Yolanda Redhead
McKinney,TX
Summary
Highly motivated and results-oriented Clinical Quality Consultant with 7+ years of experience in healthcare operations and quality management. Proven ability to leverage expertise in HEDIS, process improvement, and project management to drive operational excellence and achieve strategic objectives. Adept at building strong relationships with key stakeholders and fostering collaboration within cross-functional teams. Thrives in a fast-paced environment and enjoys tackling complex challenges.
Overview
9
9
years of professional experience
Work History
Clinical Quality Consultant II
WellMed Medical Management - United Health Group
09.2022 - Current
- Serve as a dedicated resource for a key large business client.
- Provided end-to-end clinical quality life cycle consulting services to improve clinical operations and HEDIS scores across all segments, including the clinical operations shared services model.
- In 2023, supported 85% of assigned providers in achieving a 4.79+ star rating.
- Managed quality technology solutions, service solutions, data solutions, product implementation, HEDIS strategy and consultation, service optimization, regulatory consultation, and preparedness.
- Acted as a primary liaison between functional teams, and clinical operations teams to ensure exceptional client service.
- Led and influenced cross-functional teams to achieve contractual quality oversight requirements.
Clinical Quality Consultant I
WellMed Medical Management - United Health Group
08.2018 - 09.2022
- Developed market business plans to motivate providers to improve Stars measures.
- Conducted introductory training sessions for providers and staff on the WellMed Quality Program.
- Tracked trends and barriers within assigned patient groups to achieve better outcomes.
- Partnered with stakeholders to strategize best practices for provider offices, focusing on quality measures compliance.
- Served as a primary point of contact for all STARS-related activities within the assigned market.
- Improved client satisfaction by effectively managing multiple projects and consistently meeting deadlines.
Back Office Supervisor/Senior Care Champion
Villiage Health Partners
04.2015 - 02.2018
- Supervised personnel, conducted performance evaluations, and provided training and orientation.
- Resolved grievances and personnel problems, providing input on counseling and disciplinary issues.
- Assisted in developing departmental policies and programs.
- Evaluated daily patient flow to maintain access standards and foster open communication.
- Spearheaded operational process revamp and contributed to implementation of FIVE-STAR Quality System.
- Designed and implemented plans to promote team success and achieve a Four-Star rating.
- Assisted physicians in understanding HEDIS, 5-Star Rating, and Quality Measures to guide optimal patient care.
Education
BBA - Business Management
Colorado State University
Fort Collins, CO04.2024
Associate of Science - General Studies
Collin County Community College District
Plano, TX05.2016
Liscense Vocational Nurse - Nursing
Dallas Nursing Institute
Dallas, TX02.2011
Skills
- HEDIS Quality Improvement
- Clinical Operations Management
- Project Management
- Data Analysis and Reporting (Tableau, MS Excel)
- Process Improvement (Lean Six Sigma Black Belt)
- Leadership and Team Management
- Communication and Interpersonal Skills
- Client Relationship Management
Additional Information
- Lean Six Sigma Black Belt Certification | Management and Strategy Institute - October 2019
Timeline
Clinical Quality Consultant II
WellMed Medical Management - United Health Group
09.2022 - Current
Clinical Quality Consultant I
WellMed Medical Management - United Health Group
08.2018 - 09.2022
Back Office Supervisor/Senior Care Champion
Villiage Health Partners
04.2015 - 02.2018
BBA - Business Management
Colorado State University
Associate of Science - General Studies
Collin County Community College District
Liscense Vocational Nurse - Nursing
Dallas Nursing Institute
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