Shawna Urashima
Kailua
Summary
Motivated healthcare professional with a strong focus on quality improvement, operational leadership, and performance excellence. Demonstrated experience leading teams, driving continuous improvement initiatives, and fostering cross-functional collaboration. Seeking a Quality Improvement Manager role to leverage leadership expertise and advance organizational quality outcomes.
Overview
12
12
years of professional experience
Work History
Supervisor, Quality Improvement
Centene Corporation
06.2024 - Current
- Provides leadership and oversight of quality initiatives supporting organizational performance, regulatory compliance, and continuous improvement.
- Supervises Quality Improvement staff, ensuring accuracy, timeliness, accountability, and alignment with federal, state, and accreditation standards.
- Leads performance improvement projects, audits, and quality reviews to identify gaps and drive measurable outcomes.
- Analyzes qualitative and quantitative data, including member complaints, surveys, and access-to-care metrics, to identify trends and conduct root cause analysis.
- Collaborates cross-functionally with Provider Relations, Clinical Operations, Behavioral Health, and Compliance to implement and sustain improvement strategies.
- Ensures audit readiness through comprehensive documentation, timely reporting, and adherence to regulatory requirements.
- Develops and enhances policies, procedures, and workflows to improve efficiency and standardization.
- Communicates quality findings, progress, and outcomes to leadership to support improvements in member experience and service delivery.
Quality Improvement Specialist
Centene Corporation
01.2022 - Current
- Analyzes, updates, and modifies procedures and processes to continually improve QI operations to maintain contractual and accreditation requirements.
- Manages and monitors quality improvement initiatives including, but not limited to, development and implementation of preventive health and chronic outcome improvement interventions.
- Monitors and investigates all quality of care concerns and collaborates with medical directors to determine impacts and next steps for actions.
- Monitors quality complaints to identify trends and educational opportunities for improvement.
- Assists in implementation of market specific strategies that improve the quality and outcomes of member's care.
- Trains, mentors, and provides guidance to new and current Quality Improvement Specialists and Patient Care Advocates regarding policy and procedure, systematic tools, workload and best practices.
- Participates and coordinates various Quality committees and work groups convened to improve process and/or health outcomes, and contributes meaningful detail based on functional knowledge.
Case Manager, Service Coordinator
Hawaii Medical Services Association
01.2020 - 01.2022
- Responsible for assessing patient needs, developing a person-centered Health Action Plan, and facilitating the delivery of appropriate physical and behavioral health services across the continuum of the health coordination services.
- Developed appropriate care plans for at-risk individuals and high-risk families.
- Collaborated with various healthcare providers to facilitate delivery of services.
- Partnered with clients to develop reachable goals and reasonable action lists for individualized service plans.
- Optimized program resource utilization to prevent unnecessary hospital admissions.
- Collaborated with different disciplines to provide cohesive care to patients.
- Lowered costs while improving care quality by coordinating services and collaborating with dedicated healthcare team.
- Experience with medical insurance prior authorization procedures.
Registered Nurse
Adventist Health Castle
01.2017 - 01.2020
- Administered oral, intramuscular and IV medications to patients and assessed, monitored, and documented patient conditions.
- Coordinated care with an interdisciplinary team including physicians, pharmacists, case management, rehab therapies, and other clinical staff to prepare for treatment, carry out interventions and enhance continuum of care to deliver comprehensive services.
- Developed and adapted individualized treatment plans according to patient recovery goals.
- Educated patients and families on treatment strategies and at-home care.
- Delivered high-quality nursing care to patients on 34-bed medical-surgical unit with emphasis on a wide range of specialties including orthopedics, urology, respiratory, systemic, palliative, gastrointestinal, and post-operative patients.
- Assessed patients in active drug and alcohol withdrawal and provided interventions to manage physical and psychological withdrawal symptoms.
- Oversaw patient admission and discharge processes to coordinate efficient movements and related paperwork.
Part-time Teacher
Hawaii State Department Of Education
01.2014 - 01.2016
- Identified early signs of emotional, developmental and health delays or problems in students.
- Collaborated with the Hawaii Community Foundation to identify and educate at risk youth through positive outreach programs such as Why Try, nutrition education, and peer pressure management.
- Connected parents to child's education through regular home visits, individual behavior support plans, and quarterly parent meetings.
- Established positive relationships with students, parents, fellow teachers and school administrators.
- Identified and documented learning achievements by reporting outcomes, performance information and program adjustments used to boost comprehension.
- Worked one-on-one with struggling students to design individualized lesson plans to increase progress.
- Combined discipline plan with effective measures and lesson plans to increase concentration, participation and progress student accountability.
Education
Bachelor of Science - Nursing
University of Hawaii At Manoa
Honolulu01.2017
Bachelor of Arts - Psychology
University of Hawaii At Manoa
Honolulu01.2011
Skills
- Quality & Performance Improvement
- Regulatory Compliance & Accreditation Readiness
- Process Enhancement & Outcome Analysis
- Cross-Functional & Interdisciplinary Leadership
- Staff Training, Mentoring & Development
- Root Cause Analysis & Corrective Action Planning
Timeline
Supervisor, Quality Improvement
Centene Corporation
06.2024 - Current
Quality Improvement Specialist
Centene Corporation
01.2022 - Current
Case Manager, Service Coordinator
Hawaii Medical Services Association
01.2020 - 01.2022
Registered Nurse
Adventist Health Castle
01.2017 - 01.2020
Part-time Teacher
Hawaii State Department Of Education
01.2014 - 01.2016
Bachelor of Arts - Psychology
University of Hawaii At Manoa
Bachelor of Science - Nursing
University of Hawaii At Manoa