Melissa Curry, Mba Email & Phone Number

Mckinney, Tx, Us

Dallas-Fort Worth Metroplex

Agent licensed to sell insurance through New York Life Insurance Company

Dallas, Texas, United States

Dallas, Texas, United States

• Review and analyze regulatory, quality, safety, and health issues and documents related to the organizations clinical services and practices and provide oral and written assessments that may arise.• Offer knowledge of 340B management and oversight and provide guidance for 340B access, pharmaceutical eligibility, and oversight for compliance of federal and state regulations. • Abide by all State and/or agency policies, procedures, ordinances, and/or laws pertaining to the Agency’s operation at all times.• Review, evaluate, and assess clinic processes and procedures and provide feedback and documents recommendations of process improvement.• Develop programs to enable process improvement and strategize methods to implement the developed processes.• Provide training to Physicians and Advanced Practitioners and Company healthcare personnel regarding the safe and effective use of electronic health records, policies, and procedures, and assist with development and review of clinical training content.• Assist in Facilitating new/current provider credentialing and licensing. • Coach and mentor management and other members of the leadership cohort to identify areas that require improvement and assist with developing problem-solving skills and change management. • Consult with organizational personnel to develop clinical marketing strategies and evaluate current processes.• Any other promotional/educational consulting activity as requested by the organization.

Pittsburgh, Pennsylvania

• Analyze strategies and operations to evaluate efforts to advance organization’s mission. • Establish organizational standards and guiding principles for processes, protocols, and training.• Analyze, develop, and implement policies, objectives, or activities to ensure continuing operations, to build sustainable income streams, and improve programs and services. • Serve as the primary resource for Medical Specialty support, information, and best practices and protocols in Southwestern PA. • In conjunction with the organization’s leadership, establish and implement short, intermediate and long-term strategic initiatives. • Collaborate with Board of Directors on decision making, quality performance, and provide monthly updates on clinical progression and expansion.• Responsible for oversight of grant funding programs for Title V, X, XX, and provide annual data for auditing purposes. • Monitor budgetary aspects of Clinic operations and adjust towards fiscal targets. • Maintain knowledge of overseeing a 501(c)3 organization • Govern all aspects of on-site and remote medical care. • Ensure adherence to federal, state and local laws concerning safety, confidentiality and provisions of a nonprofit medical care. • Direct, coach, manage, evaluate and develop Clinic staff. • Maintain compliance in all aspects of the revenue cycle practices, including but not limited to coding compliance and billing rules and regulations by payer and by state.• Investigate and resolve complex problems and coordinate efforts to provide innovative strategies and solutions.• Demonstrate an understanding of crucial revenue cycle areas, which include but not limited to: intake, benefits verification, and prior authorization, financial assistance, billing/coding, collections, denials/underpayments, cash posting, managed services, credentialing, AR rundown and patient account calls.

Pittsburgh, Pennsylvania

• Oversee patient centered medical home physician practices at UPP General Internal Medicine Oakland and South office and manage day to day clinical practices and revenue cycle management. • Monitor shared savings reports and support practices in reducing gaps in care and hospital admissions. • Provide care coordination among health plan members within specified practices. • Collaborate with UPP providers to share ideas, make recommendations of areas to improve and utilize critical thinking skills to facilitate a plan of care within the practice. • Strong knowledge of payer reimbursement methodologies and contracting.• Plan standards and identify trends and opportunities for improvement based on information obtained from interaction with members and providers.• Present or contribute to complex case reviews by the interdisciplinary team summarizing clinical and social history, healthcare resource utilization, case management interventions. • Provide training and orientation to new hired staff on policies, procedures and workflows.• Carryout initiative for LGBTQ work group alongside UPMC health plan president of government affairs and affiliates to design policy and quality measures to provide adequate health care for the LGBTQ community. • Attend and present at Medicare Retention meetings to educate prospective members and active members on programs available through the health plan.• Participant in the Health Plan Transgender Task force initiative to carryout policies and quality measures for care management implemented throughout the health plan

Pittsburgh, Pennsylvania

• Report directly to the Director of Professional Services and Chief Executive Officer and carry out day-to-day activities like quality and improvement and supervision of over 50 employees.• Carryout scheduling and provide guidance for all clinical staff. • Manage and monitor telehealth devices and coordinate care as indicated. ICD-10 coder and Oasis processor. • Provide care coordination for clinical staff, providers and patients. • Attend strategic planning quarterly meetings and assist in developing policies and procedures to improve quality measures. • Perform in-home assessments and implement standard nursing practices as needed.

Transition patients from the hospital/ long-term care setting to home by performing discharge planning while patient is in the healthcare setting and making necessary preparations for a smooth transition to the home setting. Marketing SNF, ALF and other facilities to promote healthcare referrals in the Mon Valley and Washington area. Perform in home assessments and evaluate the need for the following skilled services: Physical therapy, occupational therapy, speech therapy, nursing, home health aide, social worker. Computer documentation for skilled visits and oasis documentation. Perform lectures to skilled nursing facilities regarding nursing documentation and legal compliance to all disciplines pertaining to interdisciplinary care team. Obtain referrals from physicians and obtain authorization from insurance and give detail description of clients need for homecare services. Supervise RN’s, LPN’s, PT, OT, ST, and MSW and coordinate care accordingly. Communication documentation via follow up phone calls with patients. Assist with coordinating doctor’s visit, and transfer clients to outpatient care once discharged from home health care. Assist D.O.N with QA review and documentation, perform schedules, and obtain surveys, review patient charts and track hospital readmission records. In home visits performed for initial start of care visits and discharge. Performing skilled care as ordered for the following: wound care, medication administration, vitals, instruct on emergency planning, medical management, disease process, diet, exercise, fall and safety precautions.

Master Of Business Administration - Mba, Business Administration And Management, General

MBA-Healthcare Management

Bachelor Of Science In Nursing Bsn, Science Of Nursing

Associate Of Science - As, Registered Nursing/Registered Nurse