Kimberly Mosby
North Las Vegas,NV
Summary
Results-driven healthcare leader offering 24 years of clinical, administrative, and patient care experience. Gifted in building and implementing approaches to increase quality and streamline procedures. Significant leadership background directing multidisciplinary healthcare teams to achieve care objectives and outperform business targets.
Overview
16
16
years of professional experience
Work History
Clinical Operations Manager II
Southwest Medical Part Of Optum
08.2011 - Current
- Maximized performance by monitoring daily activities and mentoring 40 team members for 6 locations
- Monitored and analyzed business performance to identify areas of improvement and make necessary adjustments
- Recruited trained, and mentored new employees, fostering their professional development
- Conducted performance evaluations for staff members, identifying strengths as well as areas for growth and improvement opportunities
- Delegated tasks to staff members, monitored completion of all duties and provided support to enhance performance
- Organized health fairs and community events to raise health awareness and improve HEDIS compliance
- Monitored and analyzed business performance to identify areas of improvement and make necessary adjustments
- Ensured regulatory compliance with timely audits, thorough documentation, and prompt corrective actions.
- Spearheaded process improvement initiatives that resulted in increased efficiency and improved patient care quality.
Clinical Health Coordinator
Coventry Health Care
01.2008 - 08.2011
- Conducted regular assessments of patient needs and coordinated services accordingly with relevant healthcare professionals
- Served as liaison between patients, families, and healthcare providers to ensure seamless transitions across different levels of care
- Established patient-centric approach to care coordination, resulting in increased satisfaction and improved health outcomes
- Reduced hospital readmission rates 10% through effective post-discharge follow-up and support
- Promoted preventive healthcare measures, leading to decreased instances of chronic conditions among patients.
- Provided ongoing support to both patients and families throughout their healthcare journey, addressing concerns or challenges as they arose.
Education
Master of Science - Health Administration
University of Phoenix
Las Vegas, NV05.2013
Bachelor of Science - Health Administration
DeVry University
Kansas City, MO05.2008
Skills
- Medical practice management
- Medical terminology, ICD-9, ICD-10, CPT, HCPCS
- Project Management
- Capitation, Managed Care Line of Business
- Contracting/Credentialing Providers
- HEDIS, NCQA
- Medicare, Medicaid, Commercial Insurances
- Strategic Planning
- Utilization Management
- Excellent Communication
- Leadership Skills
Accomplishments
- Managed care for over 100,000 patients.
- Capitation/Managed Care line of business
- Devised effective policies and protocols resulting in 80% compliance with audit requirements.
- Managed team of 50 staff members.
Timeline
Clinical Operations Manager II
Southwest Medical Part Of Optum
08.2011 - Current
Clinical Health Coordinator
Coventry Health Care
01.2008 - 08.2011
Master of Science - Health Administration
University of Phoenix
Bachelor of Science - Health Administration
DeVry University
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