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
2022.12 - 2024.06
- 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
2022.07 - 2023.12
- 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
2022.05 - 2022.09
- 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
2020.07 - 2022.04
- 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
2020.04 - 2021.11
- 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
2020.01 - 2020.06
- 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 2021.08 - 2022.08
Practical Nursing -
Pearl River Community College
Hattiesburg, MS 2018.08 - 2019.07
Master of Science - Health Administration
Belhaven University
Jackson, MS 2014.01 - 2016.05
Bachelor of Science - Health Policy and Administration
The University of Southern Mississippi
Hattiesburg, MS 2009.08 - 2013.12
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
2022.12 - 2024.06
CPR/BLS Certification
2022-08
Quality Control Analyst
Maximus- VES Services
2022.07 - 2023.12
Outreach and Engagement Specialist
Eleanor Health
2022.05 - 2022.09
Associate of Science - Nursing
Pearl River Community College
2021.08 - 2022.08
Licensed Practical Nurse/HEDIS Review Nurse
Worldwide Travel Staffing
2020.07 - 2022.04
CDC-Info Correspondence/IRS Supervisor
Maximus
2020.04 - 2021.11
Direct Access Coordinator
Hattiesburg Clinic
2020.01 - 2020.06
Practical Nursing -
Pearl River Community College
2018.08 - 2019.07
Graduate Certificate in Human Resources
2018-08
Master of Science - Health Administration
Belhaven University
2014.01 - 2016.05
Bachelor of Science - Health Policy and Administration
The University of Southern Mississippi
2009.08 - 2013.12