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Healthcare Management and Quality Improvement professional with more than 25 years of experience in the fields of nursing, quality and risk management, and clinical utilization and case management. Self-directed with solid leadership skills and a proven track record of developing and executing healthcare quality and utilization programs, as well as an exceptional ability to build and mentor teams. Registered Nurse and also hold the CPHQ (Certified Professional in Healthcare Quality), a comprehensive credential which covers the fields of quality, case, utilization and risk management and emphasizes how all of these programs and processes integrate into an effective system. A self-described "quality geek", enjoys learning, teaching, exploring, sharing, implementing and identifying best practices in all healthcare settings.
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Clinical Quality Program ManagerAnthem Blue Cross And Blue Shield Aug 2016 - May 2019 -
Clinical Quality Program ConsultantAnthem Mar 2014 - Aug 2016
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Director, Health ServicesUniversal American Mar 2009 - Oct 2013Oklahoma City, Oklahoma AreaDirection and management of all utilization and case management activities for the Medicare Advantage programs in Oklahoma City area. Managed budget and team goals, including productivity and outcomes. Responsible for reporting activities and outcomes to corporate management and physician and hospital partners. Development and implementation of a Transitional Case Management program which decreased the 30-day acute readmission rate from 18% to less than 12%. Streamlined operations to decrease referral/authorization turnaround time to less than 48 hours. -
Clinical Liaison / Director Of Case ManagementEdmond Specialty Hospital 2007 - 2009Edmond, OkPerform clinical evaluations; determining client eligibility/need for long-term acute care hospital (LTAC) services. Develop problem list and initial plan of care for clients accepted to LTAC. Comprehensive utilization and case management services for assigned LTAC clients. DRG assignment and compliance. Targeted and general marketing strategies for current and potential referral sources. Clinical review and investigation to identify and correct quality and/or liability issues
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Hospital Qiosc DirectorOklahoma Foundation For Medical Quality 2001 - 2006Oklahoma City, Oklahoma AreaExecution of CMS national priority area projects and special projects, resulting in award of “Star QIOSC” for two consecutive years. Facilitated and coordinated national taskforces and workgroups in the development and implementation of national performance measures and the production of peer-reviewed articles and reports of this work. Partners in this work included AHA, AMA, JCAHO, IHI and CDC. Prepared and presented national presentations to promote and educate quality professionals about the approved standards, evidence base and intervention tools. Development of a critically acclaimed review and synopsis of current literature and science related to national Surgical Care Improvement Project. -
Utilization Management DirectorChickasaw Nation Health System 1994 - 2001Ada, OkDevelopment of an award-winning Case Management program for the referred care (Contract Health) program in a busy and proactive American Indian health care system. Recruited by Administration to bring CM/UM concepts throughout health system. Creation and implementation of Utilization Management Department which encompassed hospital and peri-operative case management, quality and risk management, utilization review and successful JCAHO certification, while supervising up to 14 personnel. Clinical review and investigation to identify and correct quality and/or liability issues. Participation and coordination of Health System and Medical Staff Quality Teams and Compliance Committee. Preparation and presentation of activity and quality reports to Medical Executive, Governing Body, Administration, and external regulatory bodies.
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Frequently Asked Questions about Karina Carr
What is Karina Carr's role at the current company?
Karina Carr's current role is Healthcare Quality and Utilization Professional.
What is Karina Carr's email address?
Karina Carr's email address is ka****@****hem.com
What is Karina Carr's direct phone number?
Karina Carr's direct phone number is +140597*****
What schools did Karina Carr attend?
Karina Carr attended East Central University, East Central University.
What are some of Karina Carr's interests?
Karina Carr has interest in Boating, Antiquing, Fishing, Gardening.
What skills is Karina Carr known for?
Karina Carr has skills like Utilization Management, Hospitals, Utilization Review, Disease Management, Healthcare Management, Medicare, Managed Care, Healthcare, Medicaid, Healthcare Information Technology, Nursing, Case Managment.
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1columbia-academy.com1 +144362XXXXX
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Karina Carr
Greater Boston4keurigdrpepper.com, tripadvisor.com, conventures.com, gtigrows.com -
Karina Carr
Senior Coordinator-Port Terminal Operations/ Vessel Closure -Area South EastKennesaw, Ga3aol.com, hapag-lloyd.com, thegeekpit.com2 1678560XXXX
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