Lori Bacani
Corona,CA
Summary
Seasoned Clinical Effectiveness Coordinator with robust peer review expertise and a 97% IRR accuracy in core measure abstraction. At Corona Regional Medical Center, supported JCAHO compliance and enhanced medical documentation, ensuring accurate severity of illness representation. Demonstrates exceptional communication and documentation review skills, vital for quality healthcare delivery and data integrity. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
40
40
years of professional experience
Work History
CLINICAL EFFECTIVENESS COORDINATOR, QUALITY MANAGEMENT
CORONA REGIONAL MEDICAL CENTER
11.2017 - Current
- Analyzes sepsis bundle compliance data to assist with documentation, coding, clinical care, and improved outcomes.
- Collaborates with Risk Management as needed for case reviews.
- Supports and coordinates Medical Staff Peer Review committee and activities.
- Prepares clinical summaries for physician review.
- Communicates with physicians regarding need for case reviews.
- Creates Multispecialty Quality Review Committee (MSQRC) minutes.
- Performs data entry into MIDAS database to facilitate Ongoing Professional Practice Evaluation (OPPE).
- Provides Quality of Care trend reports for the Medical Staff Department.
SENIOR CLINICAL DATA SPECIALIST
Q-CENTRIX
11.2022 - 01.2024
- Remote core measure (sepsis, perinatal, ED throughput, stroke) abstraction with 97% IRR accuracy.
CLINICAL DOCUMENTATION IMPROVEMENT SPECIALIST
CORONA REGIONAL MEDICAL CENTER
05.2015 - 11.2017
- Performs timely and comprehensive medical record reviews (concurrent and retrospective) to ensure documentation is accurate, consistent, complete, and supports severity of illness (SOI) and risk of mortality (ROM).
- Identifies principal diagnosis, secondary diagnosis, and procedures to assign working DRGs.
- Queries physicians to clarify incomplete or conflicting documentation.
- Collaborates with coding staff regarding assigned DRG discrepancies and other coding issues.
CLINICAL DOCUMENTATION IMPROVEMENT SPECIALIST
RIVERSIDE COMMUNITY HOSPITAL
07.2013 - 05.2015
- Performs reviews of medical records and compiles physician queries, both concurrently and retrospectively, to ensure documentation is accurate, consistent, and supports the patient's severity of illness (SOI).
- Identifies educational opportunities, including discrepancies in clinical indicators and diagnostic statements, which impact DRG assignment, SOI, risk of mortality and resource utilization.
- Participates in multidisciplinary committee meetings as needed.
CLINICAL DOCUMENTATION IMPROVEMENT SPECIALIST
SOUTHWEST HEALTHCARE
01.2011 - 01.2013
WOMENS' HEART DISEASE SCREENING PROGRAM COORDINATOR
RANCHO SPRINGS MEDICAL CENTER
01.2009 - 01.2011
LVN CLINICAL INSTRUCTOR
SUMMIT CAREER COLLEGE
01.2006 - 01.2009
HEDIS FIELD REVIEWER
MOLINA HEALTHCARE
01.2005 - 01.2008
GI LAB
RIVERSIDE COMMUNITY HOSPITAL
01.2003 - 01.2006
OUTPATIENT SURGERY
CORONA REGIONAL MEDICAL CENTER
01.2001 - 01.2003
OUTPATIENT SURGERY & PREADMIT TESTING
MISSION HOSPITAL
01.1995 - 01.2001
ICU, PCU, PACU
LONG BEACH MEMORIAL MEDICAL CENTER
01.1987 - 01.1995
ICU, CARDIAC REHAB
ST. JOSEPH MEDICAL CENTER
01.1984 - 01.1987
Education
Master of Science - Nursing And Health Education
UNIVERSITY OF PHOENIX
01.2010
Bachelor of Arts - Journalism, Print
CALIFORNIA STATE UNIVERSITY
01.1995
DIPLOMA IN NURSING -
MEMORIAL HOSPITAL SCHOOL OF NURSING
01.1984
Skills
- Documentation Review
- Core Measure Abstraction
- Cerner/MIDAS/Meditech
- Adaptability
- Trustworthiness
Timeline
SENIOR CLINICAL DATA SPECIALIST
Q-CENTRIX
11.2022 - 01.2024
CLINICAL EFFECTIVENESS COORDINATOR, QUALITY MANAGEMENT
CORONA REGIONAL MEDICAL CENTER
11.2017 - Current
CLINICAL DOCUMENTATION IMPROVEMENT SPECIALIST
CORONA REGIONAL MEDICAL CENTER
05.2015 - 11.2017
CLINICAL DOCUMENTATION IMPROVEMENT SPECIALIST
RIVERSIDE COMMUNITY HOSPITAL
07.2013 - 05.2015
CLINICAL DOCUMENTATION IMPROVEMENT SPECIALIST
SOUTHWEST HEALTHCARE
01.2011 - 01.2013
WOMENS' HEART DISEASE SCREENING PROGRAM COORDINATOR
RANCHO SPRINGS MEDICAL CENTER
01.2009 - 01.2011
LVN CLINICAL INSTRUCTOR
SUMMIT CAREER COLLEGE
01.2006 - 01.2009
HEDIS FIELD REVIEWER
MOLINA HEALTHCARE
01.2005 - 01.2008
GI LAB
RIVERSIDE COMMUNITY HOSPITAL
01.2003 - 01.2006
OUTPATIENT SURGERY
CORONA REGIONAL MEDICAL CENTER
01.2001 - 01.2003
OUTPATIENT SURGERY & PREADMIT TESTING
MISSION HOSPITAL
01.1995 - 01.2001
ICU, PCU, PACU
LONG BEACH MEMORIAL MEDICAL CENTER
01.1987 - 01.1995
ICU, CARDIAC REHAB
ST. JOSEPH MEDICAL CENTER
01.1984 - 01.1987
Master of Science - Nursing And Health Education
UNIVERSITY OF PHOENIX
Bachelor of Arts - Journalism, Print
CALIFORNIA STATE UNIVERSITY
DIPLOMA IN NURSING -
MEMORIAL HOSPITAL SCHOOL OF NURSING