Healthcare leader with 20 years of experience in driving strategic initiatives and enhancing regulatory frameworks. Proven expertise in quality improvement and stakeholder engagement, successfully leading teams to achieve HITRUST certification and optimize compliance processes. Background includes healthcare operations, patient care, government regulations, and technical team planning, contributing to organizational resilience and excellence in patient care.
Hi, I’m
Jessica Nance
Trout Creek,MI
Summary
Overview
20
years of professional experience
1
Certification
Work History
Liveops, Inc., United States
Director, Healthcare Compliance
04.2024 - Current
Job overview
- Oversee and continuously improve the healthcare compliance delivery model, functioning as an independent and objective body that reviews and evaluates healthcare compliance and regulatory issues and concerns.
- Playing a pivotal role in developing and executing strategic plans that align with organizational goals and drive long-term success as part of the Strategic Planning & Enablement team; enabling teams by providing the necessary tools, resources, and support to achieve strategic objectives and enhance overall performance.
- Analyze processes, enact change, and think strategically to achieve business goals.
- Continuously assesses our compliance delivery model and build protocols and processes to continue adapt to evolving regulatory changes.
- Partners with BI experts and healthcare teams to create advance analytics.
- As a key team member, I contributed to our organization's successful attainment of HITRUST certification.
- Key stakeholder in the team leading the SOC 2 Type 2 audit and HITRUST R2 Certification, ensuring our compliance with industry standards.
- Additionally, I am part of the stakeholder group responsible for our business continuity planning (BCP), coordinating our Governance, Risk, & Compliance Team efforts, all while enhancing our organization's resilience and preparedness.
- Resident Healthcare SME across the healthcare verticals.
- Support sales & marketing with potential RFP's/RFI's, marketing blogs & case studies, and current client annual questionnaire's, surveys, and required attestations.
Verana Health
Senior Manager, Practice Experience
11.2021 - 04.2024
Job overview
- Manage and build meaningful relationships with Academic Medical Centers, large practices, and Medical Groups to deliver meaningful data to help practices transform quality initiatives.
- Specializing in Epic and Cerner practices across IRIS and Axon Registries.
- Support the practices use of quality dashboards to help practices enhance quality of patient care by benchmarking quality measure performance and identifying specific and actionable opportunities for improvement.
- Successfully led troubleshooting team to decrease data operation ticket count by 50% within 30 days of taking over project management of team.
- Work directly with mapping, curation, and QS teams to improve quality measure accuracy for more meaningful and powerful provider data.
KSB HospitalDixon, Illinois
Quality Improvement & Regulatory Manager
06.2019 - 04.2023
Job overview
- Led all teams associated with inpatient and outpatient regulatory and quality programs. Including IQR, OQR, MIPS, IPFQR, Promoting Interoperability, and more.
- Successfully led the hospital through CMS audit for Inpatient Quality Reporting while avoiding all penalties.
- Provided education to teams participating in MIPS and led to year over year quality improvement; ending in perfect MIPS scores upon my full time departure.
- Consulted for the hospital starting in 2021 and guided them through regulatory programs through April 2023.
KSB HospitalDixon, Illinois
Meaningful Use & MACRA Coordinator/Quality Specialist
03.2017 - 06.2019
Job overview
- QPP, MACRA, MIPS, & Promoting Interoperability Program expert for ambulatory and hospital services.
- I gather, analyze, and interpret data from multiple sources for the hospital and clinic systems.
- I strive to use meaningful data to create and implement protocols that decrease complications and patient safety issues in hospital and clinic departments.
- Physician and staff engagement is something necessary for these improvements.
- I thoroughly investigate complications, occurrence data, and patient safety data to improve patient outcomes.
- Currently, I sit on the Emergency Preparedness Committee, Application Systems Committee, Complication/PSI Team, Outpatient Performance Improvement Council, Ambulatory Medication Reconciliation Committee, Rewards & Recognition Committee, and Patient Portal Team.
KSB HospitalDixon, Illinois
Office LPN - Float
05.2015 - 04.2017
Job overview
- Assist in PQRS physician chart review in ambulatory and emergency sectors
- Triage all patient phone calls related to urgent needs, medical questions, and facilitating communication between patient and providers
- Maintain strict confidentiality
- Prior insurance authorizations and verification as needed for procedures or medications.
- Assisted with patient admissions, discharges, and transfers efficiently.
- Administered medications and treatments according to established protocols.
- Educated patients and families on health management and care plans.
- Collaborated with nurses and doctors to ensure comprehensive patient care.
- Trained new staff on hospital policies and patient care procedures.
- Efficient use of EHR
- Facilitate direct admissions to the hospital when needed.
Lincare Holdings, IncRock Falls, Illinois
Healthcare Specialist, LPN, Area Trainer
05.2008 - 05.2015
Job overview
- Train all new Healthcare Specialist staff in Illinois & Iowa territories.
- Create training materials and reference materials for all new Healthcare Specialist's.
- Contact insurance companies for initial insurance verification for all and any DME equipment.
- Obtain prior authorizations when necessary & provide documentation for denials and appeals: was able to decrease denial rate down to 12.5% with overall held sales for my responsible areas of just 3-4%.
- Run and work an aging report as needed to keep authorizations current for DME and respiratory services for patients in the home.
- Contact patients and discuss financial responsibility, collections, and help with completion of financial hardship forms where applicable.
- Respiratory Assessment with screening Oximetry. Report results to physicians and medical staff.
- Education on disease process, prescribed therapies and equipment management, follow-up reporting, talk directly to physicians and their nursing staff to help care for patients in highest quality possible to improve their quality of life.
- Set up all CPAP and Bi-level equipment, set up an array of durable medical equipment including wheelchairs, walkers, oxygen, nebulizers, suction machines, etc.
- Provide pulmonary education and asthma intervention and management to patients.
- Help to maximize compliance through careful instruction and follow-up monitoring related to CPAP and Bi-level therapy.
- In-home instruction and set-up for the patient and care person related to enteral services, provide staff in-services on new equipment and news with different disease processes and updates to clinical core manual updates as well as safety policies.
- Ordering stock for office including medical equipment, paperwork, & general item.
- Manage the NHV (non-invasive home ventilation unit) program.
- Improve CPAP and BIPAP compliance rates from 65-67% to 95-96% through continued education.
- Consistently capture additional services and help grow office sales by 42-45%.
Gaffey Home Nursing & HospiceSterling, Illinois
CNA
06.2005 - 12.2008
Job overview
- Provided compassionate personal care to patients in home and hospice settings.
- Assisted patients with daily living activities, ensuring comfort and dignity.
- Monitored vital signs and reported changes to nursing staff promptly.
- Maintained clean and safe environments for patients, adhering to health standards.
- Supported families in understanding care plans and emotional needs of patients.
- Collaborated with healthcare teams to coordinate patient care and services effectively.
- Trained new staff on proper caregiving techniques and organizational policies efficiently.
Education
Capella UniversityRemote
MBA from Health/Health Care Administration/Management
12.2019
University Overview
Purdue University GlobalRemote
BS from Health/Health Care Administration/Management
12.2017
University Overview
Sauk Valley Community College
Associate's degree from Liberal Arts and Sciences/Liberal Studies, Nursing
12.2006
University Overview
Skills
- Quality improvement
- Healthcare strategy
- Stakeholder engagement
- Team leadership
- Effective communication
- Project management
- Change management
- Regulatory compliance
- Business continuity
- Process improvement & optimization
Certification
- Certified Professional in Healthcare Quality
- Lean Six Sigma Green Belt
Languages
Languages
English, Full Professional
Personal Information
Personal Information
Title: Director of Healthcare Compliance
Languages
English
Professional
References
References
References available upon request.Timeline
Director, Healthcare Compliance
Liveops, Inc.
04.2024 - Current
Senior Manager, Practice Experience
Verana Health
11.2021 - 04.2024
Quality Improvement & Regulatory Manager
KSB Hospital
06.2019 - 04.2023
Meaningful Use & MACRA Coordinator/Quality Specialist
KSB Hospital
03.2017 - 06.2019
Office LPN - Float
KSB Hospital
05.2015 - 04.2017
Healthcare Specialist, LPN, Area Trainer
Lincare Holdings, Inc
05.2008 - 05.2015
CNA
Gaffey Home Nursing & Hospice
06.2005 - 12.2008
Capella University
MBA from Health/Health Care Administration/Management
Purdue University Global
BS from Health/Health Care Administration/Management
Sauk Valley Community College
Associate's degree from Liberal Arts and Sciences/Liberal Studies, Nursing
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