KRISTA ERNST
Lockport,New York
Summary
Insightful clinical manager with a proven track record of directing and enhancing operations through effective employee motivational strategies and strict policy enforcement. Well-versed in industry best practices, market trends, and regulatory requirements, ensuring seamless adherence to operational standards. Talented leader with an analytical approach to business planning and day-to-day problem-solving, consistently driving organizational success.
Overview
19
19
years of professional experience
Work History
Manager, Care Management (RN)
Fidelis Care New York/Centene Corporation
10.2022 - Current
- Manage clinical services by overseeing clinical policies, procedures, and the day-to-day activities of the integrated care coordination team staff.
- Provide strategic leadership and oversight for NCQA-accredited clinical teams, ensuring compliance with accreditation standards and guidelines.
- Guiding the department through the accreditation process, culminating in the achievement of NCQA accreditation.
- Implement evidence-based practices to drive quality improvement and achieve superior patient outcomes.
- Collaborate with cross-functional teams to streamline operational processes and optimize resource allocation.
- Track data to analyze quality measures, trends, or areas for potential improvement in order to attain excellent patient outcomes.
- Updated workflows and processes that resulted in a member engagement rate of 68% percent.
Supervisor, Care Management (RN)
Fidelis Care New York/Centene Corporation
11.2019 - 10.2022
- Provided assessment, education and oversight for Case Management operations, including daily staffing, employee evaluations, staff coaching, orientation of new staff, and identification and monitoring of performance metrics and competencies.
- Conducted internal audits of team members to monitor compliance with workflow, process and timeliness of tasks assigned.
- Monitored Compliance of departmental policies and procedures.
- Utilized daily reports to analyze and manage teams daily work performance.
- Developed and initiate protocols and workflow for Medicare and Medicaid Dual line of business for members within New York State.
- Served as expert resource, educator, and liaison between Case Management and other departments.
- Effectively led a diverse team of 16 telephonic case managers who are registered nurses.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows
- Increased team productivity by implementing efficient workflows and setting clear expectations for staff members.
RN Case Manager
Fidelis Care New York/Centene Corporation
04.2017 - 11.2019
- Engaged in a re-admission reduction initiative centered on post-acute case management, collaborating with members and providers to enhance appointment attendance and adherence to care plans.
- Complied with clinical care standards by working closely with providers, following departmental and state guidelines, and ensuring the achievement of proper outcomes.
- Maintained timely communication with members, caregivers, and other healthcare professionals as needed to support the achievement of a desired outcome for all involved parties.
- Offered assistance to members by identifying their developmental, physical, psychosocial, and psychological requirements to evaluate and organize suitable services.
Clinical Informatics Specialist
Kaleida Health
09.2015 - 04.2017
- Provided guidance in development, implementation and maintenance of Cerner clinical information system.
- Assisted in optimizing health information systems throughout company by demonstrating advanced knowledge of clinical processes and supporting technology.
- Collaborated with healthcare providers and IT professionals to optimize electronic health record (EHR) systems for efficient clinical workflows.
- Supported corporate objectives and applied team feedback to develop and implement information system strategy.
- Analyzed clinical data to identify trends, patterns, and opportunities for quality improvement and process optimization.
- Created and deployed informatics solutions to improve patient care, streamline documentation processes, and guarantee regulatory compliance
- Provided training and assistance to clinical staff regarding the utilization of informatics tools and systems.
Registered Nurse, Labor and Delivery
Kaleida Health
07.2005 - 09.2015
- Utilized critical thinking skills independently and collaboratively to make clinical judgements.
- Cultivated productive partnerships with physicians healthcare professionals to function as an interdisciplinary team member for comprehensive treatments.
- Proposed and executed modifications to medical unit assignment delegation and prioritization, leading to elevated patient care standards and updated care plans.
- Educated new nurses on correct techniques, care protocols, operational practices, and safety measures.
- Collaborated and coordinated with healthcare team members to assess, design, implement, and review patient care plans.
Education
Associate of Applied Science - Nursing
SUNY Niagara
Sanborn, New York06.2005
Bachelor of Science - Psychology
State University of New York At Brockport
Brockport, New York06.1996
Skills
- Priority Management
- Analytical and Critical Thinking
- Clinical Process Knowledge
- Data Analytics
- Microsoft Office
- Team Leadership
- Time Management
- Verbal and written communication
- Complex Problem-Solving
- Staff Training and Development
- Compliance Monitoring
- Regulatory Standards
- Process Management
- Risk Management
Timeline
Manager, Care Management (RN)
Fidelis Care New York/Centene Corporation
10.2022 - Current
Supervisor, Care Management (RN)
Fidelis Care New York/Centene Corporation
11.2019 - 10.2022
RN Case Manager
Fidelis Care New York/Centene Corporation
04.2017 - 11.2019
Clinical Informatics Specialist
Kaleida Health
09.2015 - 04.2017
Registered Nurse, Labor and Delivery
Kaleida Health
07.2005 - 09.2015
Associate of Applied Science - Nursing
SUNY Niagara
Bachelor of Science - Psychology
State University of New York At Brockport
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