Diana Simms Email & Phone Number

Cincinnati, Ohio, United States

Cincinnati, Ohio, United States

• Meticulously organized and prepped the company and its partners to achieve a successful URAC reaccreditation survey with zero findings.• Developed and maintained policies and procedures in compliance with statutory and regulatory local, state, and federal guidelines. • Promoted regulatory compliance adherence through education provided to all associates regarding quality program initiatives and accreditation standards.• Liaised between multi-organization executive teams to align standards, expectations, and long-term goals.• Provided regular updates to senior leadership on quality metrics by communicating consistency problems or deficiencies with compliance, standards of care, and quality assurance requirements.• Applied risk reduction techniques and improvement methodologies to foster high-reliability practices within the organization.• Collected data and performed statistical analysis of near-miss and adverse safety events.• Performed root cause, common cause, and statistical analysis on near-miss and adverse patient safety events as well as common organizational issues.• Compiled and analyzed data to identify areas of waste, support operational decision-making, and improve workflows. • Assessed patient-centered services to evaluate conformance with quality standards.• Developed quality improvement plans, policies, and operational guidelines.• Applied knowledge of Lean Six Sigma Foundations to make insightful observations of deviations and successes.

Cincinnati, Ohio, United States

• Conducted routine audits of recorded interactions between call center agents with patients and/or providers.• Evaluated competency of front-line agents, documented performance, and recommended targeted upskilling to improve noted areas of deficiency.• Educated all staff on URAC standards and confirmed the organization's maintenance of standards between accreditation periods.• Applied knowledge of Lean Six Sigma improvement methodologies to make insightful observations of deviations and successes to promote high-reliability practices within the organization.• Analyzed quality and performance data to identify areas of waste, support operational decision-making, and improve workflows.• Collected data to perform root cause, common cause, and statistical analysis of potential and actual adverse patient safety events.• Established and tracked quality department goals, objectives, and quality improvement project measures of success.• Provided regular updates to executive leadership on quality metrics by communicating/demonstrating consistency problems or deficiencies.• Liaised between quality control and other support service departments, providing project updates and consultation.

Cincinnati, Ohio, United States

• Co-Chair of Conduit's Employee Engagement and Retention Committee• Shared Leadership Member• Hired, managed, and developed 25+ associates to maximize operational performance via call monitoring, coaching, up-skilling, and professional development opportunities.• Conducted performance reviews and delivered salary adjustments to direct reports.• Led meetings to develop and deepen relationships with associates, client stakeholders, and executive leadership.• Achieved specific team objectives while maintaining high-performance KPIs.• Promoted a compassionate patient-centered culture while strengthening key safety behaviors.• Established and adapted work schedules to align with frequently changing staffing needs while maintaining client-tailored Service Level Agreements.

Cincinnati, Ohio, United States

• Secretary of BSMH/Conduit's Employee Engagement and Retention Committee.• Promoted to Team Lead (04/2021) of Top Performing Team in the Department.• Conducted Peer Mentoring Meetings to drive performance and exceed KPIs.• Delegated chat support coverage among all Team Leads to ensure optimal specialty call type support.• Answered incoming calls on a high-volume, multi-call type telephony system to independently handle consistently over 30 calls each day.• Collected, validated, and updated patient health records in Salesforce CRM and EPIC EMR to provide optimal patient care.• Completed registration and financial clearance functions prior to the patient's arrival for service.• Routinely accomplished and exceeded productivity requirements set forth by direct supervisors and workforce management.• Delivered high-quality patient care among all omni-channels.

Blanchester, Ohio, United States

• Personally recruited by MD to cover maternity leave for physician's concierge practice.• Obtained vitals, patient demographics, and accurate medical histories from patients, highlighting critical information.• Efficiently performed insurance verification, pre-certifications, and pre-authorizations via telephone, fax, and web.• Initiated HIPAA-compliant correspondence with hospitals, pharmacies, specialists, and assisted living facilities to comply with physician-ordered medication, referrals, labs, and imaging.• Contacted patients regarding unpaid and underpaid accounts to resolve issues.• Enhanced positive patient outcomes by providing knowledgeable education and clarification to patients regarding procedures, medications, lab results, nutritional information, and other physicians' orders, answering questions thoroughly.

Ohio, United States

• Remotely and directly managed the daily operations of a team of Clinical Allergy Specialists and their allergy clinics in the Ohio, Kentucky, and Illinois areas. • Focused on creating opportunities for direct reports to increase profitable productivity within their allergy clinics while maintaining the highest quality patient care.• Maintained optimal communication with all necessary branches of the corporation to successfully implement and drive profitable operations for key stakeholders.• Organized and led daily regional conference calls.• Updated Salesforce workflows and analyzed data within the SaaS/CRM platform.• Performed payroll and initiated new hire onboarding training for the region.• Assisted the Regional Account Manager with other necessary human resources responsibilities such as interviewing, annual reviews, and compensation adjustments.

Blanchester, Ohio

• Solely operated high-volume clinical allergy laboratory by providing on-site allergy testing and treatment for a well-respected Primary Care Provider. • Delivered quality hands-on patient care by administering percutaneous allergy tests and subcutaneous allergy immunotherapy injections for patients with allergy-related conditions under the direct supervision of the Physician.• Reviewed 75-100 physician cases per week to analyze ICD-9 and ICD-10 codes to begin verifying insurance coverage information. • Interfaced with insurance carriers (15-20 calls per day) to discuss patient's healthcare benefits such as CPT code coverage, co-insurance, deductibles, and OOP maximums.• Assured timely reverification of insurance benefits via telephone and web prior to patient procedures/appointments and disclosed all information to patients via signed informed consent.• Logged every patient interaction detail and call information in EMR and Salesforce to efficiently track sales opportunities, document physician requests, and record any deficiencies.• Formulated and mixed allergen immunotherapy medication adhering to strict aseptic protocols.• Implemented a state-wide protocol for communication improvement for all new employees.• Provided continuing education to colleagues as leader of Ohio's Quality Assurance Specialty Team.• Administered high-quality training for new hires through a company-wide Preceptorship program.• Demonstrated leadership through involvement in the inaugural Sierra Trailblazers Manager Development Program.

Cincinnati, Oh

• Assisted Orthodontist chair-side with all orthodontic procedures.• Consulted with patients and responsible parties in regards to treatment plans and progress updates.• Introduced new patients and their families to the practice and Orthodontist.• Completed new patient demographics and clinical data as the Orthodontist completed inital exam.• Utilized multiple sales techniques in order to gain the new patient to the practice.• Relayed treatment options and financials from Orthodontist to the new patients.• Completed initial records, explained future procedures and discussed concerns/questions with patients and their families.

Hamilton, Oh

• Assisted Orthodontist chair-side with all orthodontic procedures• Consulted with patients and responsible parties in regards to treatment plans and progress updates• Completed all labwork needed such as creating plaster models and producing Essix retainers• Underwent 3D Ortho Insight Model Scanner Training

West Chester, Oh

• Updated Dental Records• Gathered medical histories and renewed exam data• Captured Intra and extra-oral photographs• Impressed for study models• Captured and processed both film and digital radiographs (Panoramic, Periapical, TMJ and Cephlometric)• Instructed effective oral hygiene techniques with patients and their parents• Researched and relayed essential information pertinent to the patient's procedure• Assisted Orthodontist using the Four-Handed Dentistry Technique• Competency in all banding, bonding and debonding procedures• Proficiency in placing and removing arch-wires, ligatures and all orthodontic appliances• Able to assist the Doctor with recontouring of the ginigiva with a Diode Laser• Completed accurate and thorough treatment notes for each patient's procedure• Created informative letters to referring OMFS and DMDs regarding progress updates of mutual patients• Maintained quality infection control• Aided with clerical duties as needed• Implemented a quality control program to reduce costly errors and patient discomfort• Able to multi-task between all of the above responsibilities with efficiency and speed while maintaining composure and excellent chair-side manor

Bachelor Of Arts - Ba, Sociology

OWL (Ohio State Welcome Leader)

Master Of Health Administration, Health/Health Care Administration/Management