Lean Six Health

TAMELIA LAKRAJ-EDWARDS

**** ********* ******, **** ***** Gardens, FL 33418 · 561-***-****

adhtm1@r.postjobfree.com · linkedin.com/in/tlakraj-edwards

Experienced healthcare transformation professional with seven years of broad clinic, health informatics, and operational experience. Professional focus is value-based healthcare support through technology, acute care and outpatient operation management, documentation improvement, and analytical support. Strengths include knowledge of NQCA, CMS, ACHA, Lean Six Sigma, JCAHO, HRSA, FQHC, CARF, PCMH, OSHA, HCC, ICD-10, SPSS, HIPPA, Case Management, HEDIS/STARS, Microsoft Office Suite, public speaking, and various electronic health records.

CERTIFICATIONS

LEAN SIX SIGMA GREEN BELT

ECFMG

PCMH-CCE

EDUCATION

MAY 2021

MASTER OF PUBLIC HEALTH, Florida Interanational University

AREA OF STUDY: EPIDEMIOLOGY

JUNE 2019

MASTER OF CLINICAL COUNSELING AND PSYCHOLOGY, Troy State UniverSity

MAY 2012

DOCTOR OF MEDICINE, Spartan HEalth Sciences University

EXPERIENCE

JULY 2019 – PRESENT

QUALITY MANAGER, Health Care District Palm Beach County

Manages, directs and plans all aspects of acute care and ambulatory Quality, Coding, and Utilization Management with fourteen full time employees. Conduct training on HEDIS/STAR/UDS measures, HEDIS/STAR/ UDS data collection software and data collection strategies.

Successfully obtaining over 2.6 million dollars in shared savings and incentives through identifying and prioritizing key quality and utilization initiatives critical to success under performance-based payment programs to promote value based care, elevating percentage of membership in bonus earning contracts to ~100%.

Actively conducted root cause analysis and implemented timely action plans to ensure patient safety event management.

Actively develops, implements, and updates acute care and ambulatory policies and procedures as well as maintains quality assessment and improvement programs within the organization to uphold compliance with federal and state agencies such as CMS, ACHA, HRSA and various accrediting bodies to include NCQA, CARF, and TJC (JCAHO).

Successfully utilizes Lean Six Sigma certification to lead cross-functional teams, internal and external, through all phases of the PDCA cycle to improve operational and quality metrics in order to transform, acute and ambulatory organizations, through value based care model.

Led performance management workgroups aimed at improving documentation and improving clinical performance with members across the district; this included developing dashboard reports that helped to pinpoint opportunities to maximize performance in the areas of clinical quality, as well as risk adjustment.

JUNE 2018 – JUNE 2019

QAULITY IMPROVEMENT ADVISOR, Georgia Hospital Association

Oversaw transformation through value based care to more than 20 ambulatory and acute care organizations throughout South Georgia. Services included MACRA/MIPS, Meaningful use of electronic health records, patient satisfaction, patient health outcomes, quality improvement, and staff training.

Successfully drafted and published 26 policies and procedures, in compliance with TJC (JCAHO) and PCMH, for South Georgia acute care and ambulatory care organizations as well as four grant proposals for which $70K was awarded within first four months of hire.

Successfully utilizes Lean Six Sigma certification to lead cross-functional teams, internal and external, through all phases of the PDCA cycle to improve operational and quality metrics.

Actively led and coached acute care, ambulatory, and academic primary care sites towards transformation through value based care as the subject matter expert.

Actively develops, implements, and updates acute care and ambulatory policies and procedures as well as maintains quality assessment and improvement programs within the organization to uphold compliance with federal and state agencies such as CMS, ACHA, HRSA and various accrediting bodies to include NCQA, CARF, and TJC (JCAHO).

Development and execution of strategies to engage physicians, providers, and the clinical community in healthcare quality improvement efforts to include Opioid awareness with the American Medical Association President, Dr. Patrice Harris.

Led performance management workgroups aimed at improving documentation and improving clinical performance with TCPI quality advisors and GHA members across the nation; this included developing dashboard reports that helped to pinpoint opportunities to maximize performance in the areas of clinical quality, as well as risk adjustment.

APRIL 2015– JUNE 2018

POPULATION HEALTH DIRECTOR, North Atlanta Primary Care

Upgraded organization status from Level 1 NCQA PCMH status to Level 3 for all 12 locations.

Scored in top 2% for QCPI metrics for GA BCBS quality awards program

Interfaced with Georgia’s largest ACO, GA Physicians for Accountable Care (GPAC), and was selected as a Population Health Quality committee member for GPAC serving over 900 physicians and 50,000 covered lives.

Development and execution of strategies to engage physicians, providers, and the clinical community in healthcare quality improvement efforts to include MACRA/MIPS program, Chronic Care Management, and Medicare Annual Wellness Program Exams.

Promote the interoperability and effective use of registries, Electronic Health Records, and other practice management systems, while maintaining privacy and security of patient health information, to improve coordination of care delivery between primary and specialty practices, facilitating improved patient outcomes through value based care.

Liaison for the Medical Association of Georgia as they onboarded Health Paradigm, a health information exchange.

Provide strategic recommendations for improving health care affordability to C-Suite, stakeholders and healthcare professionals.

APRIL 2012– JUNE 2018

QUALITY MANAGER, Horizons Healthcare

Provides leadership and support, initially as a manager and subsequently as a consultant, in establishing the Quality Performance Initiatives at the market level. Conduct training on HEDIS/STAR measures, HEDIS/STAR data collection software and data collection strategies

Analyze and trend HEDIS/STAR rates, identify barriers to improvement of rates and creating interpretive exhibits

Provides expertise to the training department on HEDIS/STAR measures and on the tools that support the collection of HEDIS/STAR data. Participate in NCQA HEDIS or Health Plan audits

Collaborates with physicians to execute the implementation of the clinical quality initiatives as defined by enterprise. Work with IT on the interpretation of technical specifications and impact of HEDIS/STAR Measures to the data collection tools and reports utilized for the support of HEDIS/STAR measures

JULY 2013– MARCH 2015

FAMILY MEDICINE RESIDENT PHSYCIAN, Medical College of Georgia

Appropriately diagnosed and treated a variety of diseases and injuries in general practice setting. Ordered & executed diagnostic test. Analyzed diagnostic images to further investigate patient conditions. Admitted, treated, and counseled patient in both the acute care and ambulatory settings.

Administered and prescribed appropriate courses of treatment, including pharmaceutical medications. Advised and educated patient regarding diet, hygiene, and effective disease prevention methods. Accurately reported births, deaths, and outbreaks of contagious diseases to governmental authorities. Treated pediatric patients with minor illnesses, acute, and chronic health problems to include growth and developmental concerns.

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