Amy Qureshi Email and Phone Number
Registered Nurse with a driving passion for improving health outcomes through exceptional care delivery and use of data-driven insights: deep managed care and integrated health system operational knowledge; expertise in care management as an essential component of population health and driver in value based care; confident translator of regulatory requirements into efficient, adherent operational processes; extensive experience in care management and utilization management systems implementation and solutions development. Active RN license in good standing in Maryland and Pennsylvania.Key Competencies: Utilization and care management workflows, programs, operations and metrics; use of population health data for risk stratification and integration with care programs; data analysis, metrics definition and reporting; CMS regulatory compliance; NCQA accreditation and HEDIS alignment; quality and performance measurement; software implementation and process redesign; Agile methodology; team leadership; project and program management.
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Senior Director, Healthcare ConsultingCitius Healthcare ConsultingBaltimore, Md, Us -
Head Of Account ManagementBrave Health May 2024 - Sep 2024Miami, FlAccount management organization development to ensure that the payer partners realize optimal value and outcomes for their members in need of virtual mental health care services. -
Clinical ConsultantThe Terry Group Oct 2022 - May 2024Chicago, IlCase management, utilization management, and clinical SME engaged with large health systems, telehealth providers, technology vendors and state agencies delivering:- Inpatient and ambulatory case and utilization management performance optimization and operational redesign- Clinical and quality metric data modeling, analysis and opportunity identification- Interim case management leadership- Product strategy- Return on investment analysis and validation -
Senior Product Owner/ConsultantCognizant Jul 2021 - Oct 2022Baltimore, MdProduct development and consulting for the utilization management solutions providing prior authorization interoperability, enabling efficiencies and reducing burden for payers and providers through business rule automation and compliance risk visibility through payer dashboards. -
Senior Product Manager, Case And Utilization ManagementVital Data Technology Jan 2021 - Jul 2021Newport Beach, CaProduct management for commercial and customized case management and utilization management solutions for payers, providing CM operational dashboards and workflows to meet NCQA and URAC standards and essential UM requirements that align with CMS Medicare Advantage requirements. -
Director, Clinical SolutionsZyter|Trucare Dec 2017 - Jan 2021Bedford, Ma(Formerly Casenet LLC, a Centene company) CM, DM, UM, and Population Health clinical SME supporting sales and marketing in growth, and providing expertise in CMS compliance, NCQA accreditation, and quality in collaboration with the product and client success teams. -
Director, Industry PrincipalPegasystems Dec 2016 - Dec 2017Cambridge, MaClinical SME in the Health Care and Life Sciences vertical, engaging large payers, health systems, and pharmaceutical clients and collaborating in the development of core case and utilization management platform features. -
Senior Clinical Solutions ConsultantCasenet, Llc Nov 2014 - Dec 2016Bedford, MaCM, DM, and UM solution demonstrations and clinical SME support to the sales, marketing, product, and client success teams. -
Specialist SeniorDeloitte Consulting Feb 2012 - Mar 2014Greater Philadelphia AreaClinical management consultant in the Healthcare Provider Strategy and Operations organization -
Clinical Management ConsultantGreencastle Associates Consulting Jan 2010 - Feb 2012Malvern, PaClinical SME and project management in EHR implementations. -
Program ManagerPublicis Groupe 2007 - 2010Blue Bell, PaLeader of a registered nurse team providing inside sales and services for a large pharmaceutical client. -
Senior Clinical Sales Support Manager | Senior Clinical AnalystMedecision 2001 - 2006CM, DM, and UM software implementations and product demonstrations for managed care organizations. -
Case Manager | Home Health Coordinator | Staff Nurse (Rn)The Children'S Hospital Of Philadelphia 1990 - 2001
Amy Qureshi Education Details
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Nursing
Frequently Asked Questions about Amy Qureshi
What company does Amy Qureshi work for?
Amy Qureshi works for Citius Healthcare Consulting
What is Amy Qureshi's role at the current company?
Amy Qureshi's current role is Senior Director, Healthcare Consulting.
What schools did Amy Qureshi attend?
Amy Qureshi attended Cedar Crest College.
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Amy Qureshi
Greater Northampton Area, United Kingdom -
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