Description
Summary Extensive experience in managed care and acute healthcare with emphasis on Quality Management, NCQA and JCAHO, NCQA, and CARF accreditation management, Risk Management, Medical Staff Credentialing, Peer Review, and clinical data management and analysis with demonstrated success. Many years of experience with the statewide cancer registry, hospital based registries, and the American College of Surgeons Commission on Cancer. Served as Client Records- audit client records to assure compliance with state regulatory agencies. Responsible for content and accuracy of all documentation. Responsible for all auditor visits and production of information requested System Administrator for computerized record keeping system. Quality- responsible for monitoring key indicators and data management and analysis to include data displays for quality management and for national accreditation (CARF). Responsible for CARF accreditation survey process - prep through to completion of survey Responsible for working with the state regions to assure compliance with DOJ the settlement stipulations for the agency a resource to accreditation stakeholders to assist with standards compliance to achieve and maintain accreditation. Successful in assisting Standard Owners to close outstanding action items from survey conducted in 2007. Responsible for standard compliance for Georgia Region Select NCQA standards Department of Human Resources standards for managed care organizations and internal Kaiser Quality Program * Work directly with standard owners to provide standard updates and clarifications * Provide review services for policies measurement documents and reports as needed demonstrate compliance Coordinated hospital risk management activities and programs