliance
- Process Evaluations
- Internal Auditing
- Policy and Program Development
- Excel, PowerPoint, Adobe Pro & Teams
- Motivational Leadership
- Workflow Planning
- Remote work
Timeline
RN Care Management Quality Improvement Specialist
Paramount Healthcare
10.2019 - Current
Clinical Coordinator/Case Manager/ClinicalCharge Nurse
Ohio Health Riverside Hospital
08.2010 - 10.2019
Associate of Science - Nursing
Columbus State Community College
Bachelor of Arts - Psychology
Ohio University