Conducted reviews (and/or quality over-reads of such reviews) of care providers, sites, facilities, medical records, and other associated medical-field materials, personnel, and documents either onsite or at remote locations. Such reviews included (amongst others): Care Provider Site Reviews, Chart Keeping Standard Reviews, HEDIS Hybrid Chart Abstractions, Medicare Risk Adjustment, Custom QI Reviews and/or Care Provider Site and/or Care Provider Monitoring Reviews.HEDIS Projects for: Fidelis, Humana, Visiting Nurse Services of NY, Riverside Hospital, NYS DSRIP, Med Review Inc (NYCHSRO), Affinity, UMASS.

Quality Management - Medicaid/Medicare, HEDIS Chart Review

Responsible for creating a partnership relationship with providers and other initiatives and implementing the concept of a Medical Home for our members to achieve this full integrated and accountable system of care.Assessed current practice patterns, assets and challenges utilizing Medical Home Index, NCQA Standards, HEDIS audits, site reviews and medical records reviews. In partnership with the PCP, evaluate results of the initial assessment. Establish a project plan with the practice that establishes goals and objectives for improvement. Provided ongoing practice support and sustains the partnership. Established regular meetings to track progress. Identified and facilitated at least one practice in each MPC region to become SSB Physician Champions by obtaining NCQA certification as a Patient Centered Medical Home. Improved the understanding and sensitivity to the unique needs of this population and the care giversIdentified opportunities for improvement in member health outcomes based on ongoing review of trends in member complaints and claims data.Conducted and project managed annual Performance Improvement Projects (PIPs) and initiatives, in accordance to health plan, State and national benchmark goals for Medicaid (STAR, CHIP, STAR+PLUS) & Medicare programs. Established indicators for monitoring and evaluating the full spectrum of care and services provided to members for quality, appropriateness, continuous improvement and satisfaction.Provided education in the area of quality management to all departments and assisted in ensuring compliance with regulatory and accrediting organizations. Prepared monthly and quarterly QM reports for intradepartmental team leaders and other QM-related committee meetings. Provided ongoing review of claims resolution and other quality indicators for delegated health services vendors.Conducted on-site medical record reviews at various provider facilities for HEDIS

Conducted reviews (and/or quality over-reads of such reviews) of care providers, sites, facilities, medical records, and other associated medical-field materials, personnel, and documents either onsite or at remote locations. Such reviews included (amongst others): Care Provider Site Reviews, Chart Keeping Standard Reviews, HEDIS Hybrid Chart Abstractions, Medicare Risk Adjustment, Custom QI Reviews and/or Care Provider Site and/or Care Provider Monitoring Reviews.Assisted in the coordination of communication processes with administrative management, field staff as well as other affiliates, strategic partners, and other external individuals and organization

Conducted physical assessments, provided pre-admission and discharge patient education, administered medication and other treatments in a busy Medical/Surgical hospital unit per standards of care protocol.Coordinated patient care assignments, maintained drug accountability, ensured proper documentation and equipment maintenance.

Owner/President of independent talent agency, with primary focus on music industry clientele. Managed platinum selling recording artist, “Ginuwine,” gold selling recording artist, “Sole,” Grammy® nominated producer, “Baby Paul,” producer “Staybent,” and songwriter/Artist, “Shae Jones.”Negotiated contractual agreements for clients, including recording advancements and compensation, publishing and related royalties. Marketed clients and acquired new businesses (e.g. recording contracts, new performance venue arrangements, endorsement deals, radio or other interviews, and various appearances).

Served as booking agent and assistant to CEO of Pyramid Entertainment Group, Inc.Sought and exclusively signed new, talent for agency.Served as primary agent/liaison between various recording artists (“Gladys Knight,” “Kool and The Gang,” “KC & The Sunshine Band,” “The Isley Brothers,” “Ginuwine,” and “Case.”) and other internal/external agents and business partners regarding their appearances/performances.