LORI HODGES
Summary
Results-driven professional with a proven track record in managing client engagements and driving strategic initiatives. Strong emphasis on team collaboration and outcome achievement fosters a productive work environment. Recognized for adaptability and dependability in fast-paced settings, bringing a unique blend of project management expertise, stakeholder communication skills, and analytical problem-solving abilities to every challenge. Committed to delivering exceptional results while enhancing client satisfaction and operational efficiency.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Records Retrieval Specialist (Contractor)
Robert Half Agency
03.2024 - Current
- Coordinate retrieval of medical records from various healthcare facilities, utilizing a variety of EMRs, to ensure compliance and timely access.
- Monitor Progress of record retrieval efforts, identifying bottlenecks and implementing solutions to streamline workflows.
- Assigned to specialized Quality Assurance team to audit and coach 40= FTEs and contractors in HEDIS medical record retrieval, achieving 100% compliance with CMS quality targets through performance management systems.
Provider Relations Engagement Manager
Post Acute Analytics
01.2022 - 07.2023
- Fostered relationships with over 5k post-acute facilities in partnership with health plan initiatives promoting SaaS lifecycle management, managing end-to-end delivery of projects.
- Developed and delivered impactful executive-level presentations for national accounts, addressing change management strategies, and offering insights into key performance indicators (KPIs), data analysis, market trends, metrics, and strategic coaching for quality improvement
- Led integration initiatives for designated clients, ensuring successful completion prior to the contract deadline, generating additional $50k monthly in revenue for startup
- Collaborated on cross-functional process improvement projects leading to the development of a provider database.
Performance Improvement Specialist
Genesis Physicians Group
04.2019 - 01.2022
- Boosted Managed Care shared savings contracts from $4 million to $8.4 million, achieving CMS quality rating increase to 97.4%
- Spearheaded network clinician performance by communicating contracted measures, analyzing baselines, proposing targets and the continuous monitoring, and tracking of deliverables for quality payment programs
- Served as SME for HEDIS and performance measures, developed improvement plans by conducting reviews of medical documentation and record abstractions, and delivering education on risk adjusted coding, and documentation
- Cross-functional collaboration to create comprehensive educational programs for physicians and staff, focusing on quality performance measures and best practices
- Analyzed complex data sets, generating insightful reports for presentations on metrics and utilization trends, accompanied by actionable recommendations to enhance contracted quality and HEDIS/STAR measures.
- Leveraged technology solutions to streamline reporting processes, increasing accuracy and accessibility of data insights.
- Deployed predictive analytics models to forecast future trends.
Telehealth Clinical Technician | Health Informatics
Department Of Veterans Affairs
07.2018 - 04.2019
- Project manager for the implementation of virtual telehealth clinics, to include onboarding and training of physicians and clinical staff within VISN 17.
- Management of scheduling, administrative and clinical functions for multiple specialty telehealth clinics within the VA's Community Based Outpatient Clinics (CBOCs).
- Maintained and calibrated medical equipment to ensure optimal performance and safety.
Licensed Vocational Nurse (LVN) Case Manager
Department Of Veterans Affairs
05.2013 - 07.2018
- Worked with multidisciplinary teams to carry out successful treatment plans for Veteran populations within Telehealth, ambulatory care, Spinal Cord Injury, PTSD, and substance abuse,
- Collaborated with interdisciplinary team of healthcare and social service providers to address patients' needs through effective intervention and care planning.
- Administered medications and treatments per physician orders, ensuring patient safety and compliance with protocols.
Education
MBA - Health Care Management
Western Governors University
Bachelor of Science - Health Information Management
Western Governors University
LVN Certification - Practical Nursing
Kiamichi Technology Center
Skills
- Value Based Care
- Population Health
- Healthcare Operations
- Health Care Quality Assurance
- Performance Improvement
- Cross-Functional Collaboration
- Process Optimization
- Relationship Management
- Problem Solving
- Account Management
- Project Management
- Excellent Communication Skills
- Program Management
- Data Analysis
- Metrics Driven
- Implementation
- Quality Improvement
- Process Improvement
- HEDIS
- NCQA
- Highly Organized
- Attention to Detail
- Flexibility
- Adaptability
- Provider Relations
- Startup
- Root Cause Analysis
- Data Analytics
- Training and Onboarding
- Best practices optimization
- Strategic Thinking
- Medicare Compliance
- Performance monitoring
- Performance Metrics
- Workflow Optimization
- Electronic Medical Record Software
- Clinical Quality Program Standards
- Quality Metrics
- HIPAA Guidelines
- Health Information Systems
- Data Interpretation
- Lean Six Sigma
- Microsoft Excel
- Coaching and Mentoring
- Customer Focus
- Task Prioritization
- Organization
- Problem Resolution
- Problem-Solving
- Critical Thinking
- Teamwork and Collaboration
- Conflict Resolution
- Analytical and Critical Thinking
- HEDIS Measure Expertise
- Healthcare management
- Healthcare Quality Standards
- Audit preparation
- Clinical Documentation Review
- Healthcare compliance
- Health plan operations
- Medical record review
- Excellent Communication
- Time Management
- Population Health Management
- EMR Software
- Managed Care Expertise
- Written Communication
- Customer Service
- Organization and Time Management
- Onboarding and Orientation
- Performance Tracking and Evaluation
- Workflow Analysis
Certification
CompTIA Project +
Lean Six Sigma Green Belt
Timeline
Records Retrieval Specialist (Contractor)
Robert Half Agency
03.2024 - Current
Provider Relations Engagement Manager
Post Acute Analytics
01.2022 - 07.2023
Performance Improvement Specialist
Genesis Physicians Group
04.2019 - 01.2022
Telehealth Clinical Technician | Health Informatics
Department Of Veterans Affairs
07.2018 - 04.2019
Licensed Vocational Nurse (LVN) Case Manager
Department Of Veterans Affairs
05.2013 - 07.2018
MBA - Health Care Management
Western Governors University
Bachelor of Science - Health Information Management
Western Governors University
LVN Certification - Practical Nursing
Kiamichi Technology Center