Quality Assurance Medical

Raphia M. Lewis

**** ******* ***** ? Mansfield ? Texas ? 76063

703-***-**** Cell

**********@*****.***

___________________________________________________________________________

Dear Sir or Madam:

RE: Utilization Management Specialist II

I have a proven track record of development of initiatives, complimented by

high-caliber general management skills, to deliver quality, and value to

client organizations. More than four years successfully passed all

survey's to include state, JCAHO/NCQA.

Other highlights of my background:

. "Can do" attitude thrusting me to excel towards success

. Strong nursing assessment, reasoning, critical thinking, decision and

writing skills. Not afraid to ask questions/make calls for accuracy.

Ability to read, comprehend, follow instructions to get task completed.

. Ability to listen, and comprehend information to ensure daily standard

operating procedures, projects, and tasks, are executed, and

accomplished.

. Easily establishes rapport with all levels of management, and people.

Proven multi-tasking capabilities with strong ability to plan,

prioritize, and manage complex projects under aggressive timelines.

. Experienced managing an office with physicians, nurses, allied health,

and field liaison.

. Chart audits/quality reviews on staff, documentation, billing, tracking

information, trends/benchmarks. Quality issues, and licensure.

Corrective action reports, continuous quality improvement, meetings to

maintain information flow.

. Experienced staying abreast of new federal and state laws. Updating

Bylaws to reflect current policy. Therefore, applying new rules, and

regulations into procedural format with updates.

. Experienced training, teaching, an advising to meet regulatory standards,

and professional goals. Proficient utilizing computers.

. Natural ability to establish consensus among cross-functional lines

I welcome an opportunity to speak with you to evaluate your needs, and

share my ideas.

Sincerely,

Raphia Lewis

Raphia M. Lewis

5106 Weshire Drive ? Mansfield ? Texas ? 76063

703-***-**** Cell

**********@*****.***

OBJECTIVE

Seeking a position to utilize my nursing, administrative, quality, and

management skills.

WORK EXPERIENCE

Children's Home Health Services 3/09 -

current

MAXIM Health Care 4/05- current

Variety of work assignments ranging from per visit nursing, nursing home,

private duty home care, mentally handicapped, and wound care nurse. Work

with pediatric and adults in facilities and home care. Skilled utilizing

laptop ventilator, various medical equipment, Trach, G-tube, wound

treatments, phlebotomy, hemodialysis, etc. Assess patient(s), perform

nursing care as ordered by physician. Give medications per MD order,

document care, monitor machines, and patients.

Hospice - Fairfax, Virginia 6/99 - 9/03

Credentials Analyst

Accountable for the medical-administrative, and medico-legal, aspects of

the medical staff organization; serves as an essential link between medical

staff leadership, senior management, and the board. Provides administrative

direction for Virginia, DC and Maryland offices, overseeing department's

operations, budgeting, strategic planning, development of information

systems and coordination of information flow. Responsible for establishing

and maintaining continuity in the implementation of standards applicable to

the Medical Staff relating to credentialing, licensure, quality, education

and governance functions. Participates in the development and writing of

various policies, and procedures. Assist QI department with performance

improvement designing new processes, revising existing processes, measuring

performance, making decisions about performance based on trends,

benchmarks, and guidelines established, collect, input, and evaluate data

and improve performance. Survey prep team member. Documenting training

has been completed. Run reports, query data banks, enter information in

software program for efficiency of files. Continuous mail outs requesting

information and contacting office staff to update files. Minutes, follow

up on adhoc meetings. Responsible for the operational aspects, budget,

billing, intake of paper work flow to complete hiring files, inservices,

and coordinating activity between numerous field offices and the acute

care unit. Supports the continuous flow and improvement of information to

complete in a timely manner. Performance improvement/peer review process

conducting, chart reviews, monthly/quarterly audits for statistical

reporting, and presentation. Goals of the department are met by

maintaining an efficient and productive staff through education, direction,

development, and evaluation.

EDUCATION

Master Science of Health Science -Touro University

Quality Assurance Certificate - Touro University

Bachelor of Business Administration - Averett University

LPN - Richmond School of Health and Technology

Contact this candidate