Experienced B2B sales executive with clinical and non-clinical nursing experience is in pursuit of a career that focuses on improved quality and patient satisfaction. Past sales success achieved by cultivating relationships with both internal and external customers that allows for collaborative engagement through established trust and rapport. Passionate about doing work that involves improving the overall health and well being of others.
Overview
15
15
years of professional experience
Work History
UM NURSE
Fidelis Care
Getzville, NY
09.2021 - Current
Perform clinical reviews to assess medical necessity of outpatient services.
Collaborate with medical directors in determining coverage of requested services within the scope of member contract benefits.
Consistently meets or exceeds all case review quality, production, and turn around time goals.
Received Medical Director recognition for providing high quality case reviews.
PUBLIC HEALTH CASE INVESTIGATOR
SSO PCG
Buffalo, NY
11.2020 - 02.2022
Interviewing & Data Collection-Interview patients with confirmed and suspected cases of COVID-19 to collect contact histories and potential exposure data.
Health Education-Provide cases with approved information about state isolation/quarantine procedures with follow-up to monitor compliance. Developed interviewing techniques to increase participation in case interviews.
Data Entry & Maintenance-Utilize NYS database to identify newly diagnosed patients and maintain case load productivity standards.
Coordinated with public health and local community resources to support isolation and quarantine of at-risk individuals in need of food, shelter, medical assistance.
HEDIS NURSE-FT CONTRACT
Amerigroup BCBS, Molina HC, Change HC
Buffalo, NY
01.2017 - 05.2020
Collect qualifying medical record data from physicians, various EMR systems, and claims databases for medical record audit and submission to NCQA to assess health plan performance.
Evaluate and report all HEDIS Medicaid measure data against structured audit criteria into health plan database (QSHR).
Perform nursing outreach services and patient teaching to those plan members with gaps in preventative care services and diagnostics: Colon Cancer Screening, A1C testing, Diabetic Retinal Eye Exams, Vaccines, etc. Drove initiative leading to 17% increase in 2018 in COL member compliance over 2017.
Conduct provider education and act as liaison between provider and health plan for improved medical record documentation leading to HEDIS measure gap closure.
Managed all Quality Assurance tasks and functions for 25-member abstraction team to deliver optimal scoring results for managed care client base.
LICENSED PRACTICAL NURSE
VA WNY Healthcare, McGuire Group SNF
Buffalo, NY
12.2014 - 01.2017
Helped residents to achieve their physiological and emotional needs by providing patient teaching and emotional support.
Administer all treatments, medications, and clinical procedures while providing thorough and concise documentation of clinical data.
Manage and supervise CNA staff members to ensure maximum coverage and safety resources were allocated to residents at all times.
Collaborate and work cross-functionally with allied health groups to optimize rehabilitation and overall health outcomes.
Diagnostics: Colon Cancer Screening, A1C testing, Diabetic Retinal
Eye Exams, Vaccines, etc
Drove initiative leading to a 17%
increase in 2018 in COL member compliance over 2017
Managed all Quality Assurance tasks and functions for a
25-member abstraction team to deliver optimal scoring results
for managed care client base
Worked cross-functionally with MD's, Nurse Managers, and Allied
Health groups to ensure geriatric and rehabilitation services and
promoting the health, wellness, and illness prevention to
assigned residents through daily nursing activities
Helped residents to achieve their physiological and emotional
needs by providing patient teaching and emotional support
Administer all treatments, medications, and clinical procedures
while providing thorough and concise documentation of clinical
data
Manage and supervise CNA staff members to ensure maximum
coverage and safety resources were allocated to residents at all
times
Concise but thorough documentation of all medications,
treatments, and patient information into medical EHR
Sales and territory management of world-wide logistics and
financial services portfolio
Consistently delivered UPS small package growth through
customer supply chain analysis, identifying needs, and creating
solutions that provide efficiency and overall cost savings
Demonstrated and implemented wide variety of UPS Technology
Solutions to streamline customer shipment processing while
creating supply chain visibility
Negotiated successful and profitable customer contracts through
complex analysis and strategic negotiations through
collaborative engagement
Generated $12M in validated, conversion sales from 2004-2010
Contributed an additional $4.2M in validated, penetration sales