Lisa Gonzales-Migliozzi
Olney
Summary
Dynamic healthcare professional with extensive clinical and administrative experience. Proven track record in leading projects that achieve 100% compliance with safety standards and improve patient care quality, while effectively communicating critical findings to senior leadership.
Overview
42
42
years of professional experience
1
1
Certification
Work History
Federal Registered Nurse, Clinical Manager, GS-13
The National Institute of Health-Department of Health and Human Services
07.2018 - Current
- Analyzed monthly compliance reports for unit safety standards, including infection control, medication adherence, and fall risk identification
- 2021 to present: handwashing, infection control project reported 95-100 percent compliance with outpatient staff
- Exhibited leadership in team settings, fostering collaboration and driving project success
- Provide monthly critical data analysis reports to upper executives during Covid pandemic that promoted a safe environment in alignment with quality standards
- Lead nurse in a progressive research clinic, collaborating with scientists and medical providers to ensure the integrity and quality of research is maintained
- 2022-2023 Implementation of 'First in Human' project was delivered on-time, in-budget, and according to safety monitor standards. 100 percent patient and provider satisfaction achieved.
- 2021 to present a workflow improvement patient care project was deployed improving 50 percent of the environmental clinic space that allowed for new CDC guidelines for infection control to be implemented. Project completed prior to deadline and stayed within budget
- Monitored quality assurance programs in outpatient setting, ensuring adherence to established safety and care standards
- 2021 developed safe patient coordination of care to case manager teams during a pandemic
- 2020 to present: promote infection control standards that collaborate with epidemiology experts that include quarterly updates to staff and providers
- 2020 to present: work with institute partners to improve the safe delivery of care to research participants by developing teams with various expertise
- Senior member of the Joint Task Force promoting quality healthcare to research participants
- Led project management activities for various patient quality safety measures, including research and monitoring.
- Team member of quality assurance team, making recommendations to improve healthcare practices that support quality industry indicators
- 2020-2021 Unit Project led to improve the clinic environment that supports safe patient care by rebuilding the Nursing Station, Oxygen Monitoring System, and providing wall oxygen in each exam room
- Develop and interpret nursing survey information and provide detailed findings
- Able to analyze critical medical information and make recommendations for improvement of health care delivery to physicians, scientists, and higher leadership at NIH
- Ability to research various health care matters, interpret data, and make appropriate evidence-based recommendations based on facts found in policies and procedures
- Extensive clinical expertise to assist nurses and physicians in the caring of our patient population
- 2015 and 2019 National Institute of Health Director’s Award Recipient
- 2018 and 2023 National Institute-NIAID Merit Award Recipient
- 2018 to present-Assist with the development of the Infectious Disease Consult Service, new to OP8 clinic
- 2019 National Institute of Health Director’s Award for Leadership and Mentoring
- 2020 Selected as a test writer for the AAACN Ambulatory Care Certification Exam
Nurse Consultant and Team Leader
Aetna/Coventry Health Insurance, Inc.
06.2006 - 05.2014
- Registered Nurse working in a progressive health insurance company utilizing medical and clinical skills as a Nurse Consultant analyzing the quality of healthcare delivered, researching algorithms, and making recommendations for FDA approved medications, devices, and treatments
- Collaborated as a nurse consultant on treatment strategies for infectious diseases and cardiovascular conditions.
- Project lead nurse for improvement of safety standards in treatment guidelines for Hepatitis C
- Led development of algorithms for reviewing HIV, Hepatitis C, and cardiovascular conditions, enhancing clinical decision-making.
- Served as a consultant for field sales and account management on strategic group rating strategy and product offerings
- Conducted extensive research, surveys, and cost analysis to evaluate claim and medical diagnosis data, informing treatment strategies.
- Coordinated company-wide training for physicians, scientists, nurses, CFO, CEO, brokers, and account management, improving cross-functional knowledge.
Registered Nurse and Business Systems Analyst II
Automatic Data Processing & Medical Insurance Care Services, Incorporated (ADP/MCS)
09.2001 - 06.2003
- Registered Nurse and Health Care Analyst performing research, analysis, and writing technical and functional business specifications for Windows and web-based medical review applications
- Extensive knowledge of pertinent health care issues, worker’s compensation, preferred provider organizations fee schedules, medical coding rules, and federal/state medical regulations
- Analyze medical records for determination of injuries secondary to trauma and make recommendations for payment for continued medical treatment
- Work with medical documents, codes, and diagnostic reports utilizing the nursing process to assess the appropriateness of treatment
- Prepared safety data analysis reports to improve patient safety outcomes for soft tissue injuries
- Conducted initial, re-evaluation, and appeal reviews of submitted documentation, providing written analysis and researched information to inform decision-making
- Ability to answer and research technical questions and communicate findings through written proposal and analysis documents
- Presented to product management, sales, and end-users regarding new medical information as it relates to software development
- Acting ergonomics liaison for medical outsourcing department to include seminars and ergonomic workplace assessments
Registered Nurse, Case Manager/Senior Reviewer
Fortis Disability Management (formerly DBA Core Incorporated)
08.1996 - 06.1997
- Coordinated patient care plans with interdisciplinary teams for optimal outcomes.
- Assessed patient needs and developed individualized service strategies.
- Monitored ongoing patient progress and adjusted care plans accordingly.
- Coordinated case management for extended disability claims, providing targeted treatment recommendations based on medical documentation.
Occupational Health Charge Nurse Clinician
Public Health Service/Federal Occupational Health/Department of Health and Human Services
12.1994 - 08.1996
- Charge Nurse of the Internal Revenue Service’s Headquarters Health Center that provided medical consultation services to federal employees
- Promoted quality and safety programs to ensure compliance with agency standards, enhancing service delivery.
- Served as educational liaison for IRS employees and Public Health Service, coordinating capital budget planning, supply management, QA projects, and skill assessments for nursing personnel.
- Managed capital and operational budgets, ensuring effective allocation of resources.
Primary RN Liaison, Medical Services Administrator of Health Services
Hunter Medical Government, Private Sector, and Home Care
11.1993 - 11.1994
- Facilitated communication between contracting company and front-of-house staff, improving nursing collaboration and care coordination.
- Collaborated with upper federal nursing leadership to uphold nursing standards, ensuring delivery of high-quality patient care.
Vascular Registered Nurse and Special Procedure Clinician
INOVA-Fairfax Hospital, Level I Trauma Center
07.1986 - 11.1993
- Provided care for acute, non-acute, and critically ill patients in fast-paced interventional radiology department.
- Delivered critical care during emergencies, ensuring swift and effective patient management.
- Administered medications following established protocols and guidelines.
- Collaborated with multidisciplinary teams to develop and implement comprehensive treatment plans.
Intensive Care Registered Nurse, Clinician II
Emory University-Crawford Long Memorial Hospital
09.1984 - 06.1986
- Registered Nurse in a Medical-Surgical Intensive Care Unit
- Monitored vital signs and assessed patient conditions to ensure timely interventions in critical care settings.
- Administered medications and treatments according to physician orders and hospital protocols to support optimal patient outcomes.
- Collaborated with interdisciplinary teams to develop and implement comprehensive patient care plans, enhancing overall care quality.
Education
Master of Science - Nursing
Capella University
Bachelor of Science - Business Management
National Louis University
Associate of Science - Nursing
Shepherd University
Skills
- Patient assessment
- Nursing assessment
- Care plan formulation
- Medical order implementation
- Quality and Safety Expert
- Clinical leadership
- Program development
- Team collaboration
- Underwriting Tool
- PRESS GANEY
- Excel
- Access
- Word
Announcement Number
CMS-CMMI-25-12566001-DH
Control Number
812568400
Certifications And Credentials
- Nursing Licensure as a Registered Nurse in Maryland and Compact States
- Board Certified Ambulatory Care Nurse 10/01/18-09/30/28
- AAACN Member and Board-Certified Test Writer Candidate 2020
- Current Active BCLS and AED certified
- NIH, active member of the Maryland Patient Safety Center
- Received Coventry Medical Insurance Health Care, Inc. Bonus for Outstanding Work from 2003-2012
- Quality Assurance Certification: ABQURP certification 1998-2004
- Charter member of the Nursing Congress of INOVA Fairfax Hospital Health Care System
- Received Exceptional Nurse Reviewer award for selected members at ADP/MCS in 1999
- Graduated with a 4.0 G.P.A. in a Master of Science in Nursing
- Graduated with a 3.93 G.P.A. in a Bachelor of Science in Business Management
References
Personal, Professional, and Academic References available upon request.
Career Experience
- The National Institute of Health-Department of Health and Human Services, Federal Registered Nurse, Clinical Manager, 07/01/18, Present, Betsy Wendell, Federal Team Lead Registered Research Nurse, 05/18/14, 07/01/18, Karen Evans
- Aetna/Coventry Health Insurance, Inc., Nurse Consultant and Team Leader, 06/01/06, 05/01/14, Senior Medical Risk Advisor, 06/01/04, 06/01/06, Medical Risk Advisor, 06/01/03, 06/01/04
- Automatic Data Processing & Medical Insurance Care Services, Incorporated (ADP/MCS), Registered Nurse and Business Systems Analyst II, 09/01/01, 06/01/03, Registered Nurse-Utilization Review, Level II, 06/01/97, 09/01/01
- Fortis Disability Management (formerly DBA Core Incorporated), Registered Nurse, Case Manager/Senior Reviewer, 08/01/96, 06/01/97
- Public Health Service/Federal Occupational Health/Department of Health and Human Services, Occupational Health Charge Nurse Clinician, 12/01/94, 08/01/96
- Hunter Medical Government, Private Sector, and Home Care, Primary RN Liaison, Medical Services Administrator of Health Services, 11/01/93, 11/01/94
- INOVA-Fairfax Hospital, Level I Trauma Center, Vascular Registered Nurse and Special Procedure Clinician, 07/01/86, 11/01/93
- Emory University-Crawford Long Memorial Hospital, Intensive Care Registered Nurse, Clinician II, 09/01/84, 06/01/86
Qualifications Summary
- A dedicated professional with diverse clinical and administrative expertise as a registered nurse with extensive health care experience in the government, private, and commercial industry that includes research, medical health insurance companies, hospital, and outpatient healthcare settings.
- Able to correlate, track, and implement research data into analytical and statistical information.
- Communicate findings accurately.
- Aetna Medical Health Insurance Team Lead for review of complex medical claims, assess cost, appropriateness of care, and report findings for recommendation for reimbursement/payment and continuity of care as it relates to covered benefits.
- Compliance with CMS standards for delivery of care with infectious diseases.
- Perform quality improvement surveys that promote high quality patient care.
- Task force member 2019 that analyzed survey information to improve interprofessional collaboration between various healthcare practitioners.
- Able to evaluate and report patient trends in research and make recommendations for improvement based on medical research data.
- Registered Nurse responsible for review of detailed medical records to determine patient injury from experimental medications, treatments, and injectable medications at Coventry Healthcare and ADP-MCS.
- Prepared detailed research analysis reports to upper executives with recommendations for coverage and payment.
- Highly skilled interpreting clinical data, formulating policies, writing guidelines, and monitoring quality assurance clinical programs.
- Analyze, track, trend, and editor of monthly clinical data report that reports 100 percent compliance with quality safety monitors set-forth to ensure safe patient care in the outpatient setting.
- Present outpatient clinic findings to senior leadership incorporating solutions to sustain an environment of safety.
- Effective communication, leadership, research, clinical, and organizational skills that are crucial in a changing health care industry.
Certification
- RN-Compact State Maryland
- RN-ANCC: Ambulatory Care Nursing Certification
Timeline
Federal Registered Nurse, Clinical Manager, GS-13
The National Institute of Health-Department of Health and Human Services
07.2018 - Current
Nurse Consultant and Team Leader
Aetna/Coventry Health Insurance, Inc.
06.2006 - 05.2014
Registered Nurse and Business Systems Analyst II
Automatic Data Processing & Medical Insurance Care Services, Incorporated (ADP/MCS)
09.2001 - 06.2003
Registered Nurse, Case Manager/Senior Reviewer
Fortis Disability Management (formerly DBA Core Incorporated)
08.1996 - 06.1997
Occupational Health Charge Nurse Clinician
Public Health Service/Federal Occupational Health/Department of Health and Human Services
12.1994 - 08.1996
Primary RN Liaison, Medical Services Administrator of Health Services
Hunter Medical Government, Private Sector, and Home Care
11.1993 - 11.1994
Vascular Registered Nurse and Special Procedure Clinician
INOVA-Fairfax Hospital, Level I Trauma Center
07.1986 - 11.1993
Intensive Care Registered Nurse, Clinician II
Emory University-Crawford Long Memorial Hospital
09.1984 - 06.1986
Master of Science - Nursing
Capella University
Bachelor of Science - Business Management
National Louis University
Associate of Science - Nursing
Shepherd University