Krista Ernst

Lead the strategic direction and operational oversight of clinical services, ensuring compliance with NCQA accreditation standards and regulatory requirements.

• Direct and optimize the day-to-day activities of the integrated care coordination team, ensuring the delivery of high-quality care services.
• Spearheaded the successful NCQA accreditation process, ensuring full compliance with guidelines and contributing to the organization's continued success.
• Implement evidence-based care practices to improve patient outcomes, reducing readmissions and promoting overall health.
• Leverage data analytics to identify performance trends, inform quality improvement initiatives, and optimize operational efficiency.
• Increased member engagement rate by 20% through updated workflows, process enhancements, and targeted interventions.

Managed daily care management operations, overseeing clinical workflows, staff development, and performance metrics.

• Directed a team of 16 telephonic case managers, focusing on staff performance, training, and coaching to improve operational efficiency.
• Conducted internal audits and performance assessments to ensure compliance with department policies, regulatory standards, and clinical guidelines.
• Developed and implemented specialized protocols for the Medicare and Medicaid dual line of business, streamlining care coordination for members across New York State.
• Played a key role in implementing strategic workflows that enhanced team productivity and performance while maintaining high-quality patient care standards.

Focused on patient-centered case management, working to reduce readmissions and improve care plan adherence.

• Worked closely with providers and patients to facilitate post-acute care, ensure compliance with clinical care standards, and monitor progress.
• Facilitated collaborative care plans and communication across multidisciplinary teams to ensure timely and effective care delivery.
• Delivered targeted support to members by addressing psychosocial, physical, and developmental needs, ensuring tailored care solutions.

Led the development and implementation of Cerner clinical information systems, optimizing electronic health record (EHR) systems for improved clinical workflows.

• Collaborated with IT professionals and clinical teams to refine healthcare technologies, improving data accuracy and compliance.
• Analyzed clinical data to identify process gaps and quality improvement opportunities, contributing to enhanced patient care and operational efficiency.
• Provided training to staff on new informatics tools and EHR systems, ensuring smooth integration and utilization of technology in clinical practice.

Provided direct patient care in a high-acuity labor and delivery setting, ensuring quality outcomes for both mother and child.

• Utilized clinical judgment to assess and intervene in high-risk labor and delivery situations, ensuring optimal patient outcomes.
• Collaborated with a multidisciplinary team to develop and implement patient care plans, improving patient safety and care quality.
• Mentored new nurses, fostering a supportive environment and ensuring consistent adherence to clinical protocols and safety measures.