Jessica Bly
Soddy,TN
Summary
Forward-thinking Assistant Director generates high-quality work. Leverages tenacious approach and strong attention to detail to drive success. Service-oriented and performance-driven with excellent organizational, multitasking and problem-solving skills.
Overview
10
10
years of professional experience
Work History
Associate Director of Quality Operations
Better Health Group
07.2023 - Current
- Spearheaded quality operations for Better Health Group, ensuring adherence to industry standards and regulatory requirements
- Developed and implemented comprehensive quality improvement initiatives, resulting in enhanced overall performance metrics
- Increased Medicaid STAR Scores by 1-point YOY for the past 2 years
- Collaborate with cross-functional teams to streamline processes and optimize quality assurance procedures
- Oversee the management and execution of quality programs, including HEDIS, GPRO, and Value Based Agreements fostering a culture of continuous improvement
- Established and maintained effective communication channels with providers and stakeholders to ensure alignment with quality goals
- Utilized Health Plan portals for Medicaid, CMS, and Medicaid Advantage demonstrating a deep understanding of program requirements and compliance.
Manager of Medicaid Quality Operations
Better Health Group
11.2020 - 07.2023
- Provided operational guidance for Provider consultants, AHCA, HEDIS, and NCQA at Health First Network, Inc
- Successfully implemented Ansafone vendor for IVR call campaigns
- Initiated the development of call campaigns and served as a Quality Analyst (Excel)
- Utilized Health Plan portals for Quality Programs for Medicaid
- Administered Chronic Conditions for Continuity of Care Agendas
- Implemented and created a company Dashboard with weighted scores by attributed lives
- Demonstrated expertise in IPA knowledge
- Maintained effective communication with Affiliate/Owned clinics.
Regional Quality Manager
Community Health Systems 2
11.2018 - 11.2020
- Directed 10 markets across various states, overseeing Medicare (ACO)/Medicare Advantage/BCBS Commercial/UHC/Humana Medicaid/Sunshine Medicaid
- Established Order Sets for Chronic Conditions per diagnosis
- Assisted with ACO standards and measure submissions, MIPPS training, and NCQA Certifications
- Implemented call campaigns and acted as an Athena Analyst
- Conducted HEDIS Expertise and auditing of charts
- Provided training for Quality Managers and attended Regional ACO meetings.
Hospital Administration Market Athena Analyst/Quality Coordinator
Gadsden Regional Medical Center, Community Health Systems
08.2014 - 11.2018
- Served as an Analyst for the Athena EMR System
- Supported Healthgrid Communicator, Online Scheduling, and Clinic NCQA Certifications
- Managed SNOW tickets and Greenway EMR System
- Conducted MIPPS training and acted as a Medicare Wellness Expert
- Generated reports on referrals to Hospital Administration
- Developed EBITDA plans with Operations
- Acted as a Back-up Biller/Coder and Quality Measures Champion
- Demonstrated proficiency in using Ingenious Med Admin, HEDIS, and STARS Training with various healthcare providers
- Contributed to the Transition of Care Champion role and conducted training for Medical Assistants on Athena
- Supported 11 Off-Site Clinics, performing Wellness Exams in a clinic setting
- Executed plans and initiatives for continuous improvement.
Education
BAS ORGANIZATIONAL MANAGEMENT -
SANTA FE COLLEGE
03.2024
AA ASSOCIATE IN ARTS, HEALTH SERVICES ADMINISTRATION -
SANTA FE COLLEGE
12.2023
GOOGLE DATA ANALYTICS CERTIFICATION -
MARCH 2023
Skills
- Leader of the Year Award 2019
- Technical implementation
- Project Management
- Strategic leadership
- Systems Development
- Work Planning and Prioritization
- Professional Networking
- Performance Evaluations
- Team Collaboration and Leadership
- Coaching and Mentoring
- Onboarding and training
- Organizational Development
- Operations Management
Websites
Timeline
Associate Director of Quality Operations
Better Health Group
07.2023 - Current
Manager of Medicaid Quality Operations
Better Health Group
11.2020 - 07.2023
Regional Quality Manager
Community Health Systems 2
11.2018 - 11.2020
Hospital Administration Market Athena Analyst/Quality Coordinator
Gadsden Regional Medical Center, Community Health Systems
08.2014 - 11.2018
BAS ORGANIZATIONAL MANAGEMENT -
SANTA FE COLLEGE
AA ASSOCIATE IN ARTS, HEALTH SERVICES ADMINISTRATION -
SANTA FE COLLEGE
GOOGLE DATA ANALYTICS CERTIFICATION -
MARCH 2023