Susan Williams

APPM responsible for program implementation and provider performance management which is tracked by designated provider metrics, gap closure and coding accuracy. Works directly with care providers to build relationships, ensures effective education and reporting, identifies improvement opportunities through analysis and discussion, influences provider behavior to achieve needed results. Functions independently, executes applicable provider incentive programs for health plan, data collection, data entry, quality monitoring and data uploads. Ensures quality measures are being closed on a timely manor, develops comprehensive plans to increase HEDIS performance, acts as a lead to pull necessary internal resources together in order to provide appropriate education, coaching and consultation that includes HEDIS/CAPHS/HOS and medication adherence. Coordinate and lead Stars-specific quality meetings and reports to upper leadership.

• Assessed, organized and documented patient data to develop an appropriate plan of care. Instructed patients and families regarding diagnosis, treatment plan and preventative care according to individualized health needs. Interacted with family, physicians and other disciplines regarding patient care. Interact with most insurance companies to meet Hedis Measures and STAR ratings. Work with Aledade and PCMH to reduce cost of care and achieved shared savings, researched and retrieved medical records to close care gaps. Upload needed documents to physicians portals.

• Float nurse responsible for helping on Surgical floor, Generations unit and Rehab unit.

• LPN responsible for patient care, x-rays, EKG’s, lab draws and stress test.