Katie Nease
Las Vegas,NV
Summary
Highly trained Registered Nurse with extensive clinical abilities and in-depth knowledge of Medicaid Managed Care. Demonstrating compassion towards the needs, cultural beliefs, and barriers within the community, dedicated to nurturing positive health outcomes and enhancing the quality of care and population health. With a robust background in directing and managing large-scale operations, consistently drives success through strategic planning and execution. Adept at implementing innovative solutions to enhance productivity and operational effectiveness. Known for fostering teamwork and adapting to evolving business needs, ensuring alignment with organizational goals.
Overview
12
12
years of professional experience
Work History
Director of Clinical Quality
Health Plan of Nevada Medicaid
02.2024 - Current
- Regulatory Compliance and Collaboration: Successfully collaborated with Nevada state regulators for the past seven years, ensuring compliance with all state healthcare regulations and standards
- Medicaid Contract Procurement: Experience with two procurement of Medicaid contracts through meticulous planning, strategic writing, and innovative strategy meetings, securing essential funding and resources
- Committee Leadership: Chaired and led provider advisory board, Quality improvement Committee and external patient advisory councils, driving initiatives to enhance healthcare delivery and patient outcomes
- Quality Improvement Health Plan Activities: Directed health plan strategies, continuous quality improvement efforts related to performance improvement projects, pay-for-performance quality measures, and bonus incentive programs aimed at improving population health within the Quadruple Aim framework
- Stakeholder Engagement: Built and maintained strong relationships with stakeholders across the state, including providers, community-based partners, and hospitals, to improve access to care, drive efficiencies in spending, and enhance patient satisfaction
- Regulatory and Audit Experience: Managed regulatory compliance and worked closely with external quality review organizations and auditors to ensure adherence to healthcare standards and practices
- Maternal Health and EPSDT Oversight: Oversaw strategies for maternal health and Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) programs, ensuring comprehensive care for vulnerable populations
- Advanced Payment Models: Supervised all advanced payment models within the LAN 2 framework, focusing on upside-only benefits to improve the quality of care and increase provider satisfaction
- NCQA HEDIS Experience: Responsible for Medical record chart collection, monitoring leading and lagging indicators, utilizing cause and effect tools to identify barriers, and employing Plan-Do-Study-Act (PDSA) methodology to drive improvements in healthcare quality
- Developed high-performing teams by providing mentorship, guidance, and opportunities for professional growth.
- Enhanced team collaboration through regular communication, goal setting, and performance evaluations.
Associate Director of Clinical Quality
Health Plan of Nevada Medicaid
03.2021 - 02.2024
- Oversee and develop strategies, programs and initiatives for the maternal child health population
- Experience with validated performance improvement projects to increase access to prenatal care; receiving high confidence rating and statistically significant provider performance improvement
- Leading implementation of new advanced payment models to improve health equity and birth outcomes
- Led teams of up to seven personnel, supervising daily performance as well as training and improvement plans.
- Fostered a culture of continuous improvement by encouraging staff to share innovative ideas and providing resources for professional development.
Manager Clinical Quality
Health Plan of Nevada Medicaid
09.2019 - 03.2021
- Experience leading professional registered nurses in both Northern and Southern Nevada
- Responsible for setting team direction to address business needs and influence gap in care closure for HEDIS benchmarks
- Clinical champion for implementation of maternal child projects such as: Doula Program, OB SBIRT, Stillbirth Prevention Campaign, COVID-19 pediatric provider toolkit, back to school health fairs and vaccine hesitancy trainings
- Managed and motivated employees to be productive and engaged in work.
- Accomplished multiple tasks within established timeframes.
Obstetrical Clinical Practice Consultant
Health Plan of Nevada Medicaid
06.2017 - 09.2019
- Built the first obstetrical clinical practice consultant program in Nevada and laid the foundation for a national role to mirror the success in closing gaps in care
- Responsible for building relationships with 20 OBGYN provider groups in Southern Nevada
- Developed performance benchmarks and tools to close gaps in care for both postpartum and prenatal care, which over three years lead to both metrics increasing by 33% and 22% respectively, evidenced by the plan's HEDIS performance
- Designed, monitored and educated providers on incentive payment models to close gaps in care
- Managed multiple projects simultaneously, prioritizing tasks effectively to meet deadlines and exceed expectations.
- Collaborated with cross-functional teams to deliver high-quality solutions, ensuring consistent alignment with project goals.
High Risk OB Case Manager
Health Plan of Nevada
12.2014 - 06.2017
- Perform telephonic assessments to understand cultural beliefs, linguistic needs, conditions, past medical history, obstetrical history, mental health, psychosocial and social determinant of health needs or barriers to be incorporated into individualized care plan to improve health outcomes
- Maintain NCQA accreditation case records and documentation
- Provided health education and health literature to reinforce teachings and support members
- Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
- Conducted thorough assessments of clients'' situations, identifying issues, goals, and necessary interventions.
Level III Neonatal Intensive Care Registered Nurse
Sunrise Children's Hospital
03.2013 - 12.2014
- Training and education regarding assessment and treatment of extremely low birth weight and premature infants and all medically fragile neonates requiring NICU admission
- Collaboration with medical team, case management and families to set goals for care plan and safe discharge plan to home
- Educating families on growth and development topics such as kangaroo care, breastfeeding, newborn care and infant CPR
Education
Bachelor of science of Nursing -
Roseman University of Health Sciences
Henderson, NV12.2012
Bachelor of Science - Molecular/Microbiology
University of Central Florida
Orlando, FL12.2002
Skills
- Nursing
- Strategic Leadership
- Managed Care Expertise
- Perinatal Mental Health Support
- Lactation Support
- Case Management
- Relationship building
- Strategic planning
- Verbal and written communication
- Decision-making
Activities
- Passionate about helping the most vulnerable populations from early NICU experience to high risk OB case management and focusing on Medicaid racial and ethnic disparities that impact maternal and infant outcomes.
- Nevada MCH steering Committee member since 2015 participating in the review of Title V grant goals and Healthy People 2030 benchmarks to align health plan initiatives.
- Participated in events including Black Maternal Health Week, Human Milk Donor Drive, and Climb Out of the Darkness; collaborations with community-based organizations including Nevada Urban League, Nurse Family Partnership, SN MCH, Vegas Family Doulas and Heart and Sol Collective.
2024 Sage of Clinical Service Award
Nominated for my leadership with the maternal child programs, community engagement and strategic partnerships advocating for vulnerable populations high quality of care, health care policy while supporting a positive work environment and promoting professional growth.
2023 Nevada Business Magazine -Healthcare Heroes Award
Awarded the nursing award for the development of the first Doula program at Health Plan of Nevada. The goal was to build new innovative solutions to reduce disparities and improve birth outcomes for the community.
2016 Future of Nursing 40 under 40
Awarded for health care policy advocacy and innovation surrounding reducing premature cesarean sections.
Timeline
Director of Clinical Quality
Health Plan of Nevada Medicaid
02.2024 - Current
Associate Director of Clinical Quality
Health Plan of Nevada Medicaid
03.2021 - 02.2024
Manager Clinical Quality
Health Plan of Nevada Medicaid
09.2019 - 03.2021
Obstetrical Clinical Practice Consultant
Health Plan of Nevada Medicaid
06.2017 - 09.2019
High Risk OB Case Manager
Health Plan of Nevada
12.2014 - 06.2017
Level III Neonatal Intensive Care Registered Nurse
Sunrise Children's Hospital
03.2013 - 12.2014
Bachelor of science of Nursing -
Roseman University of Health Sciences
Bachelor of Science - Molecular/Microbiology
University of Central Florida
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