Quality Assurance Medical

Aisling C. Venza-Malota

**** ****** **** ***** ( Sugar Land, Texas 77479 ( 281-***-**** ( (

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

Core Competencies

VISION AND LEADERSHIP WITH CREATIVE PROBLEM-SOLVER Well-developed

EXTENSIVE EXPERIENCE IN WITH EXCELLENT PUBLIC interpersonal skills and

HOSPITAL ADMINISTRATION, RELATIONS EXPERTISE multicultural

CUSTOMER Solid foundation in sensibility

SERVICE/RELATIONS, QUALITY medical transcription Strong can-do spirit,

ASSURANCE, AND TRAINING and records confidence, and

PROGRAM PROTOCOLS integrity

Experience:

Case Management Coordinator- Oak Bend Medical Center, Richmond, Texas (June

2010-present)

. Discharge planning experience, early identification and intervention

of discharge planning needs while conducting discharge screening

assessment. Identifies needs for reviewing and monitoring the

appropriateness of admissions, continued stays, and discharges. In

collaboration with the Social Work Department, assist in the discharge

plan, complete all necessary forms, in accordance with existing

policies and procedures. Reviews are performed in accordance with the

criteria and standards approved by the hospital. Medicare regulation

experience. Coordinates with JCAHO accredited approved vendors for

home health, medical equipment, Long Term Acute Care evaluation,

hospice, and nursing home information. Coordinates with nursing

floors and Physicians for a timely discharge process for the patient

and the family. Coordinates daily/ monthly updates and tracking for

Self Paying patients, Insurance approvals for admissions, Medicaid

qualifiers, Indigent qualifiers, Method of Transfers, LTAC referrals,

and Nursing Home referrals. Medicare knowledgeable for regulations,

prescription assistance programs, Lovenox, Plavix and IV infusion

companies. Current Notary Public until 2014. Assimilation of patient

information at the multidisciplinary team meetings. Describes

community resources available to patient population. Excels in

appropriate communication techniques with Physicians, patients, peers

and others. Acknowledges appropriate timely referral of problematic

cases to the Director for follow-ups. Effective verbal and written

communications. Identifies appropriate referral of psychosocial and

social service needs. Demonstrates ability to coordinate discharge

planning needs with services provided by outside vendors.

Demonstrates working knowledge of common managed care contracts.

Vendor mate sales and coordination ( Durable Medical Equipment,

Oxygen, CPAP, BiPAP, Medicare and commercial qualifiers for insurance,

Home Health, Rehabilitation Facilities, and Nursing Homes).

cosmetic Dermatology Patient care representative and product sales,

Memorial clinical associates, houston, texas (Jan'10-

aug'10)

Hospital Office Administrator & Presentation Instructor-35th Medical Group

U.S. Air Force

Department of Defense, Misawa USAF Base Hospital - Japan

(`05-`09)

Effort, achievement, and recognition characterize this employment

history, which includes, but is not limited to, the following:

o Achieving documented commendations and salary increases citing

"Performance Excellence" for consistently ensuring the most

productive, cost-efficient, and highest quality solutions to the

medical facility's needs - meeting or exceeding expectations and

gaining recognition as the "Go-To-Person" in the medical facility

o Skillfully managing hospital office operations; redesigning office

policies and procedures to ensure HIPAA compliance; directly

contributing to quality assurance and medical transcription

processes

o Coordinating outside vendor support for delivery of medical and

office equipment

o Working on special projects as a Program Administrator and Trainer

within both clinical and administrative offices

o Communicating extensively with doctors, residents and

administrators to coordinate calendars/schedules

o Creating and implementing innovative adaptations to new and

existing hospital QA procedures that serve as "blueprints" for

continual improvements in cost control and productivity -

initiating new computer software to provide more detailed patient

information and allow hospital administrators to evaluate the need

for current and future services; reducing response time to QA

issues by 76%; saving the facility some $40K per year by

implementing a new quality assurance system ...

o Orchestrating with Senior Partner on preparations for Joint

Commission on Accreditation of Health Care Organizations (JCAHO)

o Instituting new follow-up processes with quality assurance -

enhancing relations with carries and patients and resulting in more

timely payments to the hospital

o Conducting informative/educational PowerPoint presentations to

groups of medical/healthcare professionals on customer service

relations - varying the pace and focus of communications to

accommodate the diversified needs of those at different levels;

introducing Quality Customer Care to an audience of hundreds for

the 35th Medical Group in Japan with an on-stage presentation ...

all achieving an "Excellent" rating from the Triennial Health

Service Inspection, 2009

o Providing highly effective support to General Surgery, LD, OB,

Urology, Dental Operations, and Inpatient/Outpatient areas by

quickly identifying, defining, and rectifying medical transcription

matters

o Serving as an instrumental force in all hospital quality assurance

disciplines

o Accurately compiling, processing, analyzing, transcribing, and

communicating extensive informational and financial medical data on

patients and hospital operations, policies, and procedures for

precise decision-making - managing accounts receivable,

travel/financial accounts, insurance, collections,

inpatient/outpatient and emergency room registrations, medical

transcription/medical records, budgeting and cost reports, work

schedules for up to 40 employees, payroll ...

o Keeping pace with the latest details on hospital regulatory factors

- meeting stringent JCAHO specifications and deadlines

o Knowledgeable in Microsoft programs, Quality Assurance, HIPAA,

Patient Advocate Programs, JCAHO/HIS preparations, financial

programs administration, and customer care.

o Efficiently assessing the immediate and continuing of needs of

medical/healthcare compliance issues to establish priorities for

providing appropriate interventions based on urgency level

o Resolving challenges that impact work through systematic handling

of multiple tasks to meet optimum quality outcomes; working well

independently and as part of a team

Education: Bachelor of Science Degree in Psychology

Certificates in Quality Assurance Management and Patient

Advocate Training

Graduated May 2005, University of Maryland - Adelphi, MD

REFERENCES

Jana Endicott, Director of Case Management, OakBend Medical Center,

Richmond, Texas

Phone: 281-***-**** or email: *********@****.***

Sharon Galloway, Marketing and Development, St. Luke's Hospital, Sugar

Land, Texas

Phone: 713-***-**** or email ********@*****.***

Dr. John P. Ott, MD Internal Medicine, Medical Clinic of Houston, LLP,

Houston, Texas

Phone: 713-***-**** or email: ****@******.***

Tim Thomas, Administrator, Memorial Clinical Associates, Houston, Texas

Phone:713-***-**** or 713-***-****

Contact this candidate