Quality Improvement Specialist resume example with 16+ years of experience

Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • H: (555) 432-1000
  • C:
  • Date of Birth:
  • India:
  • :
  • single:
Professional Summary

Accomplished Operation Director offering over 20 years of Long Term Care Operation. Successful in leading high-performing teams and partners to sustain road map and business goals. Methodical in developing and operating programs including organization and implementation of direct supports, person centered planning, health care, advocacy, stakeholder relations, regulatory compliance, staff development/training, and financial management.

  • Performance Metric
  • Strength Coaching
  • Executive-Level Presentations
  • Recommendations for Action
  • Performance Improvement
  • Prevention Programs
  • Project Implementation
  • Individualized Care Plans
  • Operational Procedures
  • Crisis Prevention Intervention
  • Training Programs
  • Staff Development
Work History
Quality Improvement Specialist, 04/2021 - Current
Banner Health Tucson, AZ,
  • Review records for compliance with best practice, contracts, and Medicaid standards
  • Mentor new hires to ensure quality standards are met
  • Ensure Peer Reviews are completed timely and accurately
  • Report findings to management and ensure required follow-up is completed
  • Perform trainings as identified by quality assurance outcomes
  • Contribute to the development and implementation of Performance Improvement Plans for internal improvement
  • Prepare files and service centers for audits and site visits
  • Participate in the Risk Management program by identifying risk and addressing appropriately
  • Survey clients and caregivers for satisfaction and report outcomes to Operation Management
  • Work side by side with the clinical team and billing team for program development and improvement
  • This includes training, problem-solving, and support
  • Participate in the accreditation process
  • Regularly review reports to monitor trends with utilization management and compliance to ensure maximum benefit to the company
  • Participate in special quality assurance projects as needed.
Program Director/Area Director of Operations, 05/2006 - Current
Hillsborough County Sheriff's Office Tampa, FL,
  • Oversees licensing compliance for program services and supports
  • Implement systems to effectively manage budget
  • Employ proactive strategies to reduce or eliminate serious incidents and limit risk
  • Maintain and foster communication and relationships with individuals, families, managed care contractors and other stakeholders
  • Monitor customer satisfaction and implement improvement strategies
  • Advocate for Individuals receiving services
  • Participates in building relationships with applicable governmental authorities such as counties, regional centers and managed care contractors, and all referral agencies
  • Managerial Contributions:
  • Managed and supervised 100-117 employees ranging from Direct Care to Middle Management
  • This included over 20 clinical staff (Director of Nurses, RN, LPN, clinical contractors)
  • Directed areas with multiple functions including Residential and Adult Day Treatment
  • Assisted Executive Manager in planning and executing the annual budget
  • Coordinated with human resources team in forming/onboarding and training a cross functional department
  • Provided oversight for social services, clinical and residential services.
  • Provided ongoing direction and leadership for program operations.
  • Collaborated with various teams to uncover issues, identify applicable solutions and offer guidance.
  • Maintained and updated project related documents.
  • Improved success of program by making proactive adjustments to operations.
  • Orchestrated smooth and efficient program development by collaborating cross-functionally across departments.

Child Protective Investigator, 07/2005 - 09/2005
Department Of Children And Family City, STATE,
  • Of children and families
  • Responsible for investigating claims of child neglect and abuse
  • Worked with a team of professionals in preventing harm to children by conducting environmental and character studies to determine the likelihood of further abuse, and work with law enforcement to ensure the continued safety and well-being of children.
  • Conducted in-depth assessments to determine if children were safe from harm and abuse at home.
  • Interviewed children, members of families, medical personnel and law enforcement to gain valuable information for each case.
  • Devised and implemented safety plans for children suspected as victims of abuse or neglect.
  • Remained objective in handling each case, especially when children and families were in high-stress situations.
  • Built solid and trusting rapport with children and families, fostering trust and communication to meet case needs.
Bachelor of Professional Studies: Human Services, Expected in
Metropolitian College of New York - New York, NY.,

college for human services. new york, NY.

  • Dean's List [six consecutive semesters]
Master of Public Administration: MPA: Human Services, Expected in
Metropolitan College of New York - New York, NY
  • Dean's List (three semesters).

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Resume Overview

School Attended

  • Metropolitian College of New York
  • Metropolitan College of New York

Job Titles Held:

  • Quality Improvement Specialist
  • Program Director/Area Director of Operations
  • Child Protective Investigator


  • Bachelor of Professional Studies
  • Master of Public Administration: MPA

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