Chelsea Stuart Email & Phone Number

United States

Created and implemented reporting for government payer product support, making it compliant and profitable, billing out $230K in 2022Key analyst and project manager for driving successful outcomes for clients and projects, i.e.: CA AB-457 client reporting build out for 30 clientsEngaged with clients, managers, product, and data science to ensure reporting.

Telecommute

An integral member of the team that is responsible for the relationships for all HEDIS reporting vendors, auditors, NCQA, and regulators for insurance plans across all lines of business.Coordinated NCQA accreditation reporting needs and requirements. This included review of Health Plan Rating requirements, accreditation result review and approvals.

Greater Salt Lake City Area

• Performed the analyzation and validation of over 50,000 employees electronic medical record security access provisioning while the company was performing a migration.Quarterly security audits required validation of.
• Project management in Jira and Version One software

Greater Salt Lake City Area

Performed all activities surrounding HEDIS, state, and risk adjustment reporting, that resulted in ensuring 4 Star Accreditation. Engaged, scheduled, and coordinated work and trainings for 30+ provider offices quarterly. This included documentation and chart collection management from EMRs, invoicing, problem mitigation, and training of NCQA measure impact.

Greater Salt Lake City Area

• Performed medical documentation evaluation for completeness and coding reporting correctness. Education was provided to providers to assist in mitigating risk. Additional notes:
• Became a Certified Medical Coder
• Performed internal coding audits for Intermountain providers
• Educated providers on their findings and proper coding practices
• Educated offices to better support providers in coding practices
• Educated providers and offices about Risk Adjustment coding and ICD-10 implementation

Greater Salt Lake City Area

• Performed auditing and data analysis based on CMS Value Based Reimbursement for rural hospitals to ensure they were eligible for the additional 4% financial provisioning. Engaged with administration to provide insight.
• Worked to better assist multiple rural hospitals in meeting CMS guidelines
• Established working relationships with nurse case managers in rural hospitals
• Audited Value Based Purchasing measures for CMS
• Data analysis
• Assisted in Joint Commission and CMS audits and rule implementation

Provo, Utah Area

• Managed a busy group of support staff for a busy orthopedic and sports medicine clinic. Hiring, training, evaluation, and scheduling were required. Migration, integration, and training provided to staff to move to EMR.
• Management of medical assistants, athletic trainers, back office staff, andschedulers; including interviewing and training
• Assisted provider in transitioning from transcription to EMR
• Management of provider and surgical scheduling
• Prepared and assisted in office procedures
• Proper use of coding for preauthorization of surgeries and procedures