Marquita Rhymes
MHA, RN
Houston,TX
Summary
Strongly motivated registered nurse with proven leadership skills that brings matchless patient care, demonstrated expertise in comprehensive nursing principles, exceptional communication, an administrative mindset and genuine compassion to ensure safe, quality client care.
Overview
4
4
years of professional experience
9
9
years of post-secondary education
2
2
Certifications
Work History
HEDIS Quality Improvement Abstractor
Centene, Superior Health Services
12.2022 - 06.2024
- Reviewing medical records and documents to abstract clinical data for HEDIS reporting.
- Researching any discrepancies found by reviewing medical records, claims data and any other relevant information
- Documenting findings in applicable HEDIS databases and on prescribed cloud-based platforms.
Quality Control Analyst
Maximus- VES Services
07.2022 - 12.2023
- Reviews and submits veterans' VA Compensation and Pension reports and diagnostics for general medical, ophthalmological, psychology, audiological, otolaryngology, and dental exams.
- Acts as liaison and company representative between clients and physicians.
- Drafts MES addendums, QA addendums, VA clarifications and abnormal letters.
- Ensures each report meets VA's strict rating requirements prior to submission to VA.
- Arranges delivery of final reports to VA in an efficient and timely manner.
Outreach and Engagement Specialist
Eleanor Health
05.2022 - 09.2022
- Perform initial and ongoing virtual outreach to a prequalified cohort of potential members with the goal of engaging them in care
- Utilize motivational interviewing techniques to understand the needs and barriers to care for assigned potential members, and work cross-functionally with other team members and care teams to address these needs & remove barriers.
- Track all interactions with potential members in a centralized CRM platform with high-quality documentation and attention to detail.
Licensed Practical Nurse/HEDIS Review Nurse
Worldwide Travel Staffing
07.2020 - 04.2022
- Provided medically prescribed services and care including medication administration, wound care, and other treatments
- Supervised, trained and developed incoming nurses and nursing aids
- Collaborated with interdisciplinary team of healthcare and social service providers to address patients' needs through effective intervention and care planning.
- Completed minimum data set assessments
- Worked under the supervision of HEDIS staff to ensure medical records were abstracted in a timely and accurate manner
- Performed medical record reviews with charts collected from provider offices, clinics and hospitals
- Reviewed, analyzed and compiled patient files and abstracted key data and information as part of healthcare reporting requirements
CDC-Info Correspondence/IRS Supervisor
Maximus
04.2020 - 11.2021
- Supervised the work of CSRs to ensure adherence to quality standards, deadlines, and proper procedures
- Assigned duties and evaluated employees’ job performance
- Issued corrective actions as needed
- Monitored call quality and provided individual constructive feedback to enhance performance and address areas in need of improvement.
Direct Access Coordinator
Hattiesburg Clinic
01.2020 - 06.2020
- Coordinated colon cancer screening referrals from internal and external providers
- Determined patient eligibility and obtained prior authorization for testing and procedures
- Provided direct or indirect nursing care to patients who presented with urgent, emergency, or potential health problems
Education
Associate of Science - Nursing
Pearl River Community College
Hattiesburg, MS 08.2021 - 08.2022
Practical Nursing -
Pearl River Community College
Hattiesburg, MS 08.2018 - 07.2019
Master of Science - Health Administration
Belhaven University
Jackson, MS 01.2014 - 05.2016
Bachelor of Science - Health Policy and Administration
The University of Southern Mississippi
Hattiesburg, MS 08.2009 - 12.2013
Skills
- Quality assurance
Documentation expertise
EMR/EHR expertise
Medical Record Review
Data Abstraction
Case Management
Verbal and written communication
HEDIS
Certification
CPR/BLS Certification
Timeline
HEDIS Quality Improvement Abstractor
Centene, Superior Health Services
12.2022 - 06.2024
CPR/BLS Certification
08-2022
Quality Control Analyst
Maximus- VES Services
07.2022 - 12.2023
Outreach and Engagement Specialist
Eleanor Health
05.2022 - 09.2022
Associate of Science - Nursing
Pearl River Community College
08.2021 - 08.2022
Licensed Practical Nurse/HEDIS Review Nurse
Worldwide Travel Staffing
07.2020 - 04.2022
CDC-Info Correspondence/IRS Supervisor
Maximus
04.2020 - 11.2021
Direct Access Coordinator
Hattiesburg Clinic
01.2020 - 06.2020
Practical Nursing -
Pearl River Community College
08.2018 - 07.2019
Graduate Certificate in Human Resources
08-2018
Master of Science - Health Administration
Belhaven University
01.2014 - 05.2016
Bachelor of Science - Health Policy and Administration
The University of Southern Mississippi
08.2009 - 12.2013
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