Nancy Ahmad
Rochester,NY
Summary
Dynamic Quality Improvement Specialist with a proven track record at Mass General Brigham Health Plan, excelling in HEDIS and CMS quality measures. Adept at cross-functional collaboration and data analysis, I drive impactful initiatives that enhance patient experience and operational efficiency, fostering a culture of continuous improvement within healthcare settings. Experienced Quality Improvement Specialist with a background in implementing and monitoring quality control systems. Strengths include problem-solving, data analysis and project management skills. Previous work involved identifying areas of improvement, designing innovative solutions for enhancing quality and efficiency, and fostering a culture of continuous improvement.
Overview
14
14
years of professional experience
Work History
Quality Improvement Specialist
Mass General Brigham Health Plan
Somerville, MA
08.2022 - Current
- Developed quality improvement plans for healthcare services within the health plan.
- Collaborated with cross-functional teams to enhance operational processes.
- Supported the implementation of new quality assurance initiatives across departments.
- Coordinated meetings to discuss progress on quality improvement projects and initiatives.
- Evaluated existing processes and procedures for effectiveness in meeting desired objectives.
- Analyzed trends in performance data collected through various methods such as root cause analysis or failure mode effects analysis.
- Trained personnel on best practices in order to promote a culture of continuous improvement within the organization.
- Reviewed customer feedback forms and used them as input when developing new strategies for improving services offered.
Preventive Care Coordinator and Stars Quality Improvement Manager
Medical Group of Central Georgia
01.2012 - 10.2021
- Built Quality Team including nurses, coders, providers, and data analyst to complete individual tasks within quality program.
- Defined goals and improvement strategies based on Stars rating within the practice and ACO.
- Implemented practices to be included within office workflow, from time of patient check-in through visit and billing process.
- Worked with each department of medical facilities to ensure quality measures would be met.
- Met with providers personally to explain suspect condition strategy and RAF score.
- Worked with EMR company to map quality measures and strategies into progress notes.
- Created forms for each aspect of preventative care and quality improvement for providers, nurses, front office staff, and patients.
- Worked with IPA to implement new strategies for ACO to improve overall Star rating.
- Led training sessions for staff on use of quality related CPT II codes to ensure capture of completed care gaps.
- Created forms and templates for Medicare Wellness visits, making it easier for providers and staff to complete visit with the most detail.
- Completed data analysis (from payer portals and practice EMR) of individual provider and overall practice quality scores each month, from which created plans to improve scores.
Education
Bachelors of Science - Biology
Georgia State University
01.2013
Skills
- HEDIS
- Emphasis in provider engagement and education
- CMS quality measures
- Member/Patient Experience Initiatives and Improvement implementation
- Excellent communication skills
- Proficient in all Microsoft applications
- Ability to plan and strategize
- Ability to implement practices
- Quality assurance
- Data analysis
- Bilingual in American English and Arabic
- Risk assessment
- Cross-functional collaboration
- Performance evaluation
- Customer feedback integration
- Attention to detail
- Team leadership
- Workflow optimization
References
Available upon request
Languages
English
Native/ Bilingual
Arabic
Native/ Bilingual
Timeline
Quality Improvement Specialist
Mass General Brigham Health Plan
08.2022 - Current
Preventive Care Coordinator and Stars Quality Improvement Manager
Medical Group of Central Georgia
01.2012 - 10.2021
Bachelors of Science - Biology
Georgia State University