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Yyyyyy x. yyyyyy

0000 xxxxxx xxxx , xxxx , xxxxx 00000

Home: (xxx-xxx-xxxx

Cell: (xxx-xxx-xxxx

abc@xyz.com

 

Senior-level Healthcare Executive with exceptional talents in quality assurance and risk management eager to contribute expertise toward supporting a progressive organization in optimizing bottom-line performance.

 

Qualifications Profile

 

Accomplished Registered Nurse offering unique blend of clinical and leadership/administrative experience, ranging from directing quality activities for a multi-state/site call center disease management company to serving as a Charge Nurse on an Intensive Care Unit.

Excel in call center quality monitoring and reporting, budget administration, public speaking/presentations, and policy and procedure development.

Proficiency with URAC credentialing and submissions. Advanced understanding of JCAHO and NCQA (National Committee for Quality Assurance) standards; enforce and improve hospital policies to strengthen compliance and elevate quality/service levels. Adept at conducting gap analysis, root cause analysis, and FMEA (failure modes and effects analysis).

Create and execute administrative, quality, and operational procedures to eliminate redundancy, standardize workflow, enhance patient care, elevate staff morale, and reduce expenses.

Able to coordinate collaborative efforts among multi-disciplinary team members to provide high quality care to patients with complex needs; considerable abilities in staff development and management.

 

Selected Achievements:

 

         Steer operations of four remote sites across six functional areas to facilitate QA and risk review, while serving as project lead for multiple initiatives.  

         Introduced strategic planning to licensure process and embraced cutting-edge technology to save $60K+ for Lifemasters.

         Captured over $400K in savings in 2007 through proficiency in quality review and cost control.

         As Associate Coordinator for General Surgical Floor at Buffalo General Hospital, served as Head of Continuous Quality Improvement (CQI) committee for two surgical units and played an integral role in creating and improving Patient Complaint Response Process.

         As Certification Coordinator for International Medical Group, secured licensure in each state for third-party verifier (TPA) status and uncovered significant savings by identifying stop-loss cases as well as potential member fraud of benefits. 

         Pioneered nursing presence in Comprehensive Cardiac Critical Care Unit at Methodist Hospital to care for acutely and critically ill patients throughout care plan in same room.

         Provided tours of hospital unit to visitors such as administrators from international countries.

 

Professional Experience

 

Lifemasters Supported Healthcare, Inc., Indianapolis, IN, 2008 to Present

Quality Team Manager

         Spearhead quality programs for LifeMasters sites spanning several states, consistently ensuring compliance with state licensure criteria, federal regulations, and URAC and NCQA accreditation standards.

         Apply sharp leadership talents toward supervising and evaluating personnel, establishing and maintaining client and customer satisfaction, managing quality requirements for all operational staff, and ensuring company adheres to certification (URAC) and contract requirements. 

 

Continued ►

 

 

 

Yyyyyy x. yyyyyy ~ Page 2 of 2

 

Professional Experience continued

 

         Conduct in-depth risk assessments and report findings to Executive Quality Committee, paramount to uncovering and minimizing potential loss. 

         Diligently administer company s complaint process and database.

 

MDwise Hoosier Alliance, Indianapolis, IN, 2007 to 2008

Quality Management

         Drove daily Quality Department operations supporting Medicaid population inclusive of administrative functions, policy development, and compliance with state regulations and NCQA standards.

         Delegated and supervised Quality Of Care (QOC) investigations as required and served as Project Lead on several initiatives.

         Standardized QOC/PQI reporting expectations for parent company s nine other delivery systems.

 

Volt Services Group / Eli Lilly and Company, Indianapolis, IN, 2005 to 2007

Global Product Safety Associate / Case Manager, Neuroscience Dept.

         Scrutinized and fortified Quality Control databases, participated in Six Sigma initiatives, and served as Case Manager for a Fortune 500 pharmaceutical manufacturer. 

         Formulated workflow database models where initial cases are entered and held for (U.S.) processing and identified incongruent matches between European and U.S. documents.

         Exercised solid prioritization skills to report adverse events to proper regulatory agencies, participate in regulatory reviews, and assist with audit cycles.

         Assigned as preceptor for new divisional staff after only nine months with department.

 

Prior Background:

 

Clinical Nurse, ICU, St. Vincent s Hospital, Indianapolis, IN, 2001 to 2005

Certification Coordinator, International Medical Group, Inc., Indianapolis, IN, 2001 to 2003

Comprehensive Cardiac Critical Care Unit, ICU, Methodist Hospital, Indianapolis, IN, 1999 to 2001

Associate Coordinator for General Surgical Floor, Buffalo General Hospital, Buffalo, NY, 1992 to 1996

 

Education

 

Bachelor of Science Degree in Nursing, Niagara University, Niagara University, NY

 

Legal Nurse Consultant Diploma, The Kaplan Colleges, College for Professional Studies, FL

 

Registered Nurse (RN) License C States of Indiana and New York

 

Professional Development  

 

  • BLS and ACLS Certifications
  • JB Quality Solutions Seminar
  • Neuro Assessment C Integra NeuroSciences C St. Vincent s Hospital
  • 13th Annual Cardiovascular Nursing Seminar C Clarian Health Partners, Inc.
  • Academy for Healthcare Management

 

Affiliations

 

American Society for Quality (ASQ) American Association of Legal Nurse Consultants (AALNC) Indiana State Nurses Association (ISNA)

 

 

 

Yyyyyy x. yyyyyy

0000 xxxxxx xxxx , xxxx , xxxxx 00000

Home: (xxx-xxx-xxxx

Cell: (xxx-xxx-xxxx

abc@xyz.com

 

 

 

 

 

 

 

Date

 

 

 

Hiring Agent Name

Title

Company Name

Address

City/State/Zip Code

 

Dear__________________:

 

I am currently seeking a challenging career opportunity in an executive-level health care management capacity and am submitting my resume for your review.  In advance, thank you for your time and consideration.

 

I bring to you a substantial background in the health care industry, exemplary expertise in directing quality operations and risk management, and an excellent blend of talents in multi-site/state management, uncovering cost savings, driving regulatory compliance, and staff management. To complement these qualifications, I offer first-rate planning, budgeting, organizational, analytical and critical thinking skills.   

 

As a proactive contributor to your organization, you will find me to be a highly motivated professional and stellar leader committed to supporting you in achieving your objectives through superior self-initiative and unparalleled prioritization skills. I am confident that I could be a valuable asset to <insert name of organization>, and will call you later in the week to see if we can schedule a time to meet. 

 

Sincerely,

 

 

 

Yyyyyy x. yyyyyy

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