Nadia Ince-Lovelace

• Launched medical practice that served 117 facilities -community, assisted living, and nursing homes.
• Designed and oversaw various clinical programs supporting clinicians across 6 states, while ensuring progressive clinical excellence through education, orientation, evaluations, etc
• Created and operationalized workflows for programs - Affordable Care Organization (ACO), Institutional Special Needs (ISNP), Case Management (CM), Chronic Care Management (CCM), and Fee for Service (FFS) clinical programs.
• Developed and executed operational strategies, clinical policies, and procedures to ensure quality services, compliance with regulations, audit tools, compliance monitoring, and adherence to current standards of practice.
• Directed clinical programs and collaborated with executive team to identify and implement standardized clinical models and protocols to enhance quality of patient care.
• Implemented data-driven approaches to clinical decision-making, leveraging analytics and performance metrics
• Oversaw selection and implementation of electronic medical record system that supported multiple lines of business.
• Built and fostered strong relationships with key stakeholders, including physicians, nurses, regulators, and community leaders, to drive collaboration in achieving clinical and organizational goals.
• Executed tactical initiatives to optimize clinical coding, resulting in $12M from 2021 HCC documentation.
• Developed education programs to improve patient outcomes and quality of care.
• Established, directed, and implemented evidence-based standards of practice, clinical operations, and financial controls.
• Created an auditing process to ensure Medicare & Medicaid internal documentation compliance of 95%
• Identified problematic systems and process issues, developed plans to improve, and monitored outcomes.
• Founded performance- and merit-based evaluation system to assess staff outcomes

• Executed contract negotiations and managed vendor relationships in alignment with quality initiatives.
• Led interdisciplinary committees across 5 states and multiple product lines to enhance quality outcomes, resulting in the prevention of $220M loss of quality withheld funds.
• Identified and implemented best practices, translating outcomes into tactical initiatives to drive business impact.
• Oversaw operational and administrative duties to ensure adherence to regulatory requirements.
• Analyzed data outputs to identify key insights to drive business performance.
• Chaired quality review meetings to review the effectiveness of performance mitigating risk, improving throughput, and achieving patient satisfaction.
• Improved Medicare Plan Star results from 2 to 4 Star.

• Led a coding and HEDIS team in providing business partner support across 34 states.
• Directed a cross-functional team to generate technical wireframes, solutions, and workflows.
• Produced quality reporting, analysis, and auditing to ensure adherence to quality standards and regulatory requirements.
• Identified process improvement opportunities and implemented solutions to enhance business performance.
• Project managed the technical and operational aspects of a coding business solution program 6 months before the expected deadline.
• Created policies, procedures, and workflows to support regulatory compliance.
• Conducted orientation, and performance evaluations; and fostered team development and engagement.
• Audited to verify proper integration of technical solutions and assets.
• Cultivated strong relationships and salvaged multiple business contracts.

• Collaborated with the clinical executive team to develop staffing strategy, meeting productivity, and budget goals.
• Completed annual business planning, forecasting, achieving revenue goals, and optimizing costs.
• Led cross-departmental strategies to achieve productivity and contribution margin of $10.2M
• Initiated and chaired the employee engagement committee, resulting in the improvement of employee engagement scores from 80% to 93%.
• Designed and implemented a training and audit program, achieving improved audit performance from 62% to 96% within six months.
• Developed and maintained the policy and procedure process, ensuring compliance with regulatory requirements
• Negotiated contractual content to align with customer and accrediting agencies' mandates, ensuring compliance and successful audits.
• Formulated and optimized efficient processes to comply with accrediting agencies (HSAG, CMS, NCQA, HEDIS, etc.) and contractual agreements.
• Created educational tools and conducted training sessions for peers and staff, fostering learning and development opportunities.
• Streamlined clinical management processes and techniques to maximize quality outcomes, - 5 STAR plan rating, and revenue cycle - $10M profit.

• Developed periodic performance reviews, policies, procedures, and institution education plans for multiple departments.
• Facilitated all aspects of hospital system representation for The Joint Commission (TJC) , National Committee for Quality Assurance (NCQA) , Ohio Department of Health (ODH) and Centers for Medicare and Medicaid Services (CMS) onsite or virtual surveys.
• Created and generated online institution-wide education to ensure regulatory compliance.
• Headed direct project management of accreditation compliance programs for all Cleveland Clinic hospitals.
• Oversaw the integration of data from 11 Managers to align process improvement and compliance Initiatives
• Directed routine audits to evaluate levels of compliance to maintain 95% outcomes.
• Coordinated quality strategies with Nursing Magnet programs.

• Coordinated and maintained performance improvement

programs for multiple departments and committees.

• Forecasted opportunities to improve surgical outcomes.
• Collaborated with interdisciplinary teams to implement Patient Safety Checklist which decreased the surgery infection rate.
• Orchestrated process improvement projects that directly impacted value-based reimbursement.
• Maintained physician ongoing credentialing process.
• Participated in the accrediting process and onsite surveys from outside agencies – Joint Commission, Center of Medicare & Medicaid, and Ohio Department of Health.

• Advocated for patients by communicating care preferences to practitioners, verifying interventions met treatment goals and identifying insurance coverage limitations.
• Conferred with physicians to discuss diagnoses and devise well-coordinated treatment approaches.
• Administered medications via oral, IV, and intramuscular injections and monitored responses.
• Educated patients, families, and caregivers on diagnosis and prognosis, treatment options, disease process, and management and lifestyle options.
• Collected blood, tissue, and other laboratory specimens and prepared for lab testing.
• Monitored patient condition by interpreting and tracking EKG readings, identifying irregular telemetry readings, and updating team members on changes in stability or acuity.
• Provided exceptional care to high-acute patients needing complex care such as ventilator management, extensive wound care, and rehabilitation.
• Documented treatments delivered, medications and IVs administered, discharge instructions, and follow-up care.
• Delivered a high level of quality care to diverse populations while overseeing patient admission and triaging based on acuity and appropriate department admission.
• Promoted patient and family comfort during challenging recoveries to enhance healing and eliminate non-compliance problems.

• Facilitated performance improvement teams and analysis projects - Root Cause Analysis, FEMA, PDCA/Focus.
• Mobilized performance improvement programs for Internal Medicine, Obstetrics & Gynecology, Neonatology, Surgery, Anesthesia, & Emergency Department.
• Fostered peer review process for the Departments of Surgery, Obstetrics & Gynecology & Anesthesia.
• Educated clinical staff on newly implemented policies, procedures, and the electronic medical record (EMR-EPIC)
• Constructed clinical protocols within electronic medical record
• Collaborated with Risk Management to prepare presentations for executive leadership or litigation
• Evaluated current processes to develop improvement plans.
• Produced detailed reports for use in making business decisions.
• Performed data analysis to assess business trends.
• Reviewed internal systems and organized training plans to address areas of improvement.

• Directed a department of 12 employees.
• Maintained a database of concurrent and retrospective clinical record reviews.
• Aggregated data and designed custom reports for interdisciplinary leadership.
• Achieved and maintained validations scores ≥ 96%.
• Prepared presentations and analysis of data for Joint Commission and Centers of Medicare & Medicaid initiatives.
• Developed efficient systems and workflows to meet internal and external standards that affected hospital reimbursement.
• ·Achieved staffing, departmental goals and needs under established department budget.
• Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
• Monitored workflow to improve employee time management and increase productivity.
• Evaluated employee performance and coached and trained to improve weak areas.

• Collected data to support Core Measures and other value-based performance programs.
• Performed observations and evaluated supporting documents to supplement audit findings.
• Worked closely with subject matter experts to develop solutions and improvements for clinical systems.
• Researched and validated clinical data.
• Followed established auditing processes to meet internal and regulatory requirements.
• Planned audits and audit activities to allocate necessary resources and determine theconsistency of plans with audit objectives.