Kimberly (Hope) Strange
Summary
Methodical Quality Assurance Coordinator with superb problem-solving and analytical abilities. Keeps meticulous records, identifies and troubleshoot problems. Specialties include operational improvements, internal audit program management and documentation.
Overview
19
19
years of professional experience
Work History
Quality Assurance Coordinator
Sentara Health Plan
08.2021 - Current
- Promote a consistent state of National Committee for Quality Assurance (NCQA) Health Equity survey readiness within Sentara Health Plan
- Remain abreast of current NCQA Health Equity Accreditation requirements and any subsequent changes
- Serve as a Subject Matter Expert for colleagues seeking guidance on matters related to NCQA Health Equity Accreditation
- Identify areas where additional resources were needed for successful completion of accreditation reviews, advocating for necessary support from institutional leadership
- Develop compliance training initiatives and materials, educating staff on regulations
- Liaise with clients to identify and target inefficiencies in areas of risks and business controls, process gaps and workflow discrepancies
- Analyze and identify risk areas to determine compliance with applicable NCQA Health Equity Standards
- Review Health Equity Standards and evaluate compliance, identify challenges and propose solutions
- Evaluate Sentara corporate policies, procedures, and outcomes against established benchmarks for quality assurance purposes
- Promote transparency around the status of Sentara Health Plan accreditation through regular updates at meetings or via online platforms.
- Monitor progress toward meeting accreditation goals through consistent tracking and analysis of data and policies
- Facilitate communication between internal departments regarding accreditation matters, promoting collaboration and shared understanding.
- Contribute to the expansion of accredited programs by researching new initiatives that aligned with organizational goals.
Patient Safety/ACRED/Regulatory Coordinator
Sentara Obici Hospital
01.2021 - 05.2023
- Responsible for a 33% reduction in DNV Survey findings, for survey year 2022
- Promoted a consistent state of Det Norske Veritas (DNV) survey readiness within Sentara Obici Hospital (SOH)
- Developed and implemented processes to support ongoing compliance with accreditation/regulatory agencies and standards at SOH
- Coordinated all Internal, Corporate Environmental Health Services and Corporate Accreditation and Regulatory Standards Internal Audit activities at SOH
- Responsible for interpretation and application of ISO 9001 Standards and DNV Accreditation Requirements, Interpretive Guidelines and Surveyor Guidance for Hospitals
- Coordinated and served as the initial point of contact for annual DNV Survey activities and findings
- Conducted annual Risk Assessment of SOH departments
- Developed the annual Internal Audit Schedule for SOH Internal Audit Team
- Developed customized departmental audits templates and education for the SOH Internal Audit Team
- Served as the Lead Auditor for SOH and provider of ISO 9001 oversight services
- Completed the successful conversion of annual DNV Survey Documentation submission and storage process from paper to electronic
- Responsible for Risk Mitigation efforts and Corrective Action Plan development
- Conducted annual reviews of all hospital departmental Scope of Services documents
- Monitored and reported DNV accreditation findings corrective action progress to the Quality Management System (QMS)
- Provided leadership and ongoing education for the SOH Safety Coach Committee.
- Formulated detailed recommendations based on audit findings to support annual planning and definition of goals.
- Prepared and presented comprehensive reports to upper management and audit team, covering issues and recommendations.
- Fostered strong relationships with accrediting bodies, ensuring timely updates and compliance with industry best practices.
Production Planning/Scheduler II
Huntington Ingalls Industries
03.2020 - 02.2021
- Planned sequence of fabrication, assembly, installation, and other manufacturing operations relating to specific portion of the product for guidance of production workers, in a remote work environment
- Planned detail operations from blueprints, engineering orders, change notices, and other engineering releases
- Determined the need for tooling and made recommendations for the design and planning of required tools
- Prepared shop work orders for materials and product processing and coordinated with schedulers, to ensure that items processed according to specifications and time requirements
- Maintained progress reports, schedules, and other related records.
Quality IP Data Analytics Analyst
Riverside Health System
01.2015 - 01.2019
- Responsible for the coordination, collection and submission of clinical quality measures for all five (5) facilities within Riverside Health System (RHS) to external reporting agencies
- Ensured adherence to regulatory requirements and deadlines related to Inpatient Quality reporting (IQR) and Outpatient Quality Reporting (OQR)
- Served as the RHS Subject Matter Expert (SME) for: Meaningful Use (MU), Electronic Clinical Quality Measures (eCQMs), IQR and OQR
- System Administrator for RHS Quality Reporting vendor tools, Premier and QualityNet
- Partnered with the IT Department as the Change Management Liaison for the Quality Department
- Successfully implemented the Quality Reporting Document Architecture Pre-Submission Validation Application Tool (QRDA PSVA) for RHS
- Successfully implemented a Clinical Inter Rater Reliability (IRR) Program for RHS
- Provided system-wide oversight and management of: Anthem Q-HIP, Leapfrog, Hospital Compare, QualityNet, STAR ratings, The Joint Commission (TJC), eCQM submission, CMS audit preparation, Clinical Initiative data management and submission, Premier/QUEST data abstraction
- Developed and delivered ongoing training resources for Corporate Leadership, Clinical Abstractors and Nursing staff.
- Demonstrated a high level of initiative and creativity while tackling difficult tasks.
Curriculum Development Supervisor
ARDX Consultants
07.2014 - 05.2015
- Served as an Affordable Care Act (ACA) Business Consultant for Centers for Medicare and Medicaid Services (CMS)
- Provided direct management of Reinsurance Payment Team, comprised of Technical Writers and Reinsurance Team Research Analysts
- Gathered and processed requirements from assigned client, CMS
- Worked closely with CMS to identify and log issues through HIOS Id tracking, within the Registration for Technical Assistance Portal (REGTAP) Database
- Edited and provided 2nd Level Review of FAQ submissions, training resources, and the Inquiry Tracking and Management System (ITMS)
- Researched and developed training manuals and operational documents regarding the Reinsurance Payments Program
- Compiled accurate daily, weekly and monthly reporting for senior management.
Network Relations Consultant
AMERIGROUP
03.2005 - 07.2014
- Provided contractual oversight of assigned ancillary vendors; MULTIPLAN and TELADOC
- Monitored provider credentialing process
- Served as a FACETS Super-User to test benefit logic and provide claims error resolution
- Worked closely with ancillary vendors and AMERIGROUP IT department to identify and resolve 834 enrollment file provider set-up submission errors
- Conducted negotiations and led contracting efforts with providers to build and maintain a cost effective, accessible provider network
- Identified contractual deficiencies and monitored associated Corrective Action Plan adherence
- Researched, analyzed and recommended resolution for contract disputes, non-routine claim issues, billing questions and other practices
- Coordinated communication process on such issues as administrative and medical policy, reimbursement and provider utilization patterns
- Conducted provider seminars to support the understanding of managed care and Blue Cross and Blue Shield policies and procedures
- Formally trained as Claims Analyst II and Appeals Analyst II.
Education
M.Ed - Education, Training and Development
Trident University International
Cypress, CA04.2015
Bachelor of Science - Interdisciplinary Studies
Liberty University
Lynchburg, VA10.2011
Skills
- Accreditation Expertise
- Information Gathering
- Research Abilities
- Detail Oriented
- Document Reviews
- Accreditation Standards
- Curriculum Design
- Organization and Time Management
- Operational Excellence
- Regulatory Documentation
- Internal Audits
- Compliance Reporting
Training
- DNV Physical Environment Boot Camp
- DNV Advanced ISO 9001
- Change Acceleration Process (CAP) Training
- EPIC Training Readiness Lead (TRL) Certification
- FACETS Super User Claims Certification
- Lean Six Sigma Yellow Belt Certification
Timeline
Quality Assurance Coordinator
Sentara Health Plan
08.2021 - Current
Patient Safety/ACRED/Regulatory Coordinator
Sentara Obici Hospital
01.2021 - 05.2023
Production Planning/Scheduler II
Huntington Ingalls Industries
03.2020 - 02.2021
Quality IP Data Analytics Analyst
Riverside Health System
01.2015 - 01.2019
Curriculum Development Supervisor
ARDX Consultants
07.2014 - 05.2015
Network Relations Consultant
AMERIGROUP
03.2005 - 07.2014
M.Ed - Education, Training and Development
Trident University International
Bachelor of Science - Interdisciplinary Studies
Liberty University
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