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Sr Clinical Quality Analyst Practice Manger Resume Example

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JC
Jessica Claire
Montgomery Street, San Francisco, CA 94105 (555) 432-1000, resumesample@example.com
Professional Summary

Experienced professional Registered Nurse with over 25 years of experience in the health care industry and 17 years of nursing leadership. System thinker who models professional practice, supports shared governance, and the use of evidence-based practice for safe therapeutic delivery of care. Proven success in leadership, operational excellence and organizational development with keen understanding of hospital operations from a clinical, quality, practice, and evolving models of care perspective. Recognized for inspiring management team members to excel and encouraging creative work environments. Excellent communication skills, particularly in writing and presentation. Diplomatic attitude in solving customer and employee related grievances.

Skills
  • Clinical Quality Risk Management
  • Process Implementation
  • Strategic and Tactical Planning
  • Lean/Six Sigma Black Belt Certified
  • Patient Focused- Service Performance
  • Financial Acumen
  • Budget Development/ Management
  • Professional Development/ Training
  • HEDIS, STARS, HOS, CHAPS
  • Change Management
Work History
10/2017 to Current Sr Clinical Quality Analyst / Practice Manger Texas Health & Human Services Commission | Rosenberg, TX, GEORGIA
  • Manage 40+ primary care practices and 3 Health Systems' clinical programs and provider performance tracked by designated metrics geared to assist providers achieve quality care outcomes for Medicare Advantage and Retiree population.
  • Provide ongoing strategic recommendations, training and coaching to provider groups on program implementation
  • Establish positive, long-term, consultative relationships with physicians, and medical groups.
  • Coordinate, facilitate and lead monthly meetings with provider groups to drive continual process improvement and achieve goals. Provide reporting to health plan leadership on progress of overall performance.
  • Conduct clinical quality audits for NCQA requirements specific to Medicare Advantage and Retirement population; Read and interpret standards/requirements and/or technical specifications (e.g., structure and process, CMS star ratings, NCQA/HEDIS/ CAHPS/member satisfaction specifications)
  • Identify Quality improvement or intervention opportunities and work cross-functionally to develop interventions or recommendations.
05/2009 to 08/2017 Unit Director State Of Oklahoma | {"@Context":"Http://Schema.Org", "@Type":"Jobposting",
  • Plan, direct, manage, coordinate, and monitor activities and operations for 36 bed Abdominal Organ Transplant unit to provide optimum patient and family centered care including management of 85 Full-time equivalents and assigned projects.
  • Partnered/ collaborated with staff, physician, patient and family advisers to develop and implement strategic goals and objectives.
  • Partnered with cross-functional teams to conduct thorough discovery and due diligence on existing processes.
  • Quality Lead -Hospital Acquired Pressure Ulcer Prevention Team.
  • Redesigned team structure that resulted in enhanced staff nurse's engagement and role as Champions for Skin Integrity.
  • Mentor and coached Wound Ostomy Continence Nurses in developing standard clinical practice, products, and process improvement strategies.
  • Developed and executed plans to monitor standard process adherence.
05/2002 to 05/2009 Nurse Manager JACKSON HEALTH SYSTEMS- JACKSON MEMORIAL HOSPITAL | City, STATE,
  • Directs/Coordinates all aspects of patient care, human resources, fiscal management and organizational development for 4 different Medical - Surgical thirty-six inpatient beds (Adult Surgical Abdominal Transplant, Hematology /Oncology/ Bone Marrow Transplant, Medical Surgical) units; with 185 full-time equivalents throughout eight year time-frame.
  • Partnered with physicians, social workers, activity therapists, nutritionists and case managers to develop and implement individualized care plans and documented all patient interactions and interventions in electronic charting systems.
  • Managed delivery of high level of quality care to diverse populations while overseeing patient admission and triaging based on acuity and appropriate department admission.
  • Quickly responded to situations impacting safety and security to unit, actualizing crisis prevention interventions to control and de-escalate situations.
  • Addressed disruptions in patient care, including delays in discharge, postponed procedures and discharge equipment unavailability.
Education
Expected in 05/2004 M.B.A. Master of Business Administration | Health Services Administration Nova Southeastern University, Davie, FL, GPA:
  • Majored in Business Administration
  • Minored in Health Services Administration
  • Graduated magna cum laude
Expected in 04/1995 Bachelor of Science | Nursing Bethune Cookman University, Daytona Beach, FL, GPA:
  • Member of Alpha Kappa Alpha Sorority
  • Graduated magna cum laude
  • Member of Student Nurse' Association- President (1994-1995)
Accomplishments
  • Developed Transplant education module for non-Transplant nurses to meet the CMS requirements for Emory University Hospital's CMS Transplant Certification.
  • Developed 6 highly functioning unit based teams that focused on continuous performance improvement of the following Nurse Sensitive Indicators (Hospital Acquired Pressure Ulcers, Patient Falls, Patient Satisfaction, Central Line Associated Blood Stream Infections, Catheter Associated Urinary Tract Infection, Employee engagement).
  • Developed team-building initiatives that supported collegiality through the use of technology that resulted in an increase of Press Ganey Employee Partnership Survey scores.
  • Nursing Education/ Professional Development. Developed training program for front-line nurse leaders that spanned across several divisions: Surgical Division, Procedural Area (Dialysis Unit), and Critical Care Division.
  • Abstract presentation Nursing Management Congress 2013, Chicago Illinois.
  • Support, coach, and mentor the unit's first Nurse-Led research project- IRB approved IRB00069408: Effects of elastic bandage wraps on leg edema inpatients before and after transplant. Published, Progress in Transplantation, Vol 25, No.
  • ANCC Magnet designation Emory University Hospital received several superior ratings noted on the ANCC analysis of the document review an
  • Participated in the document review for the Exemplary Professional Practice section of the Magnet Document.
  • Facilitated the opening of a seven (7) bed Oncology/ Hematology expansion unit and directed all aspects of operation as related to patient care, human capital, and regulatory compliance.
  • Collaborated with the American Cancer Society to develop unit based"Look Good, Feel Good Program to provide services to Oncology patients admitted to the Oncology Unit, Jackson Memorial Hospital.
Affiliations
  • Alpha Kappa Alpha Sorority Incorporated 1995 to present
  • American Nurses Association(ANA), 2000 to present
  • Georgia Hospital Association, Georgia Society for Clinical and Resource Management (GSCRM), Board Member, 2014-2016
  • International Transplant Nurse Association (ITNS), Georgia Chapter, 2009 to 2017.
  • Oncology Nurses Association(ONS), Miami-Dade Chapter 2002 to 2004.
Certifications
  • Registered Nurse in Georgia, License number RN202044, 01/31/2021
  • Board Certification Advanced Nurse Executive , American Nursing Credentialing Center (ANCC) - 11/2022
  • BLS certified- 08/2020

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Resume Overview

School Attended
  • Nova Southeastern University
  • Bethune Cookman University
Job Titles Held:
  • Sr Clinical Quality Analyst / Practice Manger
  • Unit Director
  • Nurse Manager
Degrees
  • M.B.A. Master of Business Administration
  • Bachelor of Science

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