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CEO/Owner

Location:
Albuquerque, New Mexico, United States
Salary:
110,000
Posted:
May 24, 2018

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Resume:

Deborah M Redford, MBA, BSN, RN

Cellular Phone: 505-***-****

Email: ac5ljf@r.postjobfree.com

Profile: Enthusiastic, hardworking RN with entrepreneurial business experience complimented by a broad range of purposeful clinical knowledge. More than 30 years of management expertise, attention to detail and emphasis on critical thinking. Experienced healthcare leader focused on improving the delivery of care while identifying opportunities to engage providers and members. Dedicated to improving member access and increasing provider satisfaction. Resourceful team player who excels at building trusting relationships with customers and colleagues, I will make a difference in your organization.

Education:

06/2012 Graduate Master of Business Administration, University of Phoenix

12/2007

Experience:

Graduate Bachelor of Science in Nursing, University of New Mexico

1/2010-Present

Deb The RN, LLC:

Experienced sales professional focused on making a difference in your organization. Resourceful problem solver who thrives in a fast-paced environment. As a nurse with an MBA, I am focused on the following areas:

Legal Nurse Consulting-I enjoy working with both plaintiff and defense counsel preparing detailed medical chronologies and case reports for medical malpractice and personal injury law firms.

Motivational Speaking- Keeping abreast of emerging models in health

care delivery; identifying innovative strategies to achieve your business goals and objectives. Focused on the development and implementation

of clinical programs that recognizes the value of all internal and external strategic partners.

Staffing-Opportunities to expand my responsibilities, incorporate my business experience in a health care role, allowing me to make a meaningful change in the delivery of health care.

9/2017-4/2018

Sandia Pueblo Health Center; Bernalillo, NM

RN Clinic Manager

Designed and implemented integrative health plan focused on providing

primary care for acute and chronic health problems in collaboration with medical clinic staff, and homecare programs. Conduct epidemiological and community surveys, field investigations and research studies to appraise and measure health needs of pueblo members. Maintain Government Performance

and Result [GPRA] standards, increased daily usage of health clinic by 37% in

last quarter of 2017.

8/2015- 9/2017

Molina Healthcare of New Mexico:

Manager of Health Care Services

Facilitating solutions for members and providers through collaboration with senior leadership, member services, appeals, claims, and the delegation oversight committee. Implementation of tactics to meet strategic initiatives for improved cost and quality outcomes for the member populations we serve. Identify opportunities to implement best practice approaches and introduce innovations to improve provider satisfaction.

Develop, initiate, and monitor performance expectations for utilization management staff. Strong partnership with Quality Department, supporting CAHP initiatives and NCQA audit preparation and compliance. Ability to

evaluate and interpret data, identify areas of improvement, and focus on interventions to improve quality outcomes.

11/2014-7/2015 Physician Surgery Center of Albuquerque:

Director of Surgical Services

Collaborating with leadership to create a culture of service

excellence that redefines the patient experience in a multispecialty

surgery center. Establishing a professional practice environment, while providing the resources necessary to support the delivery of unprecedented patient care. Responsible for initiating and maintaining payor relationships resulting in expanded services offered to the community.

3/2014-1/2015 Eye Associates of New Mexico:

Director of Surgical Services

Practice administrator responsible for clinical operations and business functions of two outpatient surgery centers in New Mexico. Facilitating a culture of performance improvement, by focusing on excellent clinical and patient outcomes, resulting in improved patient and physician satisfaction. Maintaining the highest level of compliance by exceeding national quality and regulatory standards recognized by ambulatory surgery centers.

3/2011-3/2014 Molina Healthcare:

Manager of Utilization Management

Effectively directing clinical managed care programs with emphasis on case management, prior authorization and disease management. Developing and implementing standardized health care management programs aligned with Medicare, and Medicaid guidelines designed to improve members’ quality of life while decreasing the PMPM costs. Introduce and measure collaborative health initiatives designed to improve relationships with physicians and the interdisciplinary team by providing professional development and training to their staff. Execution of long-term strategies implemented to achieve budgetary guidelines established by corporate operations, while providing members with the tools necessary to improve or maintain their health.

9/2010-3/2011 Manzano Del Sol Good Samaritan Village:

Director of Nursing

Managed a clinical staff consisting of 114 full time employees, responsible for the overseeing care in the following areas: long-term care, skilled nursing, assisted living and home and community-based services. I implemented staff retention initiatives resulting in a 50% reduction in overtime use, and a 31% reduction in staff turnover.

5/2010-9/2010 Presbyterian Heart Group:

RN Clinic Manager

Responsible for maintaining appropriate staffing, mentoring, and training of 116 full-time employees, and the coordination of 21 cardiologists’ schedules in the clinic, operating room, and hospital. Coordinated resources, developed and reviewed clinic budget while monitoring and analyzing variances and adjusting as needed.

1/2010-5/2010 Blue Cross and Blue Shield of New Mexico

Case Manager

Collaborating with physicians, care providers and ancillary support services to foster a team approach to wellness for members. Organ transplant coordination for members requiring the ability to determine appropriate action in complex situations that may not be addressed by existing policies or procedures.

1/2008-1/2010 University of New Mexico Hospital

Registered Nurse

Providing acute patient care in outpatient surgery, post-operative care and the cardiac unit. Experienced in the following specialties: emergency medicine, organ transplants, utilization and case management, quality improvement and maintaining JACHO standards.

1984-2006 Independent Financial Planner providing specialized retirement planning appropriate diversification and risk analysis designed to assist Clients with their retirement goals and insurance needs.

Licensure Certifications:

2008-Present Registered Nurse [R64220]

2008-Present BLS

Professional Associations:

2009-Present American Nurses Association



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