Understand organizational strategic focus to assist in developing bi-annual Quality Management Plan and annual departmental goals, ensuring that both align with organizational framework and goals.
Monitor Quality Management Plan and annual department goals validating initiatives, pilots, and on-going efforts are supporting successful outcomes of plan and goals.
Understand data and current workflows practices to identify pilot opportunities and workflow development with a goal of developing and implementing improved organizational processes.
Coordinate achieving Healthcare Effectiveness Data and Information Set (HEDIS) efforts internally and across multiple health plans which include closing open quality gaps and analyzing current measures against National benchmark to identify areas of growth and opportunities to maximize incentivized reimbursements.
Continuously plan for advancing the model of care in collaboration with administrative and clinical leadership by forecasting and analyzing population and market changes.
Monitor ongoing practices and quality metrics, verifying organization’s successful alignment with various reporting agencies such as National Committee of Quality Assurance’s (NCQA) Patient Centered Medical Home (PCMH) and HEDIS, Health Resources and Servies Administration (HRSA) and Uniform Data System submission.
Quality Manager
San Ysidro Health
06.2017 - 04.2021
Developed and implemented program specific indicators and continuous monitoring as it relates to audits, surveys, and studies by health plans and state agencies.
Took part in developing and maintaining relationships between health plans and vendors which lead to patients completing annual health exams, closing care gaps and maintaining relationships with their health care providers.
Analyzed monthly quality metrics while partnering with clinic leadership to focus on areas of opportunities to improve compliance rates and strategize process improvement activities.
Annual evaluation of Quality Management Program policies and procedures.
Interviewed, orientated and created training plans for onboarding team members.
Quality Coordinator
San Ysidro Health
07.2016 - 05.2017
Facilitated provider-related peer reviews.
Aggregated peer review data for bi-monthly board reports, quarterly provider data, and annual provider evaluations.
Coordinated clinic internal, health plan, state, and federal audits.
Administrative Assistant
Sharp Memorial Hospital
San Diego
10.2009 - 07.2015
Organized and coordinated meetings, including logistics and materials preparation.
Answered phone calls and emails to provide information, resulting in effective business correspondence.
Handled confidential documents in an organized fashion according to established protocol.
Composed letters, memos, reports, emails, presentations and other written correspondence as required by management staff.
Education
Masters of Public Health -
National University
San Diego, CA
11.2014
Bachelors of Art - Criminal Justice and Psychology
California State University
Fullerton, CA
05.2007
Certification
Lean Six Sigma Green Belt, University of San Diego, 2022
Patient Centered Medical Home Certified Content Expert, National Committee for Quality Assurance, 2019
Health Management+, California Primary Care Association, 2019
Personal Information
Title: MPH, PCMH CCE
Board And Volunteer Experience
Board President, San Diego Ballet, 06/01/23, 01/01/24
Quality Improvement Peer Network Chair, Health Center Partners, 06/01/22, 06/01/24
Board of Directors, San Diego Ballet, 06/01/21, 06/01/23
Board of Directors, Girls Inc. of San Diego County, 12/01/19, 02/01/21
Development Committee, Chicano Federation, 08/01/18, 07/01/20
Board of Directors, National University Alumni Association, 06/01/17, 06/01/19
Timeline
Director of Quality
San Ysidro Health
04.2021 - Current
Quality Manager
San Ysidro Health
06.2017 - 04.2021
Quality Coordinator
San Ysidro Health
07.2016 - 05.2017
Administrative Assistant
Sharp Memorial Hospital
10.2009 - 07.2015
Masters of Public Health -
National University
Bachelors of Art - Criminal Justice and Psychology
Referral/Prior Authorization Specialist at San Diego PACE, San Ysidro HealthReferral/Prior Authorization Specialist at San Diego PACE, San Ysidro Health