Summary
Work History
Education
Skills
Work Preference
Timeline
Generic
Open To Work

Melanie Severson RN

Sanger,CA

Summary

Dynamic healthcare risk management professional with a proven track record in identifying, analyzing, and mitigating potential risks to enhance patient safety and organizational efficiency. Skilled in fostering collaboration within teams to achieve strategic goals while demonstrating adaptability and reliability. Expertise in risk assessment, compliance, and strategic planning complements a results-driven mindset. Recognized for exceptional communication and problem-solving abilities that facilitate effective decision-making and promote a culture of continuous improvement.

Work History

Customer Service

Renew Auto Body & Paint
08.2024 - Current
  • Assisting a small business owner with various tasks related to customer service and bookkeeping (Quickbooks).
  • I introduced the owner to increased use of technology to improve records management, and I continue to work with him to maximize the use of the customer management system for improved data management.
  • Reorganized existing records and supplies for improved efficiency and inventory tracking.
  • Implementing recommended items and activities as required per federal and state regulations (CalOSHA, Bureau of Automotive Repair, Waste Management, etc.).

Nursing Informatics

Valley Children’s Hospital
10.2023 - 01.2024
  • Acted as a clinical liaison between operational and clinical support staff members using Epic electronic health system and third-party interfaces. Optimized workflows and provided training as needed.

Legal Nurse Consultant/Clinical Reviewer

EvenUp
06.2023 - 12.2023
  • This was a contract position with a new tech start-up that was developing an artificial intelligence program to create a medical chronology from scanned patient records.
  • Reviewed AI-generated medical chronologies against patients' medical records for accuracy and completeness. Completed corrections as needed.

Physician Peer Review/Risk Management Coordinator

Saint Agnes Medical Center
01.2022 - 04.2023
  • Initially hired as the peer review coordinator, but acquired the risk management coordinator position within three months when that position was vacated. I worked both positions until a new person was hired for the peer review coordinator, and I took on risk management exclusively approximately eight months later.
  • Coordinated all activities with the Multi-Specialty Peer Review Committee's chairperson and the different committee members for physician peer-review cases, including case identification, case summaries, case tracking, managing time-sensitive communications, and monthly meeting management.
  • Completed a gap analysis on the current versus optimal peer review coordinator activities through research and collaboration with cross-functional colleagues.
  • Researched various data sources available to be used for peer review activities, and identified obsolete and untraceable data sources in use by prior peer review coordinators. The end goal was to rework the peer review process from start to finish to make the process current, efficient, and relevant.
  • Patient safety and risk management activities, such as incident report management, investigations, case reviews, corrective action plans, and education.
  • Assisted the billing department when billing concerns arose, either through quality of care complaints submitted by patients or their insurance agencies, or when there were concerns about services billed but not completed.
  • Primary contact for various outside regulatory and other oversight agencies regarding patient complaints, billing complaints, and/or investigations.
  • Liaised with legal claims representatives (malpractice, general liability, and employee), and outside legal support when indicated.

Patient Safety Risk Manager

Sierra View Medical Center
08.2020 - 11.2020
  • Provided patient safety, peer review, and risk mitigation services to this small district hospital (we were a department of two nurses and one paralegal).
  • Collaborated with an outside IT vendor on the new online incident reporting and management system; quickly learned frontline programming to develop the new system into an easy-to-use end-user reporting system that would also be an effective tool for our quality/risk management activities.

Quality Improvement Nurse

NeuroRestorative
10.2019 - 05.2020
  • Provide patient safety, quality, risk, and regulatory activity support remotely and on-site for 11 homelike, subacute facilities across Central and Northern California.
  • I stepped in and provided on-site support for two facilities as the Acting Director of Nursing for several weeks.

Patient Safety Risk Manager

Community Medical Centers
02.2017 - 07.2019
  • Provided patient safety and risk management support to various departments within the 600+ bed regional trauma center.
  • Investigated significant incidents, and developed case reviews and corrective action plans in collaboration with the involved departments when indicated.
  • Created and presented cases for various committee or department meetings.
  • Facilitated improvement projects with various direct and indirect patient care departments.
  • Worked with outside legal, regulatory, and accreditation agencies, as needed. In the state of California, regulatory agency activity is frequent and requires a significant amount of time, knowledge, and finesse.
  • Participated in various legal activities, such as representing the organization in small claims court, assisting legal representation with case management, etc.

Patient Safety Risk Manager

The Doctors Company
10.2013 - 12.2016
  • Provided on-site and telephonic patient safety and risk management services to physicians, physician groups, and hospital/health systems within a large service area of Central California.
  • Provided consultative support to underwriting and claims staff for account and claims management.
  • Developed open-source short articles to be published on the company's website.
  • Developed PowerPoint presentations and presented the educational activities online and in person.

Deputy Chief of Quality and Risk Management

Clinica Sierra Vista Community Health Centers
06.2009 - 10.2013
  • Started with the organization as their Director of Nursing, and was asked to move to become Deputy Chief of Risk Management approximately six months after beginning employment.
  • Managed quality and risk management issues for the Fresno area Community Health Centers. There were eight locations, including primary care, specialty care, dental, radiology, pharmacy, and behavioral health. Participated in the opening of two additional locations.
  • Member of the electronic health record implementation team.
  • Point of contact for patient complaints, insurance audits/surveys, HIPAA concerns, accreditation and regulatory activities, and other investigations by oversight agencies.
  • Became familiar with NCQA, HEDIS, Pay for Performance programs, outpatient billing and required documentation practices, Joint Commission ambulatory accreditation, State of California health programs (Every Woman Counts, Healthcare for the Homeless, etc.), managed care insurance, 340B Pharmacy, and many others.
  • Collaborated with outside agencies for emergency response management. Ensured compliance with CalOSHA workplace requirements.

Education

Bachelor of Science in Nursing - Public Health Nurse certification

California State University, Fresno
Fresno
12.1996

Skills

  • Risk Management and Patient Safety concepts
  • Performance and Quality Improvement
  • Extensive knowledge of Federal and State regulations, Joint Commission accreditation requirements, Medicare/MediCal Conditions of Participation requirements, and insurance and managed care program requirements,
  • Technologically proficient with Windows products, Google products, incident reporting management programs, claims management systems, and multiple electronic health record platforms
  • Customer service
  • Flexible and adaptable
  • Critical thinking
  • Decision-making
  • Direct patient care experience: emergency room, pediatric intensive care, burn center, public health nursing (state program auditor), family and pediatric primary care, case management/utilization review, and school health nursing,

Work Preference

Work Type

Full TimePart Time

Location Preference

On-SiteRemoteHybrid

Timeline

Customer Service

Renew Auto Body & Paint
08.2024 - Current

Nursing Informatics

Valley Children’s Hospital
10.2023 - 01.2024

Legal Nurse Consultant/Clinical Reviewer

EvenUp
06.2023 - 12.2023

Physician Peer Review/Risk Management Coordinator

Saint Agnes Medical Center
01.2022 - 04.2023

Patient Safety Risk Manager

Sierra View Medical Center
08.2020 - 11.2020

Quality Improvement Nurse

NeuroRestorative
10.2019 - 05.2020

Patient Safety Risk Manager

Community Medical Centers
02.2017 - 07.2019

Patient Safety Risk Manager

The Doctors Company
10.2013 - 12.2016

Deputy Chief of Quality and Risk Management

Clinica Sierra Vista Community Health Centers
06.2009 - 10.2013

Bachelor of Science in Nursing - Public Health Nurse certification

California State University, Fresno

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