Ambitious, highly motivated MBA degree Health Care Executive who creates positive strategic alliances with organization leaders to support key business programs and initiatives by building, and retains high performing teams through hiring, developing, and motivating skilled professionals. Areas of expertise include:
Customer Service Oriented
Strategic Planning Knowledge
Health Care Reform Expertise
Microsoft Office Skills/ Word/Excel/Powerpoint/Access/Publication/Visio
Medicare Provider Educator May 2011 to May 2013Florida Blue － Jacksonville, FL
Develop strategic and tactical plans utilizing member and provider identification and stratification including tactics for communication and education for provider engagement activities then analyzed and trended this data for performance improvement initiatives Implemented an innovative risk management patient electronic medical record (EMR) tool in numerous physician offices, which resulted in a $5.5M financial improvement in less than 60 days.
Designed and implemented a Medicare Advantage risk adjustment education program, educate members and providers on program producing a 4% financial improvement.
Utilizing relationship building skills and problem solving techniques, worked with internal stakeholders on a multidepartment project teams to Identify problems, in the development of business requirements for a Patient Centered Reporting Tool.
Demonstrated analytical skills, critical thinking and problem-solving ability by addressing inaccurate coding information, utilizing charts, graphs, spreadsheets and pivot tables to validating proper coding, risk adjustment, and appropriate documentation, then develop action plans to educate physicians, staff and vendors on errors.
Spearheaded process improvement projects with the clinical care area, collected and analyzed data, monitored and evaluated process changes related to quality measures required for compliance in meeting and sustaining the National Committee on Quality Assurance (NCQA) standards, effectively improving patient care, risk factors and generated financial improvement of $40M.
Research, review, and analyze the effectiveness and efficiency of CMS requirements by physician, utilizing data mining, data analysis, data metrics, data reporting, and project management to improve prospective and retrospective risk scores.
Demonstrated decision-making skills by conducting clinical outcomes research on new health care initiatives, placing members in appropriate prospective and retrospective documentation activities so as to maintain an applicable risk score, STAR rating, and a high customer satisfaction scores.
Management Operations Analyst May 2006 to May 2011aval Hospital Jacksonville － Jacksonville, FL
Assist with preparation and implementation of standard operating procedures to improve efficiency and productivity of hospital operations and provide management with advice for a wide range of administrative, professional, and managerial functions.
Conducted business case analysis by performing root cause analysis of DOD data, perform data manipulation and analysis and respond to project change requests by identifying operational process inefficiencies, then recommend necessary improvements of staffing, productivity, and costs.
Assist in developing, analyzing and enhancing performance goals by participation in process improvement initiatives; including facilitating discussions, recommending courses of action and supporting implementation of strategic goals, for the annual business plans.
Identify, extract, and analyze health care data, conduct financial analysis utilizing project management processes and methodology, develop reports, graphs, and spreadsheets for balance scorecard, management studies, presentations, and reports.
Extracted, analyzed, and submitted recommendations on workflow analysis, performance improvement, medical record and coding complaisance, timecard completion and accuracy, and other business metrics, to identified problems and improve performance.
Provided analytical support to Naval Hospital Jacksonville and Branch Health Clinics leadership to include the clear and concise collection of analytical, statistical and financial data for benchmarking and reporting of data from internal and external data systems.
Establish reporting mechanisms and perform analysis of activities and operations to determine progress towards stated goals and objectives utilizing, DOD computer programs and disease management databases/tools such as ORYX, HEDIS.
Monitored productivity against established performance indicators by performing analysis of activities and operations and prepared recommendations for hospital and clinic management regarding progress towards staffing, workload, costs and expense goals and objectives of Naval Hospital Jacksonville and Branch Health Clinics Develop summary briefs and conduct professional presentation with recommendations for action and resolution to department heads, providers, staff, senior leaders, XO and CO of the hospital on business operations, operational improvement, and financial management programs, Participate in developing, analyzing, and preparing business models, charts, graphs spreadsheets and pivot tables for staffing charts, demographics, enrollment, access to care, productivity reports, referrals, medical costs, and budget processes for short and long-range goals with specific, measurable standards which enhanced quality patient care and increased fiscal growth.
Develop content and data on Plans, Analysis and Evaluation (PA&E) SharePoint sites and develop document libraries on dashboards, spreadsheets, balance scorecards and reports for departments and command.
Faculty Program Site Coordinator/Associate Professor August 2004 to CurrentSouthern Illinois University Carbondale － Jacksonville, FL
Responsible for recruitment of new students, retention of current students, the growth, and stability of the Health Care Management, Electronic Systems Technology and Workforce programs, utilizing direct contact and recruitment activities.
Acts as an advocate for students, faculty, and staff, working with main campus to provide oversight and input into student needs.
Engage in recruitment and retention efforts for off-campus programs of, Health Care Management, Electronic Systems Technologies and Workforce Education in the Jacksonville, FL area and campus online programs.
Develop a network for reaching potential students through on-base and off-base referrals, facilitating student enrollment into the off-campus and online programs Cultivate a positive and productive relationship with Navy College personnel and other site colleges and university leadership Identify student internship needs and interests in order to market community organizations for healthcare internships programs.
Secure and maintain partnerships with these internship sites and establish memorandum of understand contracts with the organizations.
Update student record via Banner, Student Success Collaborative (SSC), ARGOS, and other university student software systems.
Understand and demonstrate experience working with online system Desire to Learn (D2L) and Blackboard by monitoring site courses and instructing new off-campus Professors on navigating D2L software system Assist students with their educational planning and progress for degree program, monitor their academic progress, assist student with difficulties in course curriculum and learning resource tools.
Participate in staff and faculty meetings reporting on current enrollment, student participation, and student success collaborative reports.
Develop and design course curriculum, lesson plans, and tests for classes required to teach, instruct undergraduate students in managerial and supervisory skills necessary for careers in business health care management.
Stay current with all regional and state code changes and industry standards as it applies to the healthcare program subject matter being taught.
MBAUniversity of Phoenix
Masters of Business Administration
BSHUniversity of North Florida
Bachelor of Science : Health Long Term CareHealth Long Term Care
Letter of Reference, Dept Head Urology, Naval Hospital Jacksonville, November 2010
Commanding Officer Military Coin, Naval Hospital Jacksonville Florida, June 2010
Letter of Accommodation, Commanding Officer, Naval Hospital Jacksonville, November 2006
academic, administrative, Analytical Skills, balance, benchmarking, Budgeting, budget, business case analysis, Business Management, business operations, business plans, charts, clinic management, CMS, concise, Develop content, contracts, critical thinking, customer satisfaction, Customer Service, data analysis, data mining, databases, decision-making, disease management, documentation, financial, financial analysis, financial management, Fiscal Management, graphs, hiring, instructing, leadership, Leadership Skills, lesson plans, managerial, market, MBA, meetings, Access, Excel, Microsoft Office, Powerpoint, SharePoint, Word, Navy, Naval, network, clinical care, patient care, personnel, pivot tables, presentations, problem solving, problem-solving, processes, process improvement, producing, coding, progress, project management, Publication, Quality, Quality Assurance, recruitment, relationship building, reporting, Research, Risk Management, spreadsheets, staffing, strategic, strategic alliances, Strategic Planning, supervisory skills, Visio, workflow analysis
Resident Insurance License, Life, Var. Annuity & Health, W215636
NHA, Nursing Home Administrator License, NH4193
AWARDS BlueXcellence Award, Florida Blue, December 2011 & 2012 Letter of Reference, Dept Head Urology, Naval Hospital Jacksonville, November 2010 Commanding Officer Military Coin, Naval Hospital Jacksonville Florida, June 2010 Letter of Accommodation, Commanding Officer, Naval Hospital Jacksonville, November 2006 1