Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

SHELBY JANSEN

Wayland,MI

Summary

Seasoned and multifaceted professional with a diverse skill set encompassing project management, health information management, and data quality. Dedicated to cultivating collaborative environments that empower individuals and stakeholders to innovate. Passionate about enhancing patient healthcare journeys through quality improvement, project management, and leadership.

Overview

9
9
years of professional experience
1
1
Certification

Work History

Operational Specialist

Priority Health
11.2022 - Current
  • Act as data product owner and scrum master for Healthcare Effectiveness Data and Information Set (HEDIS) data team
  • Led cross-functional teams during complex projects ensuring clear communication lines were maintained throughout all stages.
  • Created detailed project plans outlining timelines, milestones, resources, and deliverables for successful execution
  • Implemented new software systems to optimize data management and reporting capabilities, increasing overall efficiency.
  • Generated reports detailing findings and recommendations for internal and external stakeholders and leadership.
  • Managed budgets for multiple projects, ensuring timely completion within allocated funds.

Project Specialist

Priority Health
05.2021 - 11.2022
  • Managed multiple quality improvement projects simultaneously, ensuring timely completion and high-quality output.
  • Collaborated with data teams and external stakeholders to onboard new data sources for HEDIS
  • Developed policies and procedures for HEDIS processes and applications.
  • Act as vendor liaison for HEDIS and PIP programs.

HEDIS Consultant

Priority Health
01.2021 - 05.2021
  • Investigated and corrected data required for medical requests sent to providers
  • Provided administrative support to meet goals and standards set by NCQA
  • Created training processes and tutorials for team on various software and tools.

Inpatient Scheduler

Mary Free Bed Rehabilitation Hospital
05.2019 - 07.2021
  • Ensured therapy compliance for inpatients according to their health plans
  • Scheduled appointments using WellSky and Cerner scheduling systems
  • Served as a scribe for physicians during interdisciplinary meetings.

Equipment and Department Coordinator

Mary Free Bed Rehabilitation Hospital
01.2017 - 08.2018
  • Facilitated communication between patients, physicians, health plans, and equipment suppliers to ensure timely provision of durable medical equipment
  • Coordinated discharge plans with multiple disciplines and resolved related issues.

Medicare Biller and Rehabilitation Specialist

Airway Oxygen
11.2014 - 01.2017
  • Facilitated communication between patients, physicians, health plans, and equipment suppliers to ensure timely provision of durable medical equipment
  • Coordinated discharge plans with multiple disciplines and resolved related issues.

Education

Bachelor of Science in Health Information Management and Computer Information Systems -

Grand Valley State University
Allendale
04.2021

Skills

  • Project Management - JIRA Agile Kanban
  • Applications - MS Office Suite Salesforce Tableau EPIC Cerner SharePoint
  • Medical Coding – ICD 10-CM ICD 10-PCS CPT HCPCS
  • Humanities – Interpersonal communication Innovative Data-driven decision-making Resourceful

Certification

  • Grand Valley State University Health Information Management Advisory Board November 2023- Present
  • Priority Health Mentorship Circle Program 2023
  • Athena Health Advocate Champion November 2022 - Present
  • Registered Health Information Management Administrator (RHIA), August 2021
  • Mental Health First Aid - 2021

Timeline

Operational Specialist

Priority Health
11.2022 - Current

Project Specialist

Priority Health
05.2021 - 11.2022

HEDIS Consultant

Priority Health
01.2021 - 05.2021

Inpatient Scheduler

Mary Free Bed Rehabilitation Hospital
05.2019 - 07.2021

Equipment and Department Coordinator

Mary Free Bed Rehabilitation Hospital
01.2017 - 08.2018

Medicare Biller and Rehabilitation Specialist

Airway Oxygen
11.2014 - 01.2017

Bachelor of Science in Health Information Management and Computer Information Systems -

Grand Valley State University

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SHELBY JANSEN