Victoria James
Vineland
Summary
Professional with strong background in investigative work, adept at gathering and analyzing information to uncover key insights. Known for collaborative teamwork and reliability, consistently adapting to evolving requirements to achieve desired outcomes. Skilled in critical thinking, problem-solving, and effective communication, ensuring thorough and accurate investigations.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Certified Investigator (IDD)
Elwyn
01.2023 - Current
- Conduct investigations through interviews, record reviews, and evidence collection
- Analyze medical and service documentation to identify discrepancies
- Prepare detailed investigative reports
- Collaborate with legal teams and regulatory agencies
- Perform risk assessments and support audits
Quality Improvement Specialist
Elwyn
07.2021 - 01.2023
- Analyzed trends and implemented improvements
- Led quality improvement initiatives resulting in enhanced service delivery standards.
- Developed and implemented training programs to ensure compliance with regulatory requirements.
- Facilitated root cause analysis sessions to resolve systemic issues affecting quality outcomes.
- Mentored junior staff on quality assurance protocols and improvement methodologies.
Residential Supervisor (QA)
PAFACOM
01.2019 - 06.2021
- Investigated incident reports and trained staff
- Facilitated training sessions for staff on best practices in resident care and crisis management techniques.
- Maintained communication with agencies and families
- Supervised daily operations, ensuring compliance with safety regulations and organizational standards.
- Developed and implemented individualized care plans for residents, enhancing quality of life and personal development.
Medical Coordinator
Heart to Heart
04.2015 - 10.2017
- Coordinated patient intake processes to enhance operational efficiency and streamline workflows.
- Developed and implemented patient scheduling protocols to optimize resource allocation.
- Managed communication between healthcare providers and patients, ensuring clarity and timely information delivery.
Education
Associate of Science - Public Administration
Cumberland County College
11-2026
Skills
- Healthcare Investigations
- Medical Record & Claims Analysis
- Regulatory Compliance (Medicaid, HIPAA)
- Fraud, Waste & Abuse Detection
- Data Analysis & Research
- Detailed Report Writing & Documentation
- Interviewing & Field Investigations
- Microsoft Office (Excel, Word, Outlook)
Certification
- Certified Investigator
- BLS Certification
- CPR / First Aid Certified
Timeline
Certified Investigator (IDD)
Elwyn
01.2023 - Current
Quality Improvement Specialist
Elwyn
07.2021 - 01.2023
Residential Supervisor (QA)
PAFACOM
01.2019 - 06.2021
Medical Coordinator
Heart to Heart
04.2015 - 10.2017
Associate of Science - Public Administration
Cumberland County College