Kendrea Derrick, MHA

• Lead operations and procedures to optimize operational efficiency while managing a budget of $500,000+
• Population health strategy, lead and monitor quality, HEDIS,STARS performance for site location
• overseeing employee/ patient retention, NPS scores and patient experience
• medicare, managed care and value based program knowledge.

• Directing a multi-disciplinary team of 30+ employees, leading the execution of in-clinic operational initiatives and clinical performance.
• Create and implement policies and process improvement procedures for effective practice management.
• Strategically monitor and oversee quality, inpatient/ER admissions, patient experience and outcomes.
• Monitor value based programs to improve patient outcomes
• Staff Management - responsible for staff recruiting, retention, coaching, mentoring and terminations.

• Develop and lead site level service strategy operation plans to maximize expense reductions.
• Develop process improvement plans for 38 hospitals across the Southwest and West region.
• Providing local/regional strategies, technical training opportunities, negotiated supplier entitlements, and staffing projections to drive financial and operational efficiency.
• Support implementation of new hospital and health facility sites and Reconcile hospital site contracts during hospital reversals.

• Analyze medical claims to ensure claims are properly dispersed and paid.
• Analyze coordination of benefits, prior authorizations and claims adjudication details.
• Analyze insurance plan contract information including summary plan documents, summary of benefit coverage, recoupment, bulk payments and other claims data.

• Compile and review client specific health plan utilization data, trends using risk stratification and predictive modeling software
• Project manage on-boarding of clients. Oversee processes entailing time sensitive information through detailed analysis of Master data, medical claims,Rx claims data, stop loss and reinsurance contracts
• Training staff and developing new department processes surrounding population health data analytics.
• extracting and Importing data into reports for clients

• Directing practice operations of two medical office locations.
• Staff management
• Manage accounts receivable, accounts payable accounts and insurance claim verification.
  

Oversee reports, correspondence, HIV program and other development-related needs.

• Support QA/QI department management to ensure compliance regulations.
• abstracting data,creating reports comparing performance to HEDIS standards as well as other NCQA measures.
• Oversee HIV testing and education program