Yurisan Machado
370 NW 133 Place Miami,FL
Summary
Adaptable professional with a quick-learning ability and a talent for adjusting to new environments. Organized and dependable at managing priorities with a positive attitude, in an effort to meet organizational goals. Driven by a passion for continuous learning and successfully navigating change.
Overview
21
21
years of professional experience
1
1
Certification
Work History
Director of Health Information Management
West Gables Rehabilitation Hospital
Miami, FL
01.2004 - Current
- Responsible for the development and oversight of the internal processes of the HIM Department, which include analysis of medical records, release of information, and medical staff credentialing.
- Monitor the initiation, revision, and implementation of revised regulations; ensure conformance to compliance initiatives.
- Responsible for the development and implementation of medical record practices, policies, and procedures to ensure the timely, quality, and accurate delivery of medical records services.
- Directs the department within the scope of the operating budget/business plan, and maintains necessary controls to ensure compliance with budgeted expenses, resources, and staff.
- Coordinates and monitors site specific activities related to chart completion procedures, statistics, and clinical pertinence reviews with the provision of feedback to respective staff and interdisciplinary departments.
- Provides direction and leadership to hospital staff as necessary to carry out departmental and organizational goals for the provision of medical record services.
- Remains current on issues, trends, and regulations impacting the health care environment and serves as a resource to interdisciplinary departments in the area of medical record and physician credentialing processes.
- Responsible for verifying and maintaining professional licenses, certifications, and qualifications of physicians, to ensure legal and regulatory requirements.
- Responsible for conducting the Ongoing Professional Practice Evaluation (OPPE) and Focused Professional Practice Evaluation (FPEE) on a regular basis for all practitioners.
- Monitor changes in accreditation standards that impact the credentialing process.
- Collaborated with legal department to ensure compliance with federal and state regulations, as it pertained to the Medical Staff Bylaws.
Director of Quality Management
West Gables Rehabilitation Hospital
Miami, FL
09.2010 - 08.2015
- Coordinate the Quality Management and Performance Improvement activities to measurably enhance the quality, process and cost effectiveness of patient and customer services rendered.
- Assist with the design and compliance of quality processes/activities in the areas of clinical/medical staff performance improvement for all applicable Joint Commission, CARF, AHCA, and CMS standards.
- Responsible for ensuring hospital wide accreditation with Joint Commission and CARF.
- Assists clinical areas in developing criteria, monitoring and reporting mechanisms and action documentation related to the hospital's CQI program.
- Serve as consultant for all clinical performance indicators being implemented within the hospital.
- Responsible for overseeing and managing all hospital committees, inclusive of: Medical Record and Utilization Review, Quality Council, Patient Safety, Medical Executive, Clinical Oversight Committee and Governing Board .
- Responsible for overseeing the Risk Management function, inclusive of: loss prevention, risk assessment, patient safety promotion and claims management.
- Develop hospital wide strategic plans to meet the needs of the hospital, patients and stakeholders.
- Responsible for the development and revision of hospital wide policies and procedures, following regulatory standard requirements.
- Perform independent and ongoing audits to ensure compliance with Federal, state and private payer health care programs.
- Maintain current knowledge of all state and federal regulations affecting the operation for Inpatient Rehabilitation Facilities (IRFs).
- Identify high-risk areas to reduce vulnerability to fraud and abuse.
- Investigate and act on matters related to compliance, including designing and coordinating internal investigations in response to reports of problems.
- Work closely with the Infection Control Coordinator to ensure compliance with CMS requirements (i.e., NDNQI, CDC/NHSN reporting requirements).
- Serve as the facility resource for guidance on designing, implementing, analyzing, and reporting on Quality Improvement.
- Responsible for investigating any patient complaints/grievances.
Education
Master of Science in Nursing -
Miami Regional University
Miami, FL08-2024
Master of Science - Executive Master in Health Services Administration
University of Central Florida
Orlando, FL08-2015
Bachelor of Science - Health Information Management
Florida International University
Miami, FL04-2003
Skills
- Healthcare compliance
- Quality improvement
- Accurate documentation
- Accreditation processes
- Auditing and compliance
- Regulatory requirements
- Root-cause analysis
- Infection control standards
- Organization and multitasking
- Risk Management
- QA metric management
- Process improvement strategies
- Healthcare management
Certification
- Registered Nurse
- Registered Health Information Administrator (RHIA)
- Healthcare Licensed Risk Manager (LHRM)
- CPR and AED Certified
Languages
English
Full Professional
Spanish
Full Professional
Timeline
Director of Quality Management
West Gables Rehabilitation Hospital
09.2010 - 08.2015
Director of Health Information Management
West Gables Rehabilitation Hospital
01.2004 - Current
- Registered Nurse
- Registered Health Information Administrator (RHIA)
- Healthcare Licensed Risk Manager (LHRM)
- CPR and AED Certified
Master of Science in Nursing -
Miami Regional University
Master of Science - Executive Master in Health Services Administration
University of Central Florida
Bachelor of Science - Health Information Management
Florida International University
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