Accomplishments: * Leading organization wide initiative for implementation of evidence based practices and just, learning culture. * Instrumental in developing automatic daily reports for healthcare acquired infections from electronic health record. * Identified and was influential in developing performance improvement initiatives to comply with Conditions of Participation (CoP's) and Joint Commission regulations for voluntary safety reporting, Quality Assurance Performance Improvement (QAPI) plans and utilization management plan. * Recognized need and assisted with operational structure to define readmission criteria for utilization management data collection and analysis. * Functioned as medical consultant in medical mal practice law firm for evaluation of deviations from standard of care and direct support for depositions and trials. * Responsible for developing response and submitting third party Additional Documentation Review (ADR) and appeal requests that resulted in 100% reimbursement. CAREER HIGHLIGHTS Shriners Hospitals for Children-Tampa, FL-2014 - Present 22 - Hospital not-for-profit multi-national health system providing specialized care to children with orthopedic conditions, burns, spinal cord injuries, and cleft lip and palate. Corporate Compliance Manager, Quality and Safety Instrumental in applying conditions of participation (CoP's) standards to utilization management, clinical documentation, medical necessity and care management initiatives. Directly involved with improving voluntary safety reporting process including development of standardized reporting process. * Serves as regional point of contact for assigned hospitals and designated quality and safety expert for the entire organization. * Responsible for developing and presenting quarterly board reports that identify adherence or deviation to compliance practice guidelines and the U.S. Sentencing Commission Federal Sentencing Guidelines. Communicate findings directly to senior management. * Oversee execution of system-wide just, learning culture. * Conducts medical record reviews to assess compliance with clinical documentation standards and facilitates report of findings to executive team. * Identify key operating metrics for strategic plan, dashboard development and monitors compliance. * Audit quality assurance process improvement (QAPI) plan and developed standardization for organization wide use based on the regulations for establishing performance improvement projects including board of governors review and approval. * Conduct new hire compliance training to central region * Member of enterprise data warehouse implementation committee Health Care Quality Project Manager- 2014 - 2015 Developed the strategic vision and infrastructure needed to implement and support a robust voluntary safety reporting program to measure voluntary reported safety events. Improved processes based on identification of best practices of key clinical and operational areas for opportunities of improvement. Facilitated process for evidence based practices and promotion of best practices for clinical and operational standardization. * Instrumental in identifying low voluntary safety event reporting and high amount of inappropriate category selection in safety reporting system database. Initiated restructuring and naming convention for safety reporting system rLSolutions database to improve event selection. * Developed system wide process for evidence based practice standards that facilitates provider involvement with guideline development. * Directly responsible for conducting literature search and writing clinical practice guidelines of healthcare acquired conditions. * Influential for placing voluntary safety reporting metrics on the system-wide strategic plan. * Founding member and leadership to Quality and Safety Council that serves as a system-wide

Highlights:

• Risk manager
• Process improvement
• quality
• Medical
• Medical Records
• Billing
• Documentation
• Medicare
• Management
• Direct Patient Care