Kristen Scott Email & Phone Number

•Design and execute innovative programs, including medical dental integration programs, to deliver positive outcomes and achieve long-term sustainable impact.• Implement initiatives and strategies to eliminate barriers to care, reduce health disparities, and address social determinants of health ranging from an individual to a population. •Instill culture of continuous improvement around whole person health by encouraging new ideas and solutions to enhance quality of life for enrollees… Show more •Design and execute innovative programs, including medical dental integration programs, to deliver positive outcomes and achieve long-term sustainable impact.• Implement initiatives and strategies to eliminate barriers to care, reduce health disparities, and address social determinants of health ranging from an individual to a population. •Instill culture of continuous improvement around whole person health by encouraging new ideas and solutions to enhance quality of life for enrollees and secure support for initiatives to reach desired results. •Development and seamless implementation of Case Management program for dental managed care, including member identification, risk stratification and effectiveness metrics to ensure continuity between medical and dental care delivery. •Provide comprehensive guidance for clinical quality programs to improve oral health outcomes and manage performance metrics for driving results tied to incentive payments or penalties. Show less

West Allis, Wi

• Create and implement quality improvement strategies for streamlining programs in support of QI initiatives to provide effective health and dental care for Medicaid, Medicare, and Marketplace recipients; along with the application of quality analysis, performance metrics, and QI reporting requirements• Provide management and oversight of Healthcare Effectiveness Data and Information Set (HEDIS), National Committee for Quality Assurance (NCQA) Accreditation, regulatory agency compliance… Show more • Create and implement quality improvement strategies for streamlining programs in support of QI initiatives to provide effective health and dental care for Medicaid, Medicare, and Marketplace recipients; along with the application of quality analysis, performance metrics, and QI reporting requirements• Provide management and oversight of Healthcare Effectiveness Data and Information Set (HEDIS), National Committee for Quality Assurance (NCQA) Accreditation, regulatory agency compliance, Credentialing and Pay for Performance (P4P) initiatives.• Led the development of processes and programs, resulting in NCQA Accreditation, demonstrating a commitment to providing the highest standards of managed care• Improved quality metrics to maximize Medicaid performance based bonus payments.• Insourced managed dental care and HEDIS project management including medical record pursuit and abstraction• QI Adherence to budget thereby avoiding variances to forecasted financial plan Show less

Blue Island, Il

• Promoted to Chief Quality Officer and transferred to a new location to implement quality infrastructure for 330-bed acute care hospital • Fostering of a culture of safety and advanced the facility to a high reliability organization (HRO) while optimizing improvements in care delivery, patient safety, and risk mitigation• Strict adherence to regulatory requirements and Value Based Purchasing metrics; as well as to Joint Commission recommendations for improvement in implementing… Show more • Promoted to Chief Quality Officer and transferred to a new location to implement quality infrastructure for 330-bed acute care hospital • Fostering of a culture of safety and advanced the facility to a high reliability organization (HRO) while optimizing improvements in care delivery, patient safety, and risk mitigation• Strict adherence to regulatory requirements and Value Based Purchasing metrics; as well as to Joint Commission recommendations for improvement in implementing sustainable action plans• Streamlining of quality performance while maximizing return under Centers for Medicare and Medicaid Services (CMS) Value Based Purchasing(VBP) requirements• Presiding over training for management and staff regarding evidence-based customer service strategies demonstrating improvement in Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) customer service ratings• Efficacy in the use of the Community Cares customer service program and oversight ofall aspects of risk management, quality management, infection control and credentialing of medical staff• Institution of quality improvement infrastructure to enhance initiatives and standardize approach to process improvements, which resulted in the improvement of patient outcomes and enhanced patient safety• Key driver in transitioning to a High Reliability Organization (HRO) by restructuring processes, changing culture, and implementing systems to avoid catastrophic events Show less

Corsicana, Tx

• Administrative management of a 165-bed acute care hospital while overseeing risk management, infection control, quality management and credentialing of medical staff• Ensured compliance with hospital processes and regulatory standards (state, CMS, and The Joint Commission), while coordinating with board of trustees, medical staff, and administrative leadership with regard to patient outcomes, performance improvement, and survey activity• Pivotal role in documenting, assessing, and… Show more • Administrative management of a 165-bed acute care hospital while overseeing risk management, infection control, quality management and credentialing of medical staff• Ensured compliance with hospital processes and regulatory standards (state, CMS, and The Joint Commission), while coordinating with board of trustees, medical staff, and administrative leadership with regard to patient outcomes, performance improvement, and survey activity• Pivotal role in documenting, assessing, and communicating outcome and performance metrics, as well as data regarding high risk processes• Partnership with medical staff and Medical Executive Committee for the advancement of analyzing physician performance, peer review and resolving quality issues• Tactical management of The Joint Commission survey and skillfully engaged leadership and staff in Joint Commission readiness activities to maintain accreditation• Optimization of safety by implementing standardized approach for evaluating serious safety events, resulting in timely action plans and enhancing patient safety• Demonstrated excellence through sustainable results for core measures, PI projects and metrics evaluating processes centered around evidence-based practice Show less

West Bend, Wi

• Promoted to Director and transferred to new location in to implement quality programs with emphasis in process compliance with federal, state, and industry guidelines for excellence in care• Management off preventive care and chronic illness management for patients of Medical Group through Quality Improvement programs• Administered project development in cooperation with the IS Team, clinic systems, and administrative staff for the implementation of technology improvements to ensure… Show more • Promoted to Director and transferred to new location in to implement quality programs with emphasis in process compliance with federal, state, and industry guidelines for excellence in care• Management off preventive care and chronic illness management for patients of Medical Group through Quality Improvement programs• Administered project development in cooperation with the IS Team, clinic systems, and administrative staff for the implementation of technology improvements to ensure adherence with industry and corporate standards• Demonstrated expertise in offering highly successful primary care medical home• Played an integral role in generating revenue by accomplishing treatment protocols and meeting initiative outcomes; served as primary contact on business development and marketing to enhance patient outreach• Collaborated with private insurance companies in implementing quality programs emphasizing health prevention and HEDIS measures; developed the Physician Quality Reporting System (PQRS) program to attain performance incentives• Successfully improved patient outcomes by instructing staff regarding plan-do-study-act (PDSA)-rapid cycle performance improvements; directed Lean/Six Sigma implementations to achieve statistically significant increase in compliance with numerous care initiatives Show less

Milwaukee, Wi

• Completion of grievance and patient care investigations and led the application of necessary action plans in order to modify processes and systems identified as problem prone• Full charge in identifying quality issues and developing process improvements to leverage and preserve patient safety• Compilation and assessment of data with the use of statistical and root cause analysis in measuring quality compliance and identifying areas for improvement• Working in collaboration with… Show more • Completion of grievance and patient care investigations and led the application of necessary action plans in order to modify processes and systems identified as problem prone• Full charge in identifying quality issues and developing process improvements to leverage and preserve patient safety• Compilation and assessment of data with the use of statistical and root cause analysis in measuring quality compliance and identifying areas for improvement• Working in collaboration with the medical, nursing, and ancillary staff regarding diverse facets of quality improvement and assurance• Collection of data from diverse databases, which included Midas and University Health System Consortium, subsequently analyzing information and leading all facets of process improvements• Recognition for the standardization of processes while assisting the development and implementation of corporate policies• Coordination with the Risk Management Team in determining critical quality issues and generating results-oriented solutions• Played a key role in achievement of hospital ranking in the top 10 of University Healthsystem Consortium Hospitals for quality management• Development of corporate policies, assessing regulatory compliance guidelines, analyzing data and overall quality management in order to develop enhanced processes, maximize compliance, and improve patient outcomes Show less

Milwaukee, Wi

• Close coordination with physicians and other multi-disciplinary healthcare professionals in securing optimal level of patient service• Provision of assistance in attending the psychological needs of patients and families while ensuring solid medical knowledge in educating patient treatments• Application of talents in providing direct care to diverse patients, involving critically ill and general medical/ surgical, while adhering to highest ethical and professional standards of the… Show more • Close coordination with physicians and other multi-disciplinary healthcare professionals in securing optimal level of patient service• Provision of assistance in attending the psychological needs of patients and families while ensuring solid medical knowledge in educating patient treatments• Application of talents in providing direct care to diverse patients, involving critically ill and general medical/ surgical, while adhering to highest ethical and professional standards of the nursing practice• Utilization of knowledge in intensive care and hematology/oncology while providing superior patient care and support within highly stressful situations as well as hospice care to terminally ill patients Show less

Master Of Business Administration (Mba)

Bachelor Of Science (B.S.), Nursing

Associate Of Science (A.S.), Nursing