Helen Zarate Email & Phone Number

Greater Denver Area

Greater Denver Area

Total of 20 years of HEDIS career progression of which the past 12 years have been with Change Healthcare . Serving in more than five functions including, Project Manager, Assistant Project Manager, Service Request (SR), Quality Assurance (QA), Subject Matter Expert (SME) and Abstractor, for two organizations. • Expertise includes: Medical Claims and Quality of Care Reviews, Health Insurance Medical Studies, Medicare Set Aside Analysis, Medical Office Credentialing per specific Health Insurance requirements.• Deliver error-free, year-round HEDIS performance measure reporting for multiple health plans. • Managed and developed high-performing global teams of 80-100 nurses. • Analyzed data and translated into creative solutions.• Launched quality improvement processes to elevate and optimize performance.• Partner with cross-functional teams, agencies, and providers to evaluate and close data and care gaps.• Created testing materials and clinical training manuals for software implementation. • Forecasted staffing needs and pre-screened, interviewed, and selected high performing employees. • Facilitated HEDIS quality training, contributing to an increase in pass rate. • Conducted international training related to job requirements, company software, and HEDIS measures.• Serve as SME, mentor, and coach for Abstractors and QA staff.• Serve as SR, responding to client's questions and/or concerns related to HEDIS measures.• Serve as QA and Super QA, assuring error free work. Educating abstractors on any misunderstandings of HEDIS measures.• Knowledge of NCQA and State measures with focus on Comprehensive Diabetes Care (CDC) and Well Child measures.• Prepare charts for MRRV external audits, receiving 100% pass rate.

Greater Denver Area

• Started as an Abstractor, promoted to Assistant Project Manager, and Project Manager • Deliver error-free, year-round HEDIS performance measure reporting for multiple health plans. • Analyze data and translate into creative solutions.• Launch quality improvement processes to elevate and optimize performance.• Partner with cross-functional teams, agencies, and providers to evaluate and close data and care gaps.• Created testing materials and clinical training manuals for software implementation. • Forecast staffing needs and pre-screen, interview, and select high performing employees. • Facilitated HEDIS quality training, contributing to an increase in pass rate. • Serve as SME, mentor, and coach for Abstractors.• Prepare charts for MRRV external audits, receiving 100% pass rate.

Littleton, Co

• Created curriculum and taught learning-disabled children.

• Honorable discharge after serving four years.