Tiffany L. Beaver has over 15 years of experience in healthcare project management, business development, and sales. She currently serves as an IS Project Manager for Meaningful Use at Community Health Network, where she has helped register over 300 eligible providers, earning the organization over $1.4 million in incentive payments. Previously, she held senior sales and leadership roles at GlaxoSmithKline and other healthcare companies. She has a proven track record of developing strategies to maximize revenue and market share growth.
Unblock Growth and Retain Talent in Home and Coordinated HealthcareSkedulo
油
The US will need to hire 2.3 million new health care workers by 2025 in order to adequately take care of its aging population, CNN tells us. We know that our population is aging, including the nurses who care for the elderly. In fact, one-third of them are approaching retirement age. The bottom line is that there are not enough skilled healthcare workers to meet demand. That means hospitals, providers, and agencies are going to be fighting for talent.
In this session, learn how you can make your mobile caregivers not only more productive, but happier employees. Retain top talent, be easy to work for, and watch your healthcare business grow!
Hospitals lose significant revenue when a physician position goes unfilled. This presentation was given to members of the Northeast Physician Recruiter Association. It explains why and how to build the case for a health system to invest in recruitment.
Denise Ricketts has over 25 years of experience in human resources recruitment with expertise in full-cycle recruitment, managing high-volume recruitment initiatives, and ensuring compliance with employment legislation. She has worked in unionized environments for Public Health Ontario and Lakeridge Health Corporation, where she recruited for a variety of clinical and administrative roles. Ricketts holds a Diploma in Business Administration with a focus on human resources management and has obtained her Certified Human Resources Leader designation.
Think Your Patients Are Loyal? Think Again. It Takes Work!Renown Health
油
Accenture provides latest insights on patient loyalty. Suzanne Hendery from Baystate Health shares successful best practices on consistently engaging seniors and women to drive loyalty.
AAAHC embraces changes in healthcare by adapting its accreditation programs. In 2015, AAAHC expanded its mission by acquiring HFAP, becoming the largest accreditor of employer health networks, and gaining recognition to accredit health plans. AAAHC updated its standards to reflect changing healthcare needs and established interpretative guidelines to improve communication. AAAHC surveyors demonstrate compassion through volunteer medical missions abroad. The new AAAHC CEO believes excellence is a journey and aims to make each client's accreditation experience phenomenal through collaborative learning.
The document outlines a seven-step approach to building a clinically integrated network (CIN). The steps include: 1) gathering interested stakeholders; 2) creating a value proposition; 3) developing governance and participation agreements; 4) selecting quality measures; 5) recruiting physicians; 6) measuring and improving programs; and 7) engaging payers. The goal is to improve access, health outcomes, and value through clinical integration and care coordination across providers.
What's Working? Better Benefits for Better Mental HealthMaria Fraga
油
1) Up to 20% of Canadians will experience a mental illness in their lifetime, but nearly half of those with depression or anxiety do not seek medical care due to stigma and cost barriers.
2) To address this issue, Manulife increased its mental health benefits for Canadian employees to fully cover up to $10,000 per person annually for treatment by a variety of mental health practitioners.
3) This benefit aims to remove financial barriers to care, support employees' mental health needs, and reduce disability claims related to mental illness.
On May 23, Conifer Health Solutions hosted a lecture at the ACHE Fellows Seminar in San Antonio, TX. The lecture, Planning for Success with Clinical Integration, focused on the steps associated with building a clinically integrated network; the power of strategic alignment with partners in the care community; and sustainable governance and incentive structures for the clinically integrated network.
Since the launch of the Marketplaces and Medicaid expansion, one out of every 20 Americans has been added to the Medicaid roll. More than 51 million Americans receive physical health benefits from a private Medicaid health plan (or 70% of all beneficiaries) and as of Q3 2015, 41 states had some form of private managed Medicaid. Along with the rapid expansion of Medicaid, comes the push for managed care plans to adopt value-based care approaches that tie provider reimbursement to quality measures and better outcomes. This presentation gives physicians crucial details about Medicaid and CHIP Managed Care Proposed Rule CMS 2390-P, and the five factors for value-based payment success in the era of Managed Medicaid.
Angela D. Moore is seeking a position in human resources recruiting with over 20 years of experience in childcare and staffing services. She has a Master's degree in Health Services Administration and licenses in childcare and driving. Moore is proficient in PC systems, data management, and communication. She has experience recruiting, training, and managing employees in childcare and staffing roles. Moore maintains certifications in first aid, CPR, blood pathogens, and HIPAA compliance.
This document provides a summary of Marlene A. Wise's professional experience and qualifications. She has over 25 years of experience in healthcare management, business development, and operations leadership roles within hospice, home health, skilled nursing facilities, and assisted living organizations. Her background includes developing new programs, managing multi-million dollar budgets, and achieving growth objectives through strategic planning and relationship building. She has a track record of success developing and leading healthcare organizations and teams.
Realizing the Promise of Patient-Reported Outcomes MeasuresHealth Catalyst
油
Dr. Rachel Clark Sisodia, a champion of the system-wide adoption of Patient Reported Outcomes Measures at Partners HealthcCare, will share her experience and perspective on the relevance and necessity of Patient-Reported Outcomes Measures (PROMs). In this webinar, Dr. Sisodia will highlight how the PROMs ideas have been put into practice at Partners HealthCare.
Join us and learn:
Strategies and tactics for overcoming potential barriers to collecting and effectively using PROMs.
Through specific examples, how to demonstrate that PROMs can help deliver faster, more personalized care for individual patients.
How to collect and use advanced analytics to leverage aggregate PROMs data to inform clinical patient and provider decisions.
How to use outcomes metrics for quality improvement and comparative effectiveness.
WayPoint Healthcare Advisors is a deeply experienced solutions provider anchored by strategy and focused on cost, growth, patient experience, and clinical process improvement. We translate strategy into action.
Our experts are hands-on, directly involved in
every step from planning to implementation
until the transformation is complete.
Achieving population health management through more coordinated care is becoming essential as healthcare organizations move away from fee-for-service models and begin operating in the new value-based care environment. One path to succeeding in this new environment and achieving more coordinated care is through formation of a clinically integrated network.
Yale New Haven Health System (YNHHS), a nonprofit academic medical center, is following a seven-phase plan to achieve a regional, clinically integrated network with the ultimate goal of population health management.
On March 16, 2016, President of Value-Based Care, Megan North and Amanda Skinner, Executive Director of Clinical Integration and Population Health for Yale New Haven Health System (YNHHS), co-presented at the 2016 American College of Healthcare Executives Annual Congress on Healthcare Leadership (ACHE Congress). North and Skinner shared A Step-by-Step Approach to A Clinically Integrated Network, to provide insights into each step of the clinical integration road map.
80% of organizations believe that talent plays a critical role in determining HCAHPS scores. Find out how to define and measure quality of hire and then how to find a retain that top talent.
This presentation given by WIMHRT West at the January 4, 2008, TWG meeting covers results from a
survey of Washington State providers on their use of Evidence Based Practics.
Kathy Walcott has over 20 years of experience in healthcare administration, operations, credentialing, and human resources management. She holds an MBA and multiple certificates. Her experience includes credentialing providers for Maxim Healthcare and managing credentialing, human resources, and administrative functions as Assistant Administrator at Jackson Memorial Hospital. She delivers quality work, achieves goals on time, and resolves issues diplomatically.
The document discusses the opportunity and challenges of implementing a structured physician referral program (SPRP) at a fitness facility. A SPRP can connect patients to facilities through physician referrals, but requires qualified staff, health risk assessments, outcome measurements, and tools like prescription pads and education materials. With proper planning and resources, a SPRP can significantly grow membership and revenue for a facility.
Mohammad Hassan is an experienced healthcare administrator seeking a new position. He has over 17 years of management experience in healthcare organizations. He is skilled in business development, leadership, strategic planning, and developing new medical clinics. Hassan has expertise in implementing electronic health records and claims submission systems. He is proficient in contract management, accounting, and technology.
Paradigm Health Plans is a self-funded health insurance provider formed in 2007 that has seen strong growth. Their Member Advantage Program aims to reduce out-of-pocket costs for employers and employees. Self-funded plans offer advantages like level funding and keeping surplus claim money. Paradigm provides lifestyle and health management programs to further reduce costs by 6-9% annually. They aim to control costs through negotiated rates and steering members to high quality, low cost providers.
Maura Griffin has over 20 years of experience in the healthcare industry leading market access and sales strategies. She has a strong track record of gaining formulary acceptance for new drugs and technologies within large healthcare systems. Her expertise includes developing partnerships, analyzing data, and executing collaborative initiatives to address access barriers. Griffin holds a Bachelor's degree in Biology and has taken executive programs at Harvard Business School and Harvard Chan School of Public Health focused on healthcare value and outcomes research.
Provider directory accuracy is critical to ensuring consumers get the care they need from the right doctors. The challenge is the rate at which provider data changes and getting that information into the hands of members. Now regulatory bodies are demanding health insurers put processes in place that ensure the information they collect and publish to their member populations is current and complete. Updating mandatory data fields like address, acceptance of new patients, specialty, languages spoken and more can become overwhelming for a health plan putting a strain on resources. LexisNexis explores where regulations stand, the nature of provider data and why maintaining it is a challenge, and a proven approach to managing your provider data and directories.
Why Local & Mobile Search Matter for Eye DoctorsSurefire Local
油
This document discusses the importance of local and mobile search for eye doctors. It notes that over the last two years, there has been a 150% increase in searches without "near me" included, meaning location is now assumed in searches. It also finds that over 65% of healthcare listings have inaccuracies like name, address, or phone number errors. This highlights the need for eye doctors and other healthcare providers to claim and optimize their online listings to provide accurate information to patients conducting local searches.
Tagan Hervey is seeking a position in healthcare management and has over 3 years of experience working in clinical settings as a volunteer and in utilization management. She has a bachelor's degree in health care management from Platt College. Her most recent role was as a utilization management coordinator at Centene Corporation, where her responsibilities included gathering patient information, authorizing discharges, and ensuring compliance with privacy policies.
LexisNexis Risk Solutions conducted its 2015 Fraud Mitigation Study to examine some of the trends around fraud, fraud detection and fraud analytics, particularly related to the propensity for criminals to perpetrate fraud within multiple industries. Findings uncovered that cross-industry fraud is prevalent and costly, and that fraud mitigation professionals from insurance, health care, retail, communications, insurance, financial services and government could benefit from details of fraud investigations from outside of their own industry. Check out the highlights from our fraud study here.
There are three crucial steps for building an effective top executive team:
1. Get the right people on the team and remove those who are not contributing or resisting collaboration. A new CEO removed two regional executives resisting change and improved customer satisfaction ratings.
2. Ensure the top team focuses only on work that requires collective effort, like setting cross-functional priorities. Rationalizing priorities allowed one team to boost employee satisfaction from 52% to 81% in a year.
3. Address team dynamics like a lack of trust or conflicting agendas. Diagnosing issues through surveys and having the CEO intervene to broker decisions can improve collaboration, strategy alignment, and financial outcomes. Regular check-ins with lower levels also helped embed changes
Craig J. Bracher has over 12 years of experience in healthcare and 10 years in sales. He currently works in business development at Florida Hospital Tampa, where he builds relationships between physicians and hospital administration to increase revenue. Previously, he worked in physician advocacy and marketing, growing business by 15% annually. He also has experience in claims processing and healthcare administration. Bracher has an MBA, MPH, and BS in health education.
Rozelyn D. Fields-Jackson is a highly motivated healthcare management professional seeking a challenging career opportunity to leverage her education and experience in healthcare quality improvement. She has over 8 years of experience in quality improvement, project management, healthcare operations, and auditing/compliance. Her background includes managing quality programs, developing workflows, overseeing teams, and conducting data analysis to improve efficiency and reduce costs. She holds a Bachelor's degree in Healthcare Administration and a graduate certificate in Healthcare Administration.
Alice Frost is seeking a Senior Manager position on the Quality Spectrum HEDIS速 Advantage Team at Inovalon, Inc. She has over 12 years of experience successfully project managing HEDIS速 reporting and quality improvement activities for health plans. Her experience includes managing client expectations, identifying issues, and conducting analyses that have improved HEDIS速 measure rates by an average of 3.7% annually. She also has experience training staff, analyzing data, developing applications and presentations, and serving as Acting Corporate Director of Quality Management for a Medicare Advantage plan.
On May 23, Conifer Health Solutions hosted a lecture at the ACHE Fellows Seminar in San Antonio, TX. The lecture, Planning for Success with Clinical Integration, focused on the steps associated with building a clinically integrated network; the power of strategic alignment with partners in the care community; and sustainable governance and incentive structures for the clinically integrated network.
Since the launch of the Marketplaces and Medicaid expansion, one out of every 20 Americans has been added to the Medicaid roll. More than 51 million Americans receive physical health benefits from a private Medicaid health plan (or 70% of all beneficiaries) and as of Q3 2015, 41 states had some form of private managed Medicaid. Along with the rapid expansion of Medicaid, comes the push for managed care plans to adopt value-based care approaches that tie provider reimbursement to quality measures and better outcomes. This presentation gives physicians crucial details about Medicaid and CHIP Managed Care Proposed Rule CMS 2390-P, and the five factors for value-based payment success in the era of Managed Medicaid.
Angela D. Moore is seeking a position in human resources recruiting with over 20 years of experience in childcare and staffing services. She has a Master's degree in Health Services Administration and licenses in childcare and driving. Moore is proficient in PC systems, data management, and communication. She has experience recruiting, training, and managing employees in childcare and staffing roles. Moore maintains certifications in first aid, CPR, blood pathogens, and HIPAA compliance.
This document provides a summary of Marlene A. Wise's professional experience and qualifications. She has over 25 years of experience in healthcare management, business development, and operations leadership roles within hospice, home health, skilled nursing facilities, and assisted living organizations. Her background includes developing new programs, managing multi-million dollar budgets, and achieving growth objectives through strategic planning and relationship building. She has a track record of success developing and leading healthcare organizations and teams.
Realizing the Promise of Patient-Reported Outcomes MeasuresHealth Catalyst
油
Dr. Rachel Clark Sisodia, a champion of the system-wide adoption of Patient Reported Outcomes Measures at Partners HealthcCare, will share her experience and perspective on the relevance and necessity of Patient-Reported Outcomes Measures (PROMs). In this webinar, Dr. Sisodia will highlight how the PROMs ideas have been put into practice at Partners HealthCare.
Join us and learn:
Strategies and tactics for overcoming potential barriers to collecting and effectively using PROMs.
Through specific examples, how to demonstrate that PROMs can help deliver faster, more personalized care for individual patients.
How to collect and use advanced analytics to leverage aggregate PROMs data to inform clinical patient and provider decisions.
How to use outcomes metrics for quality improvement and comparative effectiveness.
WayPoint Healthcare Advisors is a deeply experienced solutions provider anchored by strategy and focused on cost, growth, patient experience, and clinical process improvement. We translate strategy into action.
Our experts are hands-on, directly involved in
every step from planning to implementation
until the transformation is complete.
Achieving population health management through more coordinated care is becoming essential as healthcare organizations move away from fee-for-service models and begin operating in the new value-based care environment. One path to succeeding in this new environment and achieving more coordinated care is through formation of a clinically integrated network.
Yale New Haven Health System (YNHHS), a nonprofit academic medical center, is following a seven-phase plan to achieve a regional, clinically integrated network with the ultimate goal of population health management.
On March 16, 2016, President of Value-Based Care, Megan North and Amanda Skinner, Executive Director of Clinical Integration and Population Health for Yale New Haven Health System (YNHHS), co-presented at the 2016 American College of Healthcare Executives Annual Congress on Healthcare Leadership (ACHE Congress). North and Skinner shared A Step-by-Step Approach to A Clinically Integrated Network, to provide insights into each step of the clinical integration road map.
80% of organizations believe that talent plays a critical role in determining HCAHPS scores. Find out how to define and measure quality of hire and then how to find a retain that top talent.
This presentation given by WIMHRT West at the January 4, 2008, TWG meeting covers results from a
survey of Washington State providers on their use of Evidence Based Practics.
Kathy Walcott has over 20 years of experience in healthcare administration, operations, credentialing, and human resources management. She holds an MBA and multiple certificates. Her experience includes credentialing providers for Maxim Healthcare and managing credentialing, human resources, and administrative functions as Assistant Administrator at Jackson Memorial Hospital. She delivers quality work, achieves goals on time, and resolves issues diplomatically.
The document discusses the opportunity and challenges of implementing a structured physician referral program (SPRP) at a fitness facility. A SPRP can connect patients to facilities through physician referrals, but requires qualified staff, health risk assessments, outcome measurements, and tools like prescription pads and education materials. With proper planning and resources, a SPRP can significantly grow membership and revenue for a facility.
Mohammad Hassan is an experienced healthcare administrator seeking a new position. He has over 17 years of management experience in healthcare organizations. He is skilled in business development, leadership, strategic planning, and developing new medical clinics. Hassan has expertise in implementing electronic health records and claims submission systems. He is proficient in contract management, accounting, and technology.
Paradigm Health Plans is a self-funded health insurance provider formed in 2007 that has seen strong growth. Their Member Advantage Program aims to reduce out-of-pocket costs for employers and employees. Self-funded plans offer advantages like level funding and keeping surplus claim money. Paradigm provides lifestyle and health management programs to further reduce costs by 6-9% annually. They aim to control costs through negotiated rates and steering members to high quality, low cost providers.
Maura Griffin has over 20 years of experience in the healthcare industry leading market access and sales strategies. She has a strong track record of gaining formulary acceptance for new drugs and technologies within large healthcare systems. Her expertise includes developing partnerships, analyzing data, and executing collaborative initiatives to address access barriers. Griffin holds a Bachelor's degree in Biology and has taken executive programs at Harvard Business School and Harvard Chan School of Public Health focused on healthcare value and outcomes research.
Provider directory accuracy is critical to ensuring consumers get the care they need from the right doctors. The challenge is the rate at which provider data changes and getting that information into the hands of members. Now regulatory bodies are demanding health insurers put processes in place that ensure the information they collect and publish to their member populations is current and complete. Updating mandatory data fields like address, acceptance of new patients, specialty, languages spoken and more can become overwhelming for a health plan putting a strain on resources. LexisNexis explores where regulations stand, the nature of provider data and why maintaining it is a challenge, and a proven approach to managing your provider data and directories.
Why Local & Mobile Search Matter for Eye DoctorsSurefire Local
油
This document discusses the importance of local and mobile search for eye doctors. It notes that over the last two years, there has been a 150% increase in searches without "near me" included, meaning location is now assumed in searches. It also finds that over 65% of healthcare listings have inaccuracies like name, address, or phone number errors. This highlights the need for eye doctors and other healthcare providers to claim and optimize their online listings to provide accurate information to patients conducting local searches.
Tagan Hervey is seeking a position in healthcare management and has over 3 years of experience working in clinical settings as a volunteer and in utilization management. She has a bachelor's degree in health care management from Platt College. Her most recent role was as a utilization management coordinator at Centene Corporation, where her responsibilities included gathering patient information, authorizing discharges, and ensuring compliance with privacy policies.
LexisNexis Risk Solutions conducted its 2015 Fraud Mitigation Study to examine some of the trends around fraud, fraud detection and fraud analytics, particularly related to the propensity for criminals to perpetrate fraud within multiple industries. Findings uncovered that cross-industry fraud is prevalent and costly, and that fraud mitigation professionals from insurance, health care, retail, communications, insurance, financial services and government could benefit from details of fraud investigations from outside of their own industry. Check out the highlights from our fraud study here.
There are three crucial steps for building an effective top executive team:
1. Get the right people on the team and remove those who are not contributing or resisting collaboration. A new CEO removed two regional executives resisting change and improved customer satisfaction ratings.
2. Ensure the top team focuses only on work that requires collective effort, like setting cross-functional priorities. Rationalizing priorities allowed one team to boost employee satisfaction from 52% to 81% in a year.
3. Address team dynamics like a lack of trust or conflicting agendas. Diagnosing issues through surveys and having the CEO intervene to broker decisions can improve collaboration, strategy alignment, and financial outcomes. Regular check-ins with lower levels also helped embed changes
Craig J. Bracher has over 12 years of experience in healthcare and 10 years in sales. He currently works in business development at Florida Hospital Tampa, where he builds relationships between physicians and hospital administration to increase revenue. Previously, he worked in physician advocacy and marketing, growing business by 15% annually. He also has experience in claims processing and healthcare administration. Bracher has an MBA, MPH, and BS in health education.
Rozelyn D. Fields-Jackson is a highly motivated healthcare management professional seeking a challenging career opportunity to leverage her education and experience in healthcare quality improvement. She has over 8 years of experience in quality improvement, project management, healthcare operations, and auditing/compliance. Her background includes managing quality programs, developing workflows, overseeing teams, and conducting data analysis to improve efficiency and reduce costs. She holds a Bachelor's degree in Healthcare Administration and a graduate certificate in Healthcare Administration.
Alice Frost is seeking a Senior Manager position on the Quality Spectrum HEDIS速 Advantage Team at Inovalon, Inc. She has over 12 years of experience successfully project managing HEDIS速 reporting and quality improvement activities for health plans. Her experience includes managing client expectations, identifying issues, and conducting analyses that have improved HEDIS速 measure rates by an average of 3.7% annually. She also has experience training staff, analyzing data, developing applications and presentations, and serving as Acting Corporate Director of Quality Management for a Medicare Advantage plan.
Assessment 2
Quality Improvement Proposal
Overview:油
Write a quality improvement proposal, 57 pages in length, that provides your recommendations for expanding a hospital's HIT to include quality metrics that will help the organization qualify as an accountable care organization.
Health care has undergone a transformation since the release of the Institute of Medicine's 2000 report油
To Err Is Human: Building a Safer Health System.
油The report highlighted medical errors as a contributing factor leading to poor patient outcomes. The Institute of Medicine challenged organizations to implement evidence-based performance improvement strategies in order to improve patient quality and safety. Multiple governmental and regulatory agencies, such as the Centers for Medicare and Medicaid Services (CMS) and the Agency for Healthcare Quality and Research (AHRQ), vowed to strengthen and improve incentives for participation, safety, quality, and efficiency in accountable care organizations (ACOs).
Health 油information technology (HIT) performs an essential role in improving health outcomes of individuals, the community, and populations. Health organizations, consumer advocacy groups, and regulatory committees have made a commitment to explore current and future opportunities that HIT offers to continue momentum to meet the Institute of Medicine's goal of improving safety and quality.
Understanding HIT is important to improving individual, community, and population access to health care and health information. HIT enables quick and easy access to information for both patients and providers. Accessible information has been shown to improve the patient care experience and reduce redundancies, thereby reducing health care costs.
This assessment provides an opportunity for you to make recommendations for expanding a hospital's HIT in ways that will help the hospital qualify as an ACO.
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 2: Explain the relationship between care coordination and evidence-based data.油
Recommend ways to expand an organization's HIT to include quality metrics.
Identify potential problems that can arise with data gathering systems and outputs.
Competency 3: Use health information technology to guide care coordination and organizational practice.油
Describe the main focus of information gathering in health care and how it contributes to guiding the development of organizational practice.
Competency 4: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with applicable organizational, professional, and scholarly standards.油
Write clearly and concisely, using correct grammar and mechanics.
Support main points, claims, and conclusions with relevant and credible evidence, correctly formatting citations and references using APA style.
Reference
.
The document is a resume for Michael Medvedev that summarizes his experience as a results-oriented leader with a proven record of optimizing organizational operations through strategic thinking and hands-on work. He has over 20 years of experience in management, business development, and operations roles for healthcare and biotech organizations.
Louise Marcotte has over 40 years of experience in project management, clinical research, program management, training, and grant management. She has worked in healthcare, academia, consulting, and the non-profit sector. Her skills include budget development, contract negotiation, leadership, writing, and staff supervision. She has managed multi-million dollar projects and grants.
Michael Regis is an experienced executive actuary seeking new opportunities. He currently manages all actuarial aspects of Aetna's commercial business in the West region, totaling $7 billion in annual revenue and over 1.5 million members. Previously he has held senior actuarial roles at Coventry HealthCare, UnitedHealth Group, and CIGNA, leading teams of 15-35 actuaries and analysts. He specializes in pricing strategy, reserving, forecasting, and managing the financial performance of commercial and government health insurance programs.
Dustin Yudowitch has over 10 years of experience in health and wellness consulting, including managing wellness programs and directing sales teams. He holds multiple certifications in nutrition, fitness, and administration. Currently he is a Senior Innovative Wellness Consultant where he generates new business and guides strategic initiatives. He also owns a successful fitness studio he has expanded multiple times.
Tonya Davis has over 20 years of experience in healthcare provider network development and management. She has negotiated contracts and developed networks for managed Medicaid and Medicare plans in multiple states. Her experience also includes credentialing oversight, provider relations management, and developing education programs for healthcare providers.
Daniel Zembrzuski has over 40 years of experience in senior leadership roles in the healthcare industry, specializing in hospital and physician networks, health plans, and business operations. He has a proven track record of reducing healthcare costs and improving financial and operational performance through strategies like accountable care organizations and self-insured health plans. Zembrzuski holds an MBA from Wayne State University and is a Certified Management Accountant with extensive experience in areas like contract negotiation, strategic planning, and employee development.
Ruth E. Thomas's resume summarizes her experience and qualifications for health and business administration roles. She has over 25 years of experience in managed care, case management, quality management, compliance, nursing and human resources. Her resume highlights her education, certifications and professional skills in areas such as leadership, management, analytics, and Microsoft Office proficiency.
Tailoring Your Resume For TodayS PantsuitsLaura Roybal
油
The document provides advice on tailoring resumes for today's job market. It discusses different resume formats including chronological, functional, and targeted resumes. It provides examples of professional profiles and how to structure experience, education, and affiliations sections. The document also discusses using social media and networking sites like LinkedIn to expand professional opportunities and find new roles. It emphasizes customizing resumes and online presence to specific roles and keeping materials up-to-date with changing technologies and job requirements.
Cheryl Monnell is a dynamic healthcare executive with over 30 years of experience in quality improvement, project management, and leadership. She has a proven track record of achieving accreditation and increasing health plan quality scores. Her experience includes developing case management programs, managing HEDIS and CAHPS projects, and overseeing utilization management and pharmacy benefits. She currently serves as the Director of Quality Improvement at WellCare, where she helped the plan achieve NCQA accreditation and increase its star rating.
Lee Antonia Tobar has over 25 years of experience in leadership roles within non-profit organizations. She has a Masters in Public Health and has overseen multiple clinic locations as the Director of School Based Health Centers. Her experience includes fiscal management, program management, personnel management, and operations management. She has a proven track record of innovative approaches and superior interpersonal skills.
The document provides a summary of Patricia Hayner's professional experience and education. She currently works as a Program Manager at Easter Seals Southern California, where she develops behavior intervention plans, implements data-driven programming, and ensures compliance with patient privacy regulations. Previously, she was an Academic Liaison at California Virtual Academy and the owner of ASH Medical Supply, where she gained various healthcare accreditations and contracted with insurance companies. Hayner holds a M.A.Ed. in Education and Counseling Credential from Azusa Pacific University and a BA in English Literature from California Baptist University.
Cammile Bird has over 15 years of experience in senior leadership roles in the healthcare industry, specifically focused on behavioral health services. She is currently the Senior Vice President of Business Development at MedOptions, where she leads sales, business development, and strategic operations. Previously, she held several Vice President roles with responsibility for sales, operations, and strategy at Vericare and INSPIRIS. She has a proven track record of exceeding revenue goals and implementing initiatives that have driven significant business growth.
Wendelyn Bradley is a clinical informatics leader with over 30 years of experience in healthcare IT, operations, and consulting. She currently serves as an Epic Organizational Readiness Lead at Scripps Health, helping to implement a $0.5 billion integrated IT system. She has a background in nursing, medical informatics, and holds credentials including BSN, MA, MS in Medical Informatics.
This document describes a capstone project to develop predictive models that rank healthcare providers based on their value by reducing readmissions. A team created models to: 1) Rank providers based on readmission rates and costs to categorize them from best to worst. 2) Predict the value of providers using a multivariate linear model with an R^2 of 0.54. 3) Predict reduced risk-based cost per patient of 1.2% for every 1% increase in the provider value score. The models and an interactive dashboard will help payers and consumers choose higher quality, lower cost providers to improve outcomes and lower healthcare costs.
Daniel Ethan Law has over 15 years of experience in sales management and program management for medical equipment companies. He has a proven track record of leading teams to exceed sales goals and revenue targets. Currently he is a Division Manager for Lincare, overseeing operations that produce $41 million in annual revenue. Previously he held roles as District Manager and Branch Manager for Lincare, growing patient counts and revenues significantly in each role. Law has expertise in areas such as sales, operations, project management, budgeting, recruiting and leadership.
MD Anderson Cancer Center used experience mapping to understand patient experiences and improve marketing and operations. Interviews with proton therapy patients revealed that most learned about the treatment online and selected MD Anderson for its precision and reduced side effects. The mapping identified key touchpoints and opportunities for improvement, such as expanding the website and improving communications. Changes from the mapping led to increased marketing effectiveness and improved clinical operations, including a new pediatric play area. Experience mapping provided insights that enhanced patient experience and demonstrated value across the institution.
1. TIFFANY L. BEAVER, MBA, Ed.D
5607 Pinecrest Circle Noblesville, IN 46062 317.663.7838 oceanomadr@aol.comhttp://www.linkedin.com/in/tiffanybeaver
Meaningful Use Project ManagerStrategic Account Management Business Analysis
Project/Program Management Client Relationship Management Program Development
Expert in ARRA Meaningful Use objectives, thresholds, and workflows.
Medicaid and Medicare Electronic Health Records (EHR) Incentive Program eligibility expert.
Revenue builder and leader identifying emerging opportunities to maximize profit.
Creates collaborative work cultures, mentoring, training, and motivating team members as well as expanding knowledge.
Delivers innovative strategies to drive organizational growth and seizes competitive advantage in changing markets.
Team Leadership/Organizational Development:
Spearheaded a territory research study, utilizing an organizational leadership assessment tool to measure the level of
health needs within multiple organizations.
Established an eight-member committee for the Healthcare Businesswomens Association, coordinating weekly meetings,
six-month team mentoring programs, and one-on-one mentoring.
Conducted competitive analysis and formulated strategies to secure accounts, ranking in the top 10% within the region.
Integral in positioning Advair速 as a billion-dollar drugthat rose to the top 4% within the region and gained recognition in
GSKs Winners Circle in 2004.
Transitioned routing schedules to accommodate three new sales representatives, increasing sales and sample
presentations for Advair速.
Revenue/Market Share Growth:
Analyzed data and coalesced relationships with credentialing, the Indiana Health IT Extension Center, and Indiana
Medicaid which capitulated a profit margin in excess of 200%?
Initiated communication with 10 prospects, conducted competitive analysis, and demonstrated the benefits of Requip 速, a
neuroscience drug, based on customer-specific business needs, catapulting Requip速 to 4thin the region in three months.
Demonstrated the growing issues of managed care and communicated potential reimbursement savings to high-
prescribing physicians and pharmacists by forging alliances and building pertinent relationships; efforts positioned GSKs
Ventolin速 HFA asthma rescue inhaler as 1st out of 29 in the region and 7th out of 593 nationally, boosting market share
and profit.
Identified unmet territory needs through data analysis, initiated a team meeting and created a territory business plan
which interfaced our sales team and lifted the market share for Wellbutrin速 XL 3% through contact with specialists.
CAREER PROGRESSION
IS Project Manager for Meaningful Use, COMMUNITY HEALTH NETWORK[2010-present]
Analyzed data, identified eligible providers, registered and attested for 48 providers which led to revenue of
$1,000,000 nearly 200% above projected revenue.
Established eligibility of nineteen additional providers by ascertaining patient encounters in NextGen and
successfully attested for these providers, which earned the organization an additional $400,000.
Determined provider eligibility and registered for Centers of Medicare and Medicaid Services (CMS) Electronic Health
Records (EHR) Meaningful UseIncentive Program for over 300 eligible providers.
Ascertained Epic EHR certification and version through The Office of the National Coordinator for Health Information
Technology (ONC).
Inaugurated a new process of acquiring Medicaid identification for residents which will increase profit by at least
$400,000 per year.
Trained over 40 Credentialed Trainers on Meaningful Use.
Educated and answered Meaningful Use questions pertaining to ARRA, provider eligibility, registration and
attestation process, Meaningful Use objectives, and additional Epic resources.
Created a master list of over 500 eligible providers with pertinent registering and attesting information for Centers of
Medicare and Medicaid Services (CMS) Electronic Health Records (EHR) Meaningful Use Incentive Program which
streamlined the registration and attestation process.
Built strong relationships with Credentialing which enabled access to new provider information and NPI login and
passwords for all providers.
Created an Executive Document on the interpretation of Eligible Provider Meaningful Use Objectives cross-referencing the
Centers of Medicare and Medicaid Services (CMS) Federal Register Final Review, The Office of the National Coordinator
for Health Information Technology (ONC) Standards Certification Final Rule, The Indiana Code, and The Revisions to
the Standards for the Classification of Federal Data on Race and Ethnicity , to proactively prepare for an audit.
Initiated contact with the Indiana Health IT Extension Center which led to a new business contract.
Launched a document retention process to assure abidance to the six year governmental standard of the EHR
Incentive Program document retention requirement.
Member, Board of Directors & Director of Mentoring Programs, HEALTHCARE BUSINESSWOMENS ASSOCIATION[2009-2010]
2. Saved 110% on assessments and planning for the 2010 Mentoring Program to overcome budget restrictions by
driving price negotiations and on-boarding a seasoned consultant as a featured speaker at no cost for kick-off event.
Revamped the program, introducing cutting-edge tools for self-discovery and robust assessments to expand value for
women in healthcare across the globe; received positive feedback from mentors and mentees for changes.
Developed surveys to appropriately match mentees and mentors and fortify relationships.
Established organizations first presence on social media platforms, creating a marketing piece for circulation on the
HBA website and groups within LinkedIn.
Delivered presentations at Lilly to recruit participants, resulting in mentor program wait list and 30% boost in
membership.
Senior Sales Representative, GLAXOSMITHKLINE[1999-2008]
Integrated the 80/20 approach, maximized time/budget utilization, and conducted thorough data analysis, identifying
doctors with the highest market potential.
Coordinated speaker programs, selected presentation venues, arranged audio-visual equipment, and networked events.
Built alliances with physicians, nurse practitioners, physician assistants, and respiratory therapists, selling respiratory and
neuroscience pharmaceutical medications.
Developed and mentored new sales representatives through data analysis, pharmacy calls, and research studies.
Appointed to the Presidents Club in 2000 and 2004 for facilitating the highest market share growth within the region;
positioned Flovent速 and Serevent 速 for competitive advantage against Singulair 速, increasing GSKs revenue.
Led diagnostic equipment training for physicians, earning the title of Master of Spirometry Champion in the territory.
Medical Device Account Executive, VITALCOR, INC. [1998-1999]
Facilitated medical device sales to surgeons within Indiana and Kentucky; products included applied fiberoptics, light
sources, fiberoptic cables, refractors/instruments, and surgical drains.
Capitalized on business opportunities with five high-potential clients after three months in the position versus the average
one new customer per month.
Loan Officer, ADMIRAL FIDELITY[1998]Account Executive, HOMESTEADUSA[1997-1998]
CREDENTIALS
Ed.D in Organizational Leadership, IndianaWesleyanUniversity MBA, IndianaWesleyanUniversity
BS in Psychology, Purdue University Certified IMAGE Life Coach
Human Participant Protections Education for Research Teams,
National Institutes of Health |Organizational Leadership Assessment (OLA) Certified