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Manager - Decision Support Resume Example

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MANAGER - DECISION SUPPORT
Professional Summary

Meticulous manager with a data analytical background, excellent at juggling multiple tasks and working under pressure. Broad industry experience in Healthcare: front line support, EHR, revenue cycle, data and analysis, to executive level process and policy decisions. Co-chaired Quality, Measurement and Reporting committees and directed improvement efforts and initiatives

Meticulous manager with a data analytical background, excellent at juggling multiple tasks and working under pressure. Broad industry experience in Healthcare: front line support, EHR, revenue cycle, data & analysis, including executive level process and policy decision making. Co-chaired Quality, Measurement and Reporting committees and directed improvement efforts and initiatives.

Skills
  • Team leadership
  • Project management
  • Strong verbal communication
  • Process implementation
  • Extremely organized
  • Client assessment and analysis
  • Team leadership
  • Project management
  • Strong verbal communication
  • Process implementation
  • Data Analysis
  • Client assessment and analysis
Work History
01/2013 to Current
Manager - Decision SupportCompany Name – City, State
  • Managed the PAMF Regional P4P public reporting
  • Managed the PAMF Regional PQRS/GPRO public reporting
  • Built and managed the PAMF Regional RAF reporting and improvement
  • Developed new process for quality improvement which resulted in marked performance improvements for public reporting
  • Worked directly with providers and quality leadership to achieve P90 threshold goals
  • Co-Chair of the Sutter Medical Network Quality Measurement Group
  • Committee member on PAMF's: P4P Steering Committee, P4P Outreach Committee, Quality Improvement sub-committee
  • Supported affiliates clinical needs for quality analysis and improvement at various sites within BAOU.
  • Ownership over team productivity and managed work flow to meet or exceed quality service goals
  • Trained staff on clinical and operating procedures around affiliate data reporting
01/2013 to Current
Manager - Decision SupportCompany Name – City, State
  • Managed the PAMF Regional P4P public reporting
  • Managed the PAMF Regional PQRS/GPRO public reporting
  • Built and managed the PAMF Regional RAF reporting and improvement
  • Developed new process for quality improvement which resulted in marked performance improvements for public reporting
  • Worked directly with providers and quality leadership to achieve P90 threshold goals
  • Co-Chair of the Sutter Medical Network Quality Measurement Group
  • Committee member on PAMF's: P4P Steering Committee, P4P Outreach Committee, Quality Improvement sub-committee
  • Supported clinical needs for quality analysis and improvement at  affiliate sites within BAOU.
03/2004 to 01/2013
Analyst III - Decision SupportCompany Name – City, State
  • Designed, Build, and Project Managed the PAMF Regional P4P reporting
  • Designed, Build, and Project Managed for the PAMF Regional GPRO reporting
  • EPIC Ambulatory and Professional Resolute Clarity trained
  • Certified in EPIC Professional Resolute
  • SMSC EPIC EAP conversion project from MS4
  • SMSC/MPSH MS4 query reporting
  • CDM/EAP pricing for hospital
  • Cost analysis on hospital procedures and equipment
  • Auditor support for both Hospitals (SMSC & MPSH) and PAMF ambulatory Region
  • Quality analytics reporting committee member
  • Committee and Sub-committee member for Sutter and PAMF: P4P Steering Committee, P4P Outreach Committee, PQRS (GPRO) reporting
03/2004 to 01/2013
Analyst III - Decision SupportCompany Name – City, State
  • Built and Project Manager for the PAMF Regional P4P reporting
  • Built and Project Manager for the PAMF Regional GPRO Reporting
  • EPIC Ambulatory and Professional Resolute Clarity training
  • Certified in EPIC Professional Resolute
  • SMSC EPIC EAP conversion project from MS4
  • SMSC/MPSH MS4 query reporting
  • Auditor support for both Hospitals (SMSC & MPSH) and PAMF ambulatory Region
  • Quality analytics reporting committee member
  • Committee and Sub-committee member for Sutter and PAMF: P4P Steering Committee, P4P Outreach Committee, PQRS (GPRO) reporting
04/2003 to 03/2004
Patient Account Rep - Ambulatory & HospitalCompany Name – City, State
  • Reimbursement analysis for Medicare/Medicaid, Medical, managed care and PPO payors
  • Case Mix & DRG reporting analysis
  • Patient Accounting
  • A/R hospital reconciliation
  • Facility billing
  • Member of task force committee WPI: Work Process Improvement
04/2003 to 03/2004
Patient Account Rep - Ambulatory & HospitalCompany Name – City, State
  • Reimbursement analysis for Medicare/Medicaid, Medi-Cal, managed care and PPO payors
  • Case Mix & DRG reporting analysis
  • Patient Accounting
  • A/R hospital reconciliation
  • Facility billing
  • Member of task force committee WPI: Work Process Improvement
Programs

NCQA/IHA Pay For Performance

CMS Medicare five-star quality rating

CMS PQRS / GPRO

Medicare Risk Adjustment Factor (RAF)

CDM/EAP Pricing for hospital

Procedure and Equipment cost analysis

NCQA/IHA Pay For Performance

CMS Medicare five-star quality rating

CMS PQRS / GPRO

Medicare Risk Adjustment Factor (RAF)

Education
June 2009
Bachelor of Science: Business
CSUMB - City
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Resume Overview

School Attended

  • CSUMB

Job Titles Held:

  • Manager - Decision Support
  • Analyst III - Decision Support
  • Patient Account Rep - Ambulatory & Hospital

Degrees

  • Bachelor of Science : Business

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