Healthcare Clinical Manager
Resume:
Kelly M. Kritz
Mobile 414-***-**** Landline 262-***-****
*******@***.*** N3659 Oak Hill Street, Delavan, WI Clinic Manager
Accomplished Healthcare Clinic Manager with more than 30 years of experience in clinical operations management with a focus on developing and executing strategies to drive growth, savings, and optimal service. Expertise includes implementing continuous improvements, emerging technologies, and regulatory compliance. Skilled in aligning operational initiatives with organizational objectives, and fostering strong relationships. Core Competencies
Regulatory Compliance (MIPS) - Electronic Medical Record Implementation and Management - Clinical Operations Management - Customer Service - Scheduling Systems - Workforce Management - Clinical Compliance - Security Risk Assessment - Program and Project Management
- Privacy Compliance Manager (HIPAA) - Medicare & Medicaid - EMR Optimization – Scheduling Template Creation & Management - Dragon Medical One Dictation Solution & Integration- NUANCE Dictation Solution
Professional Experience
Orthopedic Institute of Wisconsin
October 2013 - present
Clinic Manager
October 2013-April 2017
Clinical Integration Manager
April 2017 - present
Busy and growing orthopedic practice of 5 clinics, and 17 providers
* Aprima Development, Implementation & Management (Electronic Medical Record); developed and implemented a new EMR for the practice, 4/2019, which drove a substantial increase in efficiencies in both staff and provider teams
* Managed staff of more than 50, spread across 5 clinics, including front desk, medical assistants, and surgical schedulers, patient access and chart prep teams.
* Continually worked to establish and implement workflow efficiencies
* Trained staff to meet the changing clinical and administrative needs
* Determined staffing needs, as well as executing full employment cycle from hiring and performance management to separation
* Optimized the use of a rotational clinic staff scheduling model, instead of a traditional shift model, in order to utilize staff efficiently and with a reduction in overtime hours
* Collaborated with administrative leadership to execute efficiencies between clinical workflow and revenue cycle management requirements in order to increase revenue and reduce claims errors
* Created and implemented quality assurance standards, effective scripting and care team specific models for patient access team in order to increase patient satisfaction
* Developed staff, through mentoring, to promote internal company growth
* Wrote and implemented policies and procedures, to increase and standardize accountability Regulatory Compliance Manager
October 2013 – present
* Developed and implemented clinical compliance programs, including HIPAA, OSHA, Meaningful Use and PQRS
* Audited and monitored patient records, documentation and quality measures
* Conducted and maintained records for compliance investigations and resolution plans
* Established compliance framework and workflows, for staff and provider teams, to effectively meet MIPS reporting measures
* Successfully created workflow that met/exceeded federal requirements for Meaningful Use, PQRS & MIPS reporting in order to obtain positive payout or neutral status from successive programs
* Oversaw and Maintained a successful Security Risk Assessment
* Drafted, implemented and reviewed policies and procedures that supported adherence to industry regulations
* Developed and optimized the use of an external compliance training model in order to standardize, record and increase efficiencies in delivery of required staff training Milwaukee Skin Center
October 1991 - May 2012
Office Manager
Full service practice
* Managed, trained and developed office staff
* HIPAA compliance officer
* Performed all insurance billing, accounts receivable processing
* Approved pharmacy refill requests, prior authorizations on scripts
* Managed relationship with pharmaceutical reps
* Administered commercial insurance carriers, Medicare and Medicaid plans, negotiated fee schedules, and reviewed contracts for renewal
* Chose and implemented the practice’s Electronic Medical Record; wrote the templates and the trained the staff
* Successfully navigated the Federal "Meaningful Use" guidelines and obtained the practice’s first payout
North Shore Therapy Services
September 1989 - September 1991
Office Manager
Eight practitioner outpatient psychiatric clinic which catered primarily to men and women struggling with eating disorders
* Performed all scheduling, billing, A/R, deposits, pre-admissions
* Implemented first computer and charting systems, for the practice, from the ground up
* Liaison with Northbrooke Hospital, admits and discharges
* Determined benefit availability
* Coached family members through insurance issues
Training and Technical Skills
Ongoing and extensive training through independent and governmental resources; including, but not limited to Meaningful Use/PQRS/CQM, Medicare billing, successful business management practices and OSHA & HIPAA Compliance; as well as ongoing work with Human Resource Management courses.
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