Dedicated and experienced healthcare professional with more than 20 years of progressive experience in healthcare and nursing management. Highly proficient and experienced in various aspects of nursing management, supervision of medical and support staff, and performance optimization. Responsible for collaborating with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources. Responsible for participating in delivery of patient education and disease management interventions, performing health coaching for members, for health improvements and management programs for chronic diseases. Strong, innovative leader who ensures optimal execution of clinic operations and delivery of the highest quality of professional healthcare.
Patient-Centered Medical Home Management
Nursing Management and Supervision
National Committee for Quality Assurance (NCQA) Accreditation Standards
Joint Commission Accreditation Standards
Healthcare Effectiveness Data and Information Set (HEDIS)
Population Health and Chronic Disease Management
Nurse ManagerOct 1999 to Current Virginia Beach, VA
Forbes Nurse ManagerJun 1998 to Sep 1999 Nursing Department
I ensure staff compliance with standards of care, regulations, and instructions; and provide the following as related to knowledge, ability, or skills: Collaborate with the Officer in Charge, Senior Medical Provider, and Clinical Coordinator in managing and oversight of medical care and ancillary services delivered in a National Committee for Quality Assurance (NCQA) level 3 Tricare Prime Clinic with enrollment of 16,000 beneficiaries.
Ensure and maintain standards of healthcare through planning, directing, analyzing, monitoring, and evaluating health care delivery systems.
Maintain compliance with higher regulatory authorities such as The Joint Commission of Healthcare Organizations (JC), NCQA, and Bureau of Medicine (BUMED).
Execute successful implementation of two Patient-Centered Medical Homes Teams: (1) Family Practice and (2) Pediatrics.
Maintain operational oversight over medical records, laboratory, pharmacy, mental health, mammography, and administrative services.
Oversight for Immunization and Allergy Services; including staff orientation, development, and continuing education to maintain highest quality of healthcare services.
Ensure medically appropriate, high quality, cost effective care through assessing the medical necessity of services, diagnostic procedures, out of network service, and appropriateness of treatment setting by utilizing the applicable medical policy and industry standards, accurately interpreting benefits, and steering members to appropriate providers, programs or community resources.
Ensure clinical programs meet Department of Health standards and improve Healthcare Effectiveness Data and Information Set (HEDIS) indicators to evaluate and manage patients with selected diseases for 16,000 enrolled patients.
Responsible for participating in delivery of patient education and disease management interventions and for performing health coaching for members, for health improvement/management programs for chronic diseases.
Administer immunizations, medications, and procedures; as well as provide a full range of professional nursing care to patients.
Administer, monitor, and evaluate the performance of 60 nursing staff employees; including, Registered Nurses, Licensed Practical Nurses, Medical Assistants and Hospital Corpsmen.
Provide solutions to problems and questions related to ethics, patient care, employee disputes, professional conduct and appearance and contract resolution.
Advise Contract Company on employee performance.
Implement clinic wide use of Electronic Medical Records: Armed Forces Health longitudinal Technology Application (AHLTA); this resulted in the standardization of medical information and patient encounters, calculations of third-party billing, integrated clinical operations to include order entry, monitoring, and results retrieval.
3 of 3 Location: Tricare Prime Clinic - Sentara Enterprise, Virginia Beach, Virginia Collaborated with Site Operating Manager in the administration and management of the Telephone Triage and Ambulatory Care Center.
Oversaw and directed all clinic departments to provide superior care and continuous patient flow.
Directed and monitored 25 nurses to provide health care for 17,775 beneficiaries.
Maintained administrative oversight for clinical care, preparation and implementation of staff schedule, and adherence to contract agency's standards of compliance.
Developed, mentored, and evaluated staff performance.
Managed provider templates.
Participated in all aspects of performance improvements.
Streamlined surveillance reports for abnormal laboratories, which became the template for other clinics.
Developed orientation and competency programs.
Administered immunizations, medications, and procedures, and provided a full range of professional nursing care to patients.
Managing Registered NurseJul 1997 to Jul 1998 Riverside Hayes Pediatrics － Hayes, Virginia
Analyzed, documented, and maintained patient records including medical history, reports and examination results, as well as managed all aspects of clinical care.
Oversaw patient referrals to ensure profitability.
Provided telephone triage and recommendations to clients.
Assumed full responsibility in ordering and maintaining medications and supplies, as well as in tracking and reporting maintenance problems.
Education and Training
Bachelor of Science, Nursing2013Old Dominion University － VANursing
Diploma, Nursing1997Bon Secours DePaul School of Nursing － VANursing
Diploma, Practical Nursing1986Southeast Community College － Lincoln, NEPractical Nursing
Associate Degree, Liberal Arts1983Long Beach City College － Long Beach, CALiberal Arts
administrative, Ambulatory Care, Armed Forces, agency, benefits, billing, coaching, clients, delivery, Department of Health, directing, Disease Management, Electronic Medical Records, Immunization, immunizations, managing, mental health, Enterprise, network, Nursing, order entry, clinical care, patient care, patient flow, Pediatrics, Prime, quality, Quality Assurance, reporting, Supervision, Telephone, Triage