Misty Brinda

In this role, I work directly with healthcare providers and their offices to improve care quality for Medicare Advantage members. This includes implementing programs, managing provider performance, and closing gaps in care and coding accuracy. The role involves building relationships with providers, analyzing data to identify improvement opportunities, and educating providers on coding and reporting best practices.

Responsibilities:

• Travel to meet providers and discuss UHC/Optum tools and incentive programs
• Build long-term consultative relationships with medical groups and physicians
• Develop provider-specific plans to improve HEDIS performance and risk adjustment
• Analyze data using various reporting tools to prioritize gap closure and educational opportunities
• Conduct chart reviews and provide feedback to improve documentation and coding
• Train provider groups on Stars measures, coding practices, and program administration
• Lead regular meetings to drive process improvement and achieve goals
• Report progress to health plan leadership
• Collaborate with interdisciplinary teams to coordinate member care
• Engage providers in UnitedHealthcare member programs

In my role as a Quality Data Analyst, I work effectively with the clinics, providers, and all levels of staff to help drive the outcomes of value-based care. It is the responsibility of this position to complete all quality reporting in a timely manner meeting the deadlines for each measurement period.

• Responsibilities:
• Analyze clinical quality data and identify patients through reports and chart reviews who have gaps in care, coding gaps and suspect medical conditions
• Provide information and education on coding gaps, suspect conditions, risk adjustment scores, value-based programs and population health initiatives to clinic staff
• Run reports for each quality measure, drilling down into the data to validate accuracy for reporting
• Create education for providers and clinical staff that help to drive quality outcomes. Focusing on preventive care for all our patient populations. Creation of annual wellness visit chart prep education to ensure proper documentation and trained the RN care managers to complete
• Prepare reports and dashboards for performance reporting of clinical quality data
• Managing data and submission through online platforms and portals for each value-based contract for CPG
• Attending monthly meetings and education with each VBP, disseminating information to leadership, providers and staff as appropriate
• Data abstraction from multiple outside EMR’s, ensuring proper documentation of data into EMR. Correcting improper documentation of quality information in patient charts so that it may pull correctly into the reports submitted for quality metrics

As a Practice Manager, I managed the daily operations of the Internal Medicine and Geriatric Service Line which includes Internal Med, Geriatrics, Home Based Primary Care, Palliative Care, and Post-Acute Care.

• Responsibilities:
• Ensuring the operations of the practices run smoothly and are staffed appropriately, covering nursing duties as needed
• Organizing, scheduling and running regular staff meetings in all assigned departments
• Monitoring the budget, overseeing the ordering and retention of supplies for all clinics
• Supervision of 25+ employees including providers, clinical and front desk staff in multiple locations
• Charge reconciliation, billing issues and patient complaints
• Timecards, hiring new staff, coaching and appraisal of employees
• Maintaining focus on quality outcomes and operational performance
• Member of the Primary Care Executive Committee
• Working with the population health team and IT to improve our patient outcomes

As the Practice Coordinator I managed the daily operations of the Internal Medicine and Diabetes clinics. Requiring critical thinking skills, decisive judgement, and the ability to work with minimal supervision in a stressful environment.

• Responsibilities:
• 24-hour accountability for the areas under my management
• Accountable for patient care, clinical outcomes, patient and staff satisfaction
• Managing the CPG float pool, worked on growth and development to create the float pool for all clinics
• Overseeing the retention of office and medical supplies
• Charge reconciliation, billing issues and patient complaints, timecards, hiring new employees, coaching and appraisal of employees, hiring, supervising and appraisal of employees
• Continued work with the population health team, government reporting, workflow development and training staff.
• Running monthly staff meetings in each location
• Delegation of work to the proper staff, covering nursing duties myself as needed
• Organizing the opening of new clinics, moving, and closing of clinics under my management
• Member of the Primary Care Executive Committee

Working as a population health coordinator, I worked within a centralized team helping clinical staff and providers to improve their performance on clinical quality measures in accordance with CMS requirements.

• Responsibilities:
• Tracking and analysis of metric performance for CPC+, ACI, MIPS, PCMH, HEDIS
• Workflow development and training, superuser for HER training
• Data submission and reporting of quality metrics
• Creating and maintaining up to date dashboards for quality, meaningful use/ACI/MU at the clinic and provider levels
• Completion of monthly dashboards for tracking hospital readmissions Updating and tracking controlled substance registries
• Leading daily staff huddles in the clinic, actively participating in all staff meetings
• Communicating effectively with my director, providers, management, and staff
• Serving as a role model within the clinic and organization
• Ability to work independently without direct supervision
• Multitasking, time management, care coordination and prioritizing workflow
• Chart reviews, data abstraction
• Pulling reports, report validation, providing clear information and recommendations to leadership based on the results
• Interim clinic manager duties

Working as a public health coordinator, it was my duty to serve as the nursing clinical expert and resource coordinator in a CPC+ and PCMH primary care office. Ensuring that patient care is provided in a safe and efficient manner.

• Responsibilities:
• Serving as a role model and encouraging mutual support and teamwork among all clinics
• Knowledge of clinical quality measures, meaningful use and PCMH
• Measure reporting and data submission
• Analyzing data and workflow development
• Training new clinical staff members (LPN/RN/MA)
• Performing daily huddles with providers, nurses, and staff
• Superuser for Nextgen EHR
• Process Improvement tracking and analysis
• Ensuring proper documentation within the EHR
• Care coordination and coverage of nursing duties as needed

Working with Internal Medicine Primary Care physicians in a clinic setting. Lead nurse for the primary care nursing team. Earned outstanding employee recognition in 2015. Maintaining a safe and productive work environment for patients and staff.

• Responsibilities:
• Rooming patients, obtaining documenting vitals, medical history, medication reconciliation, administration of medications and immunizations, assisting with procedures, prior authorizations, venipuncture, IV
• Ordering labs, CTs, XRs, any necessary testing ordered by the physician.
• Patient Education, answering medical questions, acting as a liaison between the patient and physician
• Multitasking and prioritizing workflow, triaging patients in the office and over the phone
• Care coordination, scheduling, referral tracking and follow up
• Nextgen super user and trainer, training and onboarding new MA/LPN/RN