Brenda Kaplan Rn work email
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Brenda Kaplan Rn personal email
I am a registered nurse with expansive experience as a program manager and case manager in the hospital setting as well as for a large health insurance company in a variety of roles. I created and managed a program which resulted in over $56-million in cost-savings. I successfully case managed a large service line and assisted with the creation and implementation of processes improving the bed availability for scheduled admissions, generating additional revenue. Additional strengths include: ability to collect, analyze and synthesize data, allowing the improvement of existing processes. Proven ability to create partnerships with internal and external organizations resulting in an increase of jointly run projects.
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Manager, Population HealthSt.Joseph Heritage Healthcare Nov 2016 - Apr 2023Santa Rosa, CaSupports multi-disciplinary quality improvement teams in creating, investigating, analyzing, and executing quality and performance improvement projects across multiple outpatient practice settings.o Collaborates with Medical Directors and operations leaders to develop and maintain a standard reporting package which can be produced monthly for physicians and providers to monitor P4P and organizational goals performance.o Problem solving and analysis: utilizes effective and creative problem solving techniques in conjunction with variety of information systems (Allscripts, QIS, and Cozeva) to develop solutions and resolve problems.
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Care Network Nurse Manager-ContractorSt. Joseph Heritage Health Jun 2014 - Nov 2016Santa Rosa, CaFOCUSING ON QUALITY IN A CHANGING HEALTH CARE SYSTEM. Assist the organization to remain competitive in a rapidly changing healthcare environment by identifying opportunities, developing and assisting in the successful implementation of improved processes. -
Medicare Star Program ManagerBlue Shield Of California 2012 - 2014San Francisco Bay AreaMaximized CMS Medicare STAR ratings by interfacing with organizational stakeholders including Health Services, Pharmacy, Customer Service, Provider Relations and other key stakeholders to develop relationships, anticipate or resolve issues, and promote mutually beneficial strategies and processes for quality improvement. • During HEDIS pursuit, identified internal resources on short notice when measures were in jeopardy.• Established relationships with provider groups leading to their active participation in the improvement of various star measures. -
Statewide Program Manager Healthy Families ProgramBlue Shield 2001 - 2012San Francisco Bay AreaBuilt and oversaw day-to-day operations of California’s SCHIP program for Blue Shield. • Created processes by partnering with the various departments within BSC such as claims, pharmacy, medical management, and provider relations which led to $56 million cost-savings. • Streamlined department operations allowing doubling the workload without the need to increase staff.• Routinely evaluated and improved operations giving the team the ability to identify new cases up to two months sooner than the original process.
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Manager Of Care Management-Northern Region HmoBlue Shield Of California 1997 - 2001San Francisco Bay AreaResponsible for a team of nurses and non-clinical staff which promoted the delivery of quality; cost-effective health care services based on medical necessity and contractual benefits as well providing support to IPA/MGs, members and their families. • Seamlessly transitioned the functions of entire team to San Francisco, including hiring and training a team comprised of registered nurses and authorization coordinators with minimal to no impact to members, and or providers.• Created workflows and interviewer reliability tools specific to the HMO product increasing staff morale.
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Regional Case ManagerBlue Shield Of California 1996 - 1997San Francisco Bay AreaResponsible for assisting in the case management of HMO and POS members within the 9-bay area counties.• Coordinated out of area admissions, flexing of benefits, and contracting with providers. • Partnered with IPA/Medical Groups to manage members with complex needs, acting as a resource when appropriate. • Collaborated with brokers to help transition difficult cases.• Identified the need and created a process to inform finance of high-dollar cases.
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Case Manager- Hematology/Oncology/Bone Marrow TransplantsLucile Packard Children'S Hospital @ Stanford 1992 - 1996Palo Alto, CaliforniaCase managed one of the hospital’s busiest service lines, attending rounds, monitoring utilization of patients, keeping third party payers apprised of a patient’s stay.• Conceived and led initiative to transition department from unit to service line based case management. • Identified the need & jointly created & implemented the process to move certain chemotherapy regimens from an in-patient to out-patient setting. • Selected to participate on a team responsible for coordinating the transition of the kidney & liver transplant team to LPCH from another facility.
Brenda Kaplan Rn Skills
Frequently Asked Questions about Brenda Kaplan Rn
What is Brenda Kaplan Rn's role at the current company?
Brenda Kaplan Rn's current role is Manager of Process Improvement at Providence Medical Group - formerly St. Joseph Heritage Healthcare.
What is Brenda Kaplan Rn's email address?
Brenda Kaplan Rn's email address is br****@****joe.org
What skills is Brenda Kaplan Rn known for?
Brenda Kaplan Rn has skills like Managed Care, Process Improvement, Healthcare, Health Plan Operations, Experienced Program Manager, Utilization Management, Hmo, Delegated Model, Schip, Medicare Advantage, Care Manager, Data Analysis.
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