Vanessa McAlmon
Brooklyn,NY
Summary
Bilingual medical professional with a strong desire to excel in a professional environment and leverage skills to their fullest potential. Committed to making a significant impact within a prominent organization by ensuring the delivery of high-quality healthcare services. Personable and dedicated professional passionate about enhancing healthcare quality and improving patient outcomes. Extensive knowledge of clinical guidelines and patient safety protocols, possessing strong analytical and data interpretation skills. Ready to drive meaningful improvements in clinical practices and enhance the overall quality of patient care.
Overview
19
19
years of professional experience
4
4
years of post-secondary education
Work History
Clinical Quality Improvement Specialist
Centene Fidelis
Remote, New York, NY
11.2023 - 05.2024
- First reader responsible for data entry in Company Tool
- Data entry into CITRIX, INOVALON, QCAT & COTIVITI Data Entry interfaces
- Experience in HEDIS Supplemental, Admin, and Hybrid Measures
- Specializing in WCC, IMA, CIS, CCS, CBP, HBD, COA, and CHL measures
- Promoted a culture of continuous improvement by identifying GAPS in provider education and accurately interpreting NCQA general guidelines for meeting measures each season.
- Collaborated with interdisciplinary teams to establish evidence-based practices and emphasized utilizing shared EMR systems to improve workflow efficiency and accuracy in documenting.
ABSTRACTION & OVERREAD QUALITY ANALYST
RUSSELL TOBIN-PRIDE HEALTH
Remote, New York, NY
01.2024 - 04.2024
- First reader responsible for data entry in CHANGE HEALTHCARE PORTAL
- Experienced entering data entry into DATAVANT, CIOX, INOVALON, QMRM & RATELIFT/RATEMAX Data interfaces
- Detailed knowledge of HEDIS Supplemental, Admin, and Hybrid Measures
- Key measures of influence: CBP, HBD, COA, COL, and BPD measures
- Ensured product compliance with industry standards, meticulously reviewing NCQA specifications, and maintaining adherence to execution of CAHPS.
- Adoption of multi-system workarounds during system recalibrations and maintained 95-100% abstraction score.
- Optimized resource utilization by effectively prioritizing tasks based on project timelines and risk assessment outcomes.
- Adapted and revised checklists, and job aids to reduce errors in measure sspecific abstraction.
- Ensured compliance with regulatory requirements by meticulously reviewing documentation and maintaining accurate spreadsheet displaying records of accuracy.
Clinical Quality Improvement Specialist
Centene Fidelis
Remote, New York, NY
12.2022 - 05.2023
- First reader responsible for data entry in company Tool
- Data entry into CITRIX system & COTIVITI
- Experience in HEDIS Admin and Hybrid Measures
- Specializing in WCC, BCS, IMA, CIS, COL, LSC, CCS, CBP, COA, and CHL measures
- Provider education for meeting measures
- Receipt, review, and audits of medical records maintained via EMR for Supplemental & Q.A.R.R
Nurse Quality Improvement Specialist
EmblemHealth
Melville, NY
01.2017 - 05.2017
- Adoption of HCC coding practices 85-95 % to aid in identifying members with chronic and acute conditions Under CMS GUIDELINES
- Initial reviewer over reader, and seasoned QA
- Field Retrieval, data selection, and uploads
- Experience in HEDIS Admin and Hybrid Measures
- Specializing in WCC, AWC, IMA, CIS, ABA, CCS, CBP, MRP, PPC, and FPC measures
- Evaluated 100% of patient histories, complaints, and both past and current symptoms for potential application of service dates to the abstraction process.
- Educated provider on effective and compliant documentation of disease management, patient self-care techniques, and wellness strategies to improve long-term health outcomes to achieve health plan compliance.
Nurse
Bed-Stuy Family Health Center
Brooklyn, NY
10.2013 - 08.2016
- Scheduling union staff for breaks/meals & providing coverage for the Doctors at these times.
- Triage walk-in patients and assign them to available physicians for treatment.
- Administering vaccines from 4-weeks-old to 75 years+ and collecting blood and urine for examination
- Scheduling emergency appointments for patients on a case-by-case basis
- Scheduling emergency appointments for patients on a case-by-case basis.
- Specializing in CCS, WCC, AWC, IMA, CIS, COL, CBP, W34, W15 and PPC.
- Participate in provider and staff education to meet HEDIS and QARR measures.
- Offered exceptional care and support to patients and their families recovering from acute incidents and dealing with chronic conditions.
Per Diem Overnight Nurse Supervisor
Pride Health Staffing Agency
New York, NY
09.2010 - 04.2016
- Responsibilities included but were not limited to Medication administration
- Intake of new clients including chemical dependency history & usage and continuous monitoring of all clients for signs & symptoms of withdrawal/ relapse.
- Client education on overcoming substance/ abuse/ daily charting of client progress & behaviors and included but was not limited to the management & maintenance of any known chronic illnesses
- Initiated improved collaboration between nurses and physicians resulting in more effective treatment strategies being implemented swiftly.
- Trained, evaluated, and coached clinical staff to improve performance.
- Collaborated with interdisciplinary teams to develop comprehensive treatment plans for complex patients, resulting in better health outcomes.
- Worked at least [250] hours per month as a per-diem intake nurse to maintain satisfaction with patient care standards.
Charge Nurse
Buena Vida CC&RC
Brooklyn, NY
08.2011 - 06.2014
- Receive24-hour reports from outgoing nurses on duty, check functionality, and maintain all essential equipment on the assigned unit
- Conduct rounds with the staff and ensure all residents are accounted for and alert and responsive
- Administer assigned medications and document administration using SIGMACARE EMR system
Per-Diem LPN/ Phlebotomist
Dr. Karin Kalkstein, M.D.
Bayside, NY
10.2008 - 12.2011
- Senior phlebotomist Responsible for order of drawing & centrifuging specimens
- Assisted the doctor with pap smears, triage, patient counseling, and non-surgical termination of pregnancy
- Patient Room Maintenance & preparation
- Patient education & teachings
Lindenwood Center Assistant Care Team Supervisor
Preferred Health Partners
Brooklyn, NY
03.2011 - 10.2011
- Liaison between Physicians and patients- staff and administration
- Responsible for maintaining patient flow into and out of doctor's office
- Scheduling union staff for breaks/meals & providing adequate coverage for the Doctors at these times
- Use of Nex-Gen EMR/EPM system to schedule appointments, referrals, follow-ups, and immunizations
- As per individual MD request, discuss lab results and treatment protocols with patients
- HEDIS Measures compliance liaison, chart review, and data collection
- Educate diabetic patients on different forms of insulin & how to administer use of glucometer
- Ensuring staff Maintains HIPPA compliance at all times
- Insurance verification & initiating online prior authorizations and referrals for patients
- Reviewing Physician's schedule up to three days ahead and huddling with doctor to ensure all pertinent labs and consultations are available during visit
Charge Nurse-LPN/ MEDPASS
AHRC Bloomberg
Jamaica, NY
04.2010 - 10.2010
- Responsible for Narcotic count & maintenance
- Knowing & maintaining residents status on24hr report & endorsing to nurse superior
- Initiating and documenting interventions as per MD protocol & orders
Charge Nurse- LPN
HHC Coler-Goldwater Memorial Hospital
Roosevelt Island, NY
10.2008 - 01.2010
- Responsible for narcotic distribution to residents on the unit
- Maintaining and updating the unit's24-hour report
- Preparing residents for appointments and transcribing MD orders
- Administering medical and chemical Treatments and care to chemically dependent patients
Charge Nurse- LPN
Pro Med Staffing Agency
New York, NY
06.2009 - 09.2009
- Patient Teachings, Breastfeeding techniques & posture, Contraceptive options
- Responsible for patient room stock, maintenance & preparation
- Facilitation of Fetal Monitoring as per Obstetrician/ Midwife orders
- Vaccinations (HPV), Depo & PPD implantation, PPD readings & Other I.M
- Injections
- HEDIS compliance liaison for OBGYN Dept
Office Manager/ Phlebotomist
Dr. Karin Kalkstein, M.D.
Bayside, NY
11.2006 - 10.2008
- Liaison between the doctor, the specialist, and the patient for optimal patient care
- Primary phlebotomist at the office
- Utilized Lytec Medical Management system to add and manage patients at the practice
- Performed electronic referrals and insurance verification online and telephonically
- Assisted the doctor with pap smears, triage, patient counseling, and non-surgical termination of pregnancy
Internal Medicine & Gastroenterology Office Manager
Dr. George Weingarten F.A.C.G.
Manhattan, NY
06.2005 - 11.2005
- Delivered outstanding customer service by addressing client inquiries and concerns through phone calls and email.
- The Office Manager oversees all office matters and manages the clinical care of patients
- Assist the doctor with over 50% of colonoscopies and endoscopic procedures
- Performed electronic referrals and insurance online verification
- Conducted regular inventory 1-2 times weekly for the assessments of office supplies, and clinical items essential to practice function.
Education
Bachelor of Science - Accelerated Bachelors in Nursing
Berkeley College
Woodland Park, NJ 08.2024 - Current
Associate of Arts - Pre Medical
Adelphi University
Garden City, NY 08.2016 - 12.2017
Licensed Practical Nurse Diploma - License Practical Nurse
Goldwater LPN Program
Roosevelt Island, NY 09.2007 - 06.2008
No Degree - Psychology
LaGuardia Community College
Long Is. City, NY 08.2006 - 08.2007
No Degree - National Certified Medical Assistant W/ Phlebotomy & EKG
Allen School
Jamaica, NY 09.2006 - 07.2007
Skills
- Phlebotomy-(Capillary and Venipuncture)
- Electrocardiogram (EKG)/ Holter Monitor
- Hematology/CBC, IV placement-Infusion
- Vital Signs/Direct Patient Care
- Urinalysis/Blood Culture/Testing
- Bone Density/Pap Smear Prep & Asst
- Vaccine Administration & PPD Application/Reading
- Colonoscopy/Endoscopic Assistant
- Non-Surgical Aspiration Assistant
- Autoclave Technician
- GT feedings, catheterizations, wound care
- Interdisciplinary collaboration
- Auditing and monitoring
- Teamwork and collaboration
- Customer service
- Appointment Scheduling
- Data Entry/Patient Charting
- Typing (Microsoft Word)
- Filing Faxing/Photocopying
- Benefit/Insurance Verification
- Lab Requisition Form completions
- Centrifuging/ Autoclaving Multi-line Phone System
- Monitoring of virtual & digital inboxes for providers
- Procurement of supplies & management of distribution
- Inventory/Order of Supplies
- Create/Manage Online EVR Portfolio
- Knowledge of Next-Gen EMR/EPM
- Knowledge of EPIC/ ECW/ SIGMACARE
- Patient safety
- Quality metrics
- Healthcare regulations
- Workflow optimization
- Problem-solving
- Time management
- Attention to detail
- Critical thinking
- Excellent communication
- Skills for effective organization
- Reliability
Awards
U.S. Congressional Honoree, Awards received, Honor Roll student, Perfect Attendance Certificate, Certificate of Excellence
Accomplishments
1/24/2010 U.S. Congressional Honoree
Awards received, Honor Roll student, Perfect Attendance Certificate, Certificate of Excellence
Certification
- Certified Medical Assistant (CMA)
- [Phlebotomy certification]
- Licensed Practical Nurse (LPN) - [NY] Board of Nursing.
Timeline
Bachelor of Science - Accelerated Bachelors in Nursing
Berkeley College
08.2024 - Current
ABSTRACTION & OVERREAD QUALITY ANALYST
RUSSELL TOBIN-PRIDE HEALTH
01.2024 - 04.2024
Clinical Quality Improvement Specialist
Centene Fidelis
11.2023 - 05.2024
Clinical Quality Improvement Specialist
Centene Fidelis
12.2022 - 05.2023
Nurse Quality Improvement Specialist
EmblemHealth
01.2017 - 05.2017
Associate of Arts - Pre Medical
Adelphi University
08.2016 - 12.2017
Nurse
Bed-Stuy Family Health Center
10.2013 - 08.2016
Charge Nurse
Buena Vida CC&RC
08.2011 - 06.2014
Lindenwood Center Assistant Care Team Supervisor
Preferred Health Partners
03.2011 - 10.2011
Per Diem Overnight Nurse Supervisor
Pride Health Staffing Agency
09.2010 - 04.2016
Charge Nurse-LPN/ MEDPASS
AHRC Bloomberg
04.2010 - 10.2010
Charge Nurse- LPN
Pro Med Staffing Agency
06.2009 - 09.2009
Per-Diem LPN/ Phlebotomist
Dr. Karin Kalkstein, M.D.
10.2008 - 12.2011
Charge Nurse- LPN
HHC Coler-Goldwater Memorial Hospital
10.2008 - 01.2010
Licensed Practical Nurse Diploma - License Practical Nurse
Goldwater LPN Program
09.2007 - 06.2008
Office Manager/ Phlebotomist
Dr. Karin Kalkstein, M.D.
11.2006 - 10.2008
No Degree - National Certified Medical Assistant W/ Phlebotomy & EKG
Allen School
09.2006 - 07.2007
No Degree - Psychology
LaGuardia Community College
08.2006 - 08.2007
Internal Medicine & Gastroenterology Office Manager
Dr. George Weingarten F.A.C.G.
06.2005 - 11.2005