Quality Assurance Health Care
Resume:
KAMEELAH SPENCE
Newberry, FL 32699
***************@*****.***
SUMMARY: Senior Human Services Professional, with demonstrated strengths in assessing
organizational and client needs, setting strategic direction, and implementing initiatives for departmental
goals. Expertise include: Provider Relations, Medicaid and Health Care Regulatory Interpretation,
Problem Solving, Conflict Resolution, Team Building, Instructing-Workshop Facilitation.
EDUCATION:
Nova Southeastern University Fort Lauderdale, FL
Masters of Science Degree: Health Law July 31, 2013
Concentration: Risk Management
Bennett College Greensboro, NC
Bachelor of Arts Degree: Mass Communications May 13, 2000
HEALTH CARE EXPERIENCE:
Agency for Health Care Administration – Health Quality Assurance Alachua, FL
Health Facility Evaluator II 05/2013 - Present
Coordinate and conduct surveys of health care and residential facilities. Review facility files prior to the
visit, coordinate with team members concerning objectives of the visit prior to the visit; coordinate with
team members concerning objectives of the visit when applicable, make detail observations of the facility
during the visit and documenting findings. Ensure to completion and resolution all duties and
responsibilities related to facility surveys from initial to final action including approval of corrective
actions taken by health care facilities to rectify deficiencies cited.
Department of Children and Families Ocala, FL
Adult Protective Investigator 12/2012 – 05/2013
Counseled clients and patients, individually and in group sessions, assisted in overcoming dependencies,
adjusting to life, and making changes. Counseled family members and assisted in understanding, dealing
with, and supporting client or patient. Interviewed clients, reviewed records, and conferred with other
professionals to evaluate mental or physical condition of client or patient.
Agency for Persons with Disabilities Gainesville, FL
Operations and Management Consultant I 09/2012-12/2012
Supervised a staff of 7 employees, coordinate and oversee the operation of the TIPS Sensations,
Performing Arts, Arts and Crafts and Recreation Programs with both individual residents and entire
homes in accordance with a healthy lifestyle for Tacachale residents. Appraised direct report performance
evaluations; institute disciplinary action as necessary and in accordance with Department policy and
procedure. Monitored programs and ensured quality active treatment and resident progress.
Spence 2
Department of Elder Affairs Miami, FL
CARES Assessor Supervisor 05/2012 – 08/2012
Supervised, assigned and monitored the activities of the Senior CARES Assessor and administrative
support staff. Monitored case files of assessors, senior assessors and RN staff following established
procedures and timelines. Utilized monitoring results to develop and provide training to improve
compliance; including training on the functions, goals, assessment procedures, and policies as indicated in
the Department's goals and mission. Reviewed current work flows, obtained input from staff, improves
the overall quality and quantity of work performed. Prepared and developed plans for case assignment
and workload distribution for the 11A CARES field office.
Agency for Health Care Administration – Medicaid Quality Assurance Miami, FL
Senior Human Services Program Specialist 04/2006-04/2012
Provided information, education and consultation regarding the Medicaid state plan program. Served as a
liaison between the Bureau of Medicaid services and providers in Miami-Dade and Monroe counties
providing services as: Assisted living facilities, durable medical equipment suppliers, hearing specialist,
hospice services, optometry/visual practitioners, physician services, podiatry practitioners and therapy
services. Represented the agency in Medicaid fair hearings for Home Health, DME and therapy services.
Scheduled face-to-face meetings with providers to resolve billing discrepancies and policy interpretation.
Provided technical assistance in processing electronic claims using the HP webportal. Coordinated and
conducted formal training activities and presentations for the DME (Durable Medical Equipment)
program for the Area 11 staff and providers. Assisted dually eligible beneficiaries understand their
coverage under the Part D drug prescription program. Monitored the Project AIDS Care Waiver program.
Agency for Health Care Administration – Health Quality Assurance Miami, FL
Health Facility Evaluator II 03/2004-04/2006
Coordinated and conducted surveys of health care and residential facilities. Reviewed facility files prior
to the visit, coordinated with team members concerning objectives of the visit prior to the visit;
coordinated with team members concerning objectives of the visit when applicable, made detailed
observations of the facility during the visit and documenting findings. Ensured to completion and
resolution all duties and responsibilities related to facility surveys from initial to final action including
approval of corrective actions taken by health care facilities to rectify deficiencies cited.
(Name during employment: Kameelah Brown)
State Attorney’s Office – Child Support Enforcement Miami, FL
Case Analyst 04/2001 – 03/2004
Conducted interviews and initiated case actions for referral to establish paternity for existing Temporary
Assistance to Needy Families (TANF), Food stamps, Medicaid, Foster Care and Non-Assistance Families
cases. Obtained appropriate administrative orders and court orders, and subsequently securing and
enforcing child support payments through legal and administrative remedies.
REFERENCES AVAILABLE UPON REQUEST
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