Health Medical

Sharibet Amadin

CP: 973-***-****

Email: *********@*****.***

Objectives

•Highly skilled, focused, passionate and creative problem solver who is a self-starter, team player along with proven ability to provide team-spirited leadership.

Education & Qualifications

•Seton Hall University (Online Program) - Present – September 2018

Master’s in Public Administration con. Health Policy

•William Paterson University- Graduated May 2010

Bachelors of Science in Public Health Edu, con. Nutrition

NCQA Knowledge i.e. HEDIS Specifications (SME), STAR Benchmarks

Area of Expertise: MS Outlook, MS Excel, MS Publisher, MS Access and MS Power point

EMR Programs and Databases:

•Epic, Care Cast, MedENT, Centricity, WellScore, CaseTrakker, AS-OBGYN, MedMeasures 2016, Facets, HPOTS, HIP, MPOS, Care Compass, NJIIS, SharePoint, QSHR, and Crimson.

Other Skills: SQL, V-lookup, Pivots, Sorting, Filtering, Text to Columns, along with other excel formulas

Center’s Plan for Healthy Living (Health Insurance Co.) (75 Vanderbilt Ave., Staten Island, NY)

HEDIS Manager (Feb. 2017 to Present)

•Manage and Oversee the HEDIS (Healthcare Effectiveness Data and Information Set) Project for 2018 (MY2017) audit

•Generate HEDIS measure reports (weekly) from our data warehouse, to analyze and track changes in our Medicare membership enrollment/disenrollment for our DSNP, MAPD, FIDA and ISNP lines of business

• Manage and Monitor staff outreach and medical record/claim collection efforts daily, to ensure that

we are on track with meeting our goal of 4 Star (or higher) benchmarks, for all hybrid measures

•Manage and Oversee HEDIS Work Group meetings (weekly) i.e. send out meeting details, along with meeting materials such as: the agenda, previous meeting minutes, and a written presentation/report re: project status and progress

•Collaborate with other departments for assistance and/or ideas on how to close the gaps in care and to identify opportunities to resolve the member/provider outreach barriers

•QA the staff’s medical record reviews/data entry for accuracy and compliance

CMO- Montefiore Care Management (Corporate) (3 Executive Blvd, Yonkers, NY)

Performance Improvement Analyst (Oct. 2014 – Feb. 2017)

•Responsible for leading our ACO providers and partners, through quality improvement (QI) activities/initiatives to achieve specific quality outcome goals

•Assist practice in identifying and resolving barriers to enhanced implementation and optimization of their electronic health record (EHR)

•Conduct a workflow assessment to determine practice readiness, and a gap analysis to locate any gaps in care

•Develop corrective action plans for areas that need improvement in the providers office(s)

•Create improvement strategies/tools for providers with low performing measure(s) to address, and support gaps that lead to low performance.

•Create and analyze reports to track trends and performance of our ACO provider network

•Collaborate with NYC Department of health reps, regarding meaningful use measures, and ACO quality initiatives.

•Perform onsite annual audits, i.e. ACO, and HEDIS; Mid-year audits are implemented if needed

•Manage Affinity Health Plan performance measures; track trends, patterns, and improvements

Project Manager for Patient Engagement Initiative

•Develop project work plan for patient engagement and ensured milestones were met according to timeline. Track issues, facilitate resolutions and provide weekly status reports to senior management.

•Facilitate weekly project meetings- internally and externally (EMMI/Prism) to coordinate and discuss tools, resources and next steps that would be needed to launch initiative successfully within providers’ office(s).

•Create training materials as a guide for QI staff when communicating to providers about EMMI/Prism program.

•Created training manual for Montefiore call center for patient outreach

•Conduct onsite training on EMMI/Prism initiative to providers and their staff

•Monitor and assess outreach efforts to determine productivity and areas for improvement

Amerigroup Real Solutions/WellPoint (Health Insurance Co.) (101 Wood S Ave., Iselin, NJ)

Health Outreach Specialist I (Mar. 2013 – Oct. 2014)

•Conducted campaign outreach calls focusing on HEDIS measures, with an overall reach rate of 100%. Members were educated on the importance of preventive screenings, routine care, and immunizations; along with assisting members in making appointments with his/her Primary Care Physician (PCP) and/or Specialist for the missing/overdue services.

•Supported a professional relationship with health educators and providers by participating in community education events, health fairs, and clinic days as needed.

•Conducted provider and member mailings quarterly using health educational materials, which focused on a variety of HEDIS measures i.e. Diabetes, Adolescent/Child immunization, Women’s health (BCS & CCS) to name a few

HEDIS Auditor/Specialist

•Collected, abstracted, and entered medical record data for a variety of HEDIS measures; reviewing for completeness. Retrieval and data entry rate of 90% or better.

•Viewed claimed activities to locate date of service(s) or to locate the provider that render the service(s).

•Participated in required Medical Record Review (MRR) and HEDIS training through WebEx and seminar; help train new staff/nurses for preparation of medical record collection for HEDIS as well.

•Participated in Attestation project

Pharyngitis Lead/Liaison

•Distributed educational materials to providers regarding quality care for our members with strep throat and performed audits regarding this measure.

Overlook Medical Center (99 Beauvoir Avenue, Summit, NJ)

Dietitian Assistant (Nov. 2009 – Mar. 2013)

•Maintained patient Cardex file by documenting patient food preferences, allergies, special instructions, and/or feeding problems and incorporate this information into menu selection and review.

•Communicated with unit secretaries regarding specialty items, diet changes, and/or requests.

•Refer patient dietary issues and concerns to clinical dietitian staff.

The Community Health Department (for the Valley Hospital) (15 Essex Road, Paramus, NJ)

Health Education Intern (January 2010 – May 2010)

Created educational brochures, program handouts, and flyers for seminars and events.

Composed Press Releases

Assisted with creating a health education program for older adults/nursing home residents.

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