Registered Nurse Management
Resume:
Josephine Goffe
**** ***** ****., #*** ********, MO 63132
*******@*****.***
Skills Summary Extensive experience in disease management, quality performance
improvement programs, and utilization review. Skilled in
federal, state, and managed care quality review programs.
Excellent background in medical coding including ICD 9 CM and
CPT coding. Completing certification course in Health
Information Technology.
Employment President
Wellness Solutions June 2006- Jan 2011
St. Louis, MO
Performed health screening
Provided health advice
Conducted Weight management
program January 2000-June 2006
Performed Nutritional Counseling,
and Lifestyle counseling
Regional Director, Quality
Improvement
Harmony Health Plan
Belleville, IL
Managed the regional office staff for the quality improvement,
disease management and utilization review programs for the
Medicaid Managed Care Program for the state of Illinois.
Interfaced with local, regional and corporate staff for
utilization review and quality improvement programs.
Coordinated case management program.
Coordinated quality improvement program
Coordinated disease management program
Coordinated medical review program
Provided annual training for the collection of the HEDIS
measurements.
Planned and coordinated the annual collection of the HEDIS
measurements.
Healthcare Consultant June 1995-December 1999
Managed Care Concepts
St. Louis, MO
Provided operational consultations to Long term care facilities,
Hospital utilization and case management departments, Home
health care agencies, Managed care organizations and Physician
offices.
Provided ICD 9 CM training.
Developed and implemented Telephonic Triage Service which was
utilized by Managed care organizations.
Regional Director, Business June 1993-June1995
Development
Beverly Enterprises
Fort Smith AK
Designed and managed the case management program utilized at the
long term care facilities in IN, IL, MO and KS.
Developed Sub-acute units.
Negotiated managed care contracts with Insurance Companies.
Designed training programs for medical coding, medical charting
and ICD 9 Coding.
Vice President February 1991-June 1993
Missouri Patient Care Review
Foundation
Jefferson City, Missouri
Responsibility for three offices: Kansas City, St. Louis and
Jefferson City.
Responsibility for the quality/medical review, ICD 9 CM, CPT,
and quality improvement programs for Missouri Medicare
Beneficiaries.
Developed Presentation and training programs for medical
documentation and Coding for hospital and physician providers.
Education Registered Nurse
London, England
BS Health Care Administration
Webster University, St. Louis, MO
REFERENCES Upon request
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