Project Management Quality Improvement

MIEZI KINTAUDI – MAHS, BS

323-***-**** *********@*******.***

PROFESSIONAL SUMMARY

Dynamic and results-oriented healthcare professional with over 10 years of extensive experience in senior-level management roles. Proven track record of driving strategic initiatives, optimizing operational efficiency, and enhancing overall healthcare delivery. Adept at fostering collaborative relationships with diverse stakeholders, including internal teams, external partners, and regulatory bodies. Recognized for the ability to navigate complex healthcare landscapes, I bring a wealth of expertise in project management, quality improvement, and program development. Specialized knowledge in Medicare Senior and Medical Products, ACO, and Quality Improvement, with a focus on achieving and surpassing key performance metrics. A strategic thinker with a keen understanding of healthcare trends, regulations, and emerging technologies, I am poised to contribute to senior-level management roles within the healthcare sector, driving transformative change and ensuring the delivery of high-quality patient-centered care. CORE COMPETENCIES

Strategic Planning Healthcare Policy and Regulation Healthcare Management Quality Improvement Leadership and Team Management Project Management Risk Management Change Management Cross-functional Collaboration Stakeholder Engagement Performance Metrics Analysis Patient-Centered Care Population Health Management Healthcare Technology Integration Healthcare Data Analytics Regulatory Compliance Conflict Resolution Decision-Making Clinical Integration Patient Safety Health Information Exchange Continuous Process Improvement Strategic Partnerships Development PROFESSIONAL HISTORY

Humana Jul 2018 - Present

Market Consultation & Partnership - Senior Program Delivery Management Jan 2022 - Present Spearhead the establishment of strategic goals and the seamless execution of initiatives, driving clinical, pharmacy, and quality program enhancements.

• Develop and implement influential programs fostering value-based relationships with providers, members, and market leadership, significantly impacting stakeholder relationships internally and externally.

• Independently manage and steer internal and external stakeholder relationships, contributing valuable insights to the prioritization process and ensuring alignment with organizational measurement year goals.

• Proactively identify and capitalize on opportunities to enhance market performance trends, leading quality gap analyses, and coordinating activities and communications with corporate and market-based relationship owners.

• Collaborate closely with National partners, playing a pivotal role in sustaining and elevating measures performance, while actively facilitating comprehensive training initiatives. Selected Career Benchmarks

• Boosted PCP visits by 25% for medical groups in multiple markets. Achieved a 50% increase in Annual Wellness visits.

• Significantly reduced high acuity members by 31%. Successfully narrowed HEDIS Star gaps, achieving a 35% reduction.

• Enhanced medication adherence, achieving an impressive 88% adherence rate in both small and large contracts. Senior Stars Improvement Consultant Jul 2018 - Jan 2022 Collaborated extensively with regional departments and provider partners specializing in Medicare Senior Products, leading the formulation and execution of targeted strategies to enhance HEDIS, Patient Safety, and Patient Experience performance.

• Spearheaded the identification of innovative resolution strategies and tactical approaches, addressing challenges with both internal and external partners to significantly enhance Patient Experience survey results and overall Quality performance.

• Proactively pinpointed opportunities within existing operational processes for rate improvement, ensuring the delivery of optimal quality care to members and alignment with identified Blue Chips.

• Implemented transformative processes, steering goals towards operational enhancements, and championing improvements in provider performance, member experience, market growth, and the overall satisfaction of provider partners. Selected Career Benchmarks

• Elevated Desert Pacific Southern region Part D Star rating from 3.20 to 4.00.

• Improved Part C Star rating from 3.00 to an impressive 4.10.

• Substantially increased mail order adherence, raising it from 30% to a remarkable 70%. Torrance Health IPA Sept 2016 - Jul 2018

ACO and Quality Improvement - Population Health Specialist Lead Oversaw a portfolio of 65 physician private practices, serving as a liaison and consultant for Medical Group Primary Care physicians and Specialists. Facilitated increased comprehension through culturally and linguistically appropriate education on HCC/RAF, HEDIS/NCQA, P4P, CAHPS & HOS, Stars measure Medi-Cal, and ACO for quality improvement.

• Played a key role in member outreach initiatives, ensuring effective engagement strategies for improved health outcomes.

• Managed the workflow and functions of the Population Health Specialists team, collaborating with leadership to ensure the timely and appropriate completion of work tasks.

• Conducted monthly audits on 65 independent physician practices, utilizing Health Information Exchange, CMS Enterprise Portal, Quest Portal, and insurance claims to measure health outcomes of each provider member panel.

• Spearheaded initiatives to drive quality improvement, working in tandem with leadership to align departmental goals with organizational objectives.

Selected Career Accomplishments

• Led 65% of physician practices to implement HCC processes integrated within an EHR.

• Achieved an annual change in RAF score accuracy, increasing capturing from 29% to a significant 61%. Health Net Mar 2015 - Sept 2016

Delegation Oversight Department - Administrative Analyst Prepared, researched, and analyzed information and data to craft both standard and ad hoc reports. This included audit reports for claims and utilization management, as well as performance/trend reports for Cal-Medi Connect, Special Needs Plans, Medi- Cal, Medicare, and Community Care.

• Conducted thorough analyses of processes and formulated recommendations for improvements, ensuring alignment with policies and procedures for Cal-Medi Connect, with a focus on enhancing quality and consistency.

• Provided crucial support to Regional Health Plan Officers in the successful implementation of new and expanded lines of business, such as Cal-Medi Connect, Community Care, Special Needs Plans, and the expansion of Medi-Cal and Medicare.

• Actively supported timely implementation, provided progress updates as required, and proactively addressed any barriers to ensure seamless execution.

Veterans Affairs Greater Los Angeles Healthcare System Jul 2012 - Dec 2014 Geriatric Research Education and Clinical Center Jul 2014 - Dec 2014 Project Manager

Supported the Administrative Officer in the execution and maintenance of various administrative programs, demonstrating expertise in defining task requirements and identifying elements of cost, schedule, and technical performance.

• Developed and enhanced the efficiency of administrative staff work methods and procedures, along with information and documentation systems. Achieved a level of proficiency sufficient to comprehensively identify all work required for tasks or project completion.

• Provided vital administrative liaison support between the Geriatric Research Education and Clinical Center Department and various GLA specialty areas. Functioned as a purchase card holder, acquiring necessary supplies by entering obligations crucial for maintaining the Geriatric Research Educational and Gerofit program.

• Successfully managed the coordination and communication between the Geriatric Research Education and Clinical Center Department and GLA specialty areas, ensuring the seamless acquisition of supplies and resources. Primary and Ambulatory Care Nov 2013 - Jun 2014

Administrative Analyst/Acting Administrative Officer/Internal Coach Provided crucial administrative liaison support between the Geriatric Research Education and Clinical Center Department and various GLA specialty areas, serving as a purchase card holder to ensure the acquisition of essential supplies for the Geriatric Research Educational, Gerofit program, and Clinical Center.

• Analyzed and synthesized raw data from sources such as the Primary Care Almanac, Clinic Access Index-Primary Care, Dashboard, and VSSC. Produced quarterly reports and effectively presented information to Primary and Ambulatory Care

(PACC) leadership.

• Initiated team-building sessions and introduced several Plan-Do-Study-Act (PDSA) cycles on different topics to redesign Medical Support Assistant (MSA) workflow processes. Successfully improved clinic workflows, including increasing the percentage rate of 2-day post-discharge appointments and enhancing the process of clinic patient self-checking Kiosk.

• Executed complex projects that addressed veterans' healthcare needs and reviewed existing policies, procedures, and reports related to information capture. Provided management with accurate and usable data to measure clinic performance, contributing to enhanced efficiency and effectiveness. Community Care Homeless Program Jul 2012 - Oct 2013 Social Service Assistant

Partnered with AMVETS Leadership Advocacy and Service for American Veterans to build and strengthen organizational relationships, significantly increasing community awareness to better serve homeless veterans.

• Implemented various impactful projects and activities for Team AMVETS, including the Welcome Home Program, Women's Program, and educational opportunities for veterans, contributing to the overall well-being of the veteran community.

• Took charge of coordinating donations and Stand Down events, demonstrating a commitment to developing long-term relationships and robust partnerships with businesses. Designed and recommended programs aimed at addressing the needs of homeless veterans.

• Provided educational materials, collaborated with various departments, and supported other community agencies concerning VA homeless programs, benefits, and medical and mental health services. Actively contributed to the overall improvement of community resources and support for homeless veterans. EDUCATION

Master of Arts, Human Services / Business Management, Liberty University, Lynchburg, VA Bachelor of Science, International Business, California State University, Los Angeles, CA TECHNICAL SKILLS

Tools: Microsoft Word, Microsoft PowerPoint, Microsoft Outlook, Microsoft Excel

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