Yurisan Machado
370 NW 133 Place Miami,FL
Summary
Seasoned healthcare leader with 20 years of experience in inpatient rehabilitation and more than 5 years of executive experience as Director of Quality Management. Led organization-wide quality, performance improvement, and risk management programs with sustained compliance across Joint Commission, CARF, CMS, and AHCA standards. Demonstrated success overseeing accreditation readiness, regulatory surveys, governing body reporting, and interdisciplinary performance improvement initiatives. Strong background in audit programs, root-cause analysis, policy development, and patient safety. Registered Nurse with advanced clinical education and in progress toward board certification as a Family Nurse Practitioner, recognized for effective collaboration with medical staff and senior leadership to strengthen patient safety and organizational performance.
Overview
22
22
years of professional experience
1
1
Certification
Work History
Quality Assurance and Clinical Educator
OpusCare
Miami, FL
03.2025 - Current
- Performed routine and focused audits resulting in improved documentation compliance and reduced deficiencies
- Implemented targeted education plans that strengthened staff competency and survey readiness
- Reduced repeat audit findings by standardizing documentation practices and reinforcing clinical protocols
- Supported leadership during regulatory surveys by coordinating preparation, staff education, and real-time issue resolution
- Led comprehensive ADR, recertification, F2F, CTI, IDG, POC, MAR, and clinical documentation audits, identifying risk trends and implementing corrective action plans
- Assisted in the development and delivery of targeted clinician education (RN, NP, IDT) focused on documentation accuracy, patient decline, eligibility criteria, and survey readiness
- Served as a clinical resource and educator for staff regarding standards of care, scope of practice, and documentation requirements
- Promoted a culture of accountability, patient safety, and clinical excellence through coaching and mentorship
Director of Health Information Management
West Gables Rehabilitation Hospital
Miami, FL
01.2004 - 03.2025
- 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.
- Led hospital-wide accreditation efforts, achieving Joint Commission and CARF compliance.
- 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
Post Mater of Science Degree - Family Nurse Practitioner
Miami Regional University
Miami, FL12-2025
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
- Healthcare management
- Accreditation processes (Joint Commission and CARF)
- Auditing and regulatory compliance
- Legal and medical documentation
- Root-cause analysis
- Organization and multitasking
- Risk Management
- QA metric management
- Process improvement strategies
- Patient care coordination
Certification
- Registered Nurse
- Family Nurse Practitioner (FNP) – AANPCB board-eligible; exam scheduled March 2026
- Registered Health Information Administrator (RHIA)
- Healthcare Licensed Risk Manager (LHRM)
- BLS and AED Certified
Languages
English
Full Professional
Spanish
Full Professional
Timeline
Quality Assurance and Clinical Educator
OpusCare
03.2025 - Current
Director of Quality Management
West Gables Rehabilitation Hospital
09.2010 - 08.2015
Director of Health Information Management
West Gables Rehabilitation Hospital
01.2004 - 03.2025
Master of Science - Executive Master in Health Services Administration
University of Central Florida
Bachelor of Science - Health Information Management
Florida International University
Post Mater of Science Degree - Family Nurse Practitioner
Miami Regional University
Master of Science in Nursing -
Miami Regional University