Drive quality management strategies and implement critical quality improvement initiatives for healthcare services, ensuring compliance with federal and state regulations. Execute near real-time clinical decision-making to facilitate patient care and prepare for compliance surveys. Analyze care quality, conduct thorough medical record reviews, and maintain prompt clinical decision-making. Develop comprehensive narrative reports detailing regulatory compliance, program results, and departmental intervention outcomes. Coordinate project management, identifying progress and gaps, to enact preventative measures and continuous improvement. • Provided expert coaching and troubleshooting support, enhancing the skills of 8+ quality specialists. • Earned recognition from senior leadership for advancement to a pivotal role in provider support and quality improvement. • Orchestrated data collection and report generation for over 30 quality improvement studies, contributing to a consistent 3% year-over-year annual increase in member access to Primary Care and Behavioral Health services. • Extensive medical record reviews and overviews. • Extensive monthly and annual data collection and analysis. • NCQA/HEDIS experience. • Meeting presentations and facilitation. • Risk management.

Expertly performed duties adherent to the mission, vision, and values of the company by utilizing quality improvement principles. • Executed functions towards education and support to the managed care plan under minimal supervision. • Demonstrated collaboration expertise by co-partnering with the network management team to contribute to strategies related to the development of the provider network; Collaborated with quality improvement team to implement practice-based quality initiatives. • Employed strong customer service skills by promptly acknowledging provider issues, analyzing the root cause, and developing appropriate solutions with internal clinical operations and other stakeholders to achieve positive outcomes. • Instrumental for assessing practice readiness by working with the assigned population while also supporting provider practices utilizing a broad set of tools, resources, and reports throughout tenure. • Relationship building Key Accomplishments: • Exemplified organizational leadership by implementing programs that aim to build positive provider relationships and improve quality of care for 15,000+ enrollees (per assigned region). • Vital member of the team who served 1.5 years as an interim provider relations manager (in addition to assigned role) under minimal supervision. • Contributed invaluable input to the organization by handling the oversight of 7 North Florida counties throughout tenure. • Facilitated engagement with HEDIS participants in the field. • Earned the distinction of being consecutively honored with the quarterly recipient of service excellence award for 7+ years. • Increased the number of members accessing preventive health services by 7% year over year from 2018 to 2021. • Extensive medical record reviews and overviews. • Extensive monthly and annual data collection and analysis. • NCQA/HEDIS experience. • Meeting presentations and facilitation. • Risk management.

Managed multiple application support portfolios, ensuring adherence to industry best practices and efficient escalation of customer internet issues. Conducted in-depth research to identify and integrate improvements, enhancing the brand's market presence. Developed training materials and conducted remote instructional sessions for new customer support associates and application support analysts. • Resolved technical issues for over 2K internal employees and external clients, earning recognition for exceptional problem-solving capabilities. • Earned promotion to a permanent position within six weeks by demonstrating outstanding performance and expertise in a contractual role. • Authored an instructional training manual for technical issue resolution, widely adopted for new hire training and accessible via the company's SharePoint.