Mandi Bredemann
Appleton ,WI
Summary
Accomplished Quality Compliance Nurse Professional with a proven track record at Independent Care Health Plan (iCare), a Humana Inc., excelling in enhancing 5-Star Measures and leading Quality Improvement initiatives. Expert in regulatory compliance, adept at fostering interdisciplinary collaboration, and a licensed Wisconsin nurse. Spearheaded the internal AIRS development, showcasing strong leadership and analytical skills. Skilled at multitasking and prioritizing daily assignments. Ability to handle multiple projects simultaneously with a high degree of accuracy. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
5
5
years of professional experience
Work History
Quality Compliance Nurse Professional
Independent Care Health Plan (iCare), a Humana Inc
11.2022 - Current
- Monitor and complete documentation in Adult Incident Reporting System (AIRS) of Reportable Incidents
- Contribute 5-Star Measures efforts and monitoring of initiatives
- Compliance and audit readiness for both internal and external audits
- Complete FCP Clinical Performance Improvement Project activities and documentation in accordance with DHS guidelines
- Complete Chronic Condition Improvement Project (CCIP) activities and documentation in accordance with CMS guidelines
- Collaborate with Inter Disciplinary Team (IDT), IT and Case Management to ensure consistent, comprehensive, accurate and timely data collection that is needed to conduct Plan Do Study Act (PDSA) cycles to monitor performance on an ongoing basis
- Evaluate PDSA cycles for results and current interventions and make necessary changes to goals, interventions an planned follow up as needed
- Led Quality Improvement meetings and discussions for Case Management Teams as assigned
- Led Provider Quality Committee (PQC) bi weekly meetings; monitor and report out the Statement of Deficiencies (SOD) received from the State
- Active participant in the State Quality Managed Care Organization (MCO) Quality Workgroup
- Steering Committee Member for the Falls Free Wisconsin Initiative
- Report out Family Care Partnership (FCP) Metrics at designated meetings and committees.
Registered Nurse Case Manager Badger Care +
Independent Care Health Plan (iCare)
08.2021 - 05.2022
- Evaluated member progress and adjusted care plans accordingly, ensuring continuity of care across all healthcare settings.
- Provided education and support to members and families, empowering them to make informed decisions regarding their healthcare needs.
- Improved member outcomes by consistently providing comprehensive assessments and developing tailored care plans.
- Authored initial assessments of members to develop plans for individual home care needs.
- Enhanced interdisciplinary team communication through regular case conferences, promoting effective collaboration for optimal patient care.
- Conducted comprehensive assessments of members '' physical, emotional, and social needs in order to develop individualized care plans that facilitated optimal health outcomes.
Registered Nurse Ambulatory Surgery Center
Sports Medicine Center
07.2019 - 07.2021
- Administered medications safely according to established guidelines while closely monitoring for side effects or adverse reactions requiring intervention.
- Enhanced patient satisfaction by providing compassionate, holistic nursing care that addressed physical, emotional, and spiritual needs.
- Assisted in training and mentorship of new nursing staff members, contributing to positive work environment and high-quality patient care.
- Advised patients and caregivers of proper wound management, discharge plan objectives, safe medication use, and disease management.
- Educated family members and caregivers on patient care instructions.
- Managed patients recovering from medical or surgical procedures.
- Evaluated patient histories, complaints, and current symptoms.
- Monitored patient reactions after administering medications and IV therapies.
Education
Associate of Applied Science - Nursing
Fox Valley Technical College
Appleton, WI12.2010
Skills
- Licensed by Wisconsin nursing board
- Strong team collaboration and relationship with DHS to allow for smooth communication
- Engaging and collaborating with CM, IDT, IT, and Leadership
- Took lead within the organization in collaborating with Department of Health Services (DHS) Deloitte and the other Managed Care Organizations (MCO) in the development and roll out of the Adult Incident Reporting System (AIRS) Was the lead tester for all MCO's as iCare was the only MCO submitting incidents in the system month before other MCO's
- Subject matter expert for Reportable Incidents within the organization
- Led efforts on immunization metrics, including collaboration with other MCO's on initiatives
- Led Trainings on immunization efforts, metrics and other HEDIS measures as needed
- Completing assigned audits and analyzing data for the entire program and well as the individual teams
Timeline
Quality Compliance Nurse Professional
Independent Care Health Plan (iCare), a Humana Inc
11.2022 - Current
Registered Nurse Case Manager Badger Care +
Independent Care Health Plan (iCare)
08.2021 - 05.2022
Registered Nurse Ambulatory Surgery Center
Sports Medicine Center
07.2019 - 07.2021
Associate of Applied Science - Nursing
Fox Valley Technical College
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