Andrea Barron, RN, JD, CPHRM

adty3t@r.postjobfree.com

847-***-****

SUMMARY

Resourceful, motivated and experienced medical/legal professional offering a broad range of skills and expertise in risk management, quality improvement, accreditation processes, claims management, insurance and issues of healthcare compliance.

EDUCATION AND LICENSURE

JURIS DOCTOR, DePaul University College of Law (Licensed in Illinois)

BACHELOR OF ARTS - PSYCHOLOGY, Syracuse University

BACHELOR OF SCIENCE - NURSING (With Honors), Syracuse University

CERTIFICATIONS AND LICENSES: Registered Nurse (Licensed in the State of Illinois)

Certified Professional Healthcare Risk Manager

PROFESSIONAL EXPERIENCE

Integrated Imaging Consultants, LLC, Chicago, IL 2019 to 2022

DIRECTOR OF RISK MANAGEMENT

Developed and oversaw Risk, Quality and Patient Safety program for organization of over 120 Radiologists

Tracked claims on an ongoing basis to identify risk issues

Monitored quality data for reporting to executive board

Developed standardized polices and protocols

Collaborated with defense counsel and malpractice insurer

Ran monthly risk and quality meetings

Assisted in the development of both an external and internal website

Provided and facilitated education on risk and clinical topics

Empire Risk Management Services, Chicago, IL

DIRECTOR OF RISK MANAGEMENT 2018 to 2019

•Provided consultation to 30 long term care and assisted living facilities in 4 states

•Conducted comprehensive annual and follow-up facility clinical and safety risk assessments to identify areas of high risk and provide recommendations for improvement

•Presented onsite education on topics relevant to facility

•Reviewed medical record requests and potential claims to determine potential liability

•Worked with defense counsel and claims management to evaluate exposure and monitor progress of ongoing litigation

•Assisted nursing leadership in the development of policies and clinical practice guidelines

•Developed tracking and trending quarterly reports to identify facility risks

CountyCare Health Plan, Cook County Health and Hospital Systems, Chicago, IL

MANAGER, QUALITY AND RISK 2016 to 2018

•Managed member grievance process to achieve member satisfaction, including development of tracking system, policy and process development, and training to providers

•Reviewed and investigated reported quality of care issues to improve quality of service

•Oversaw critical incident/abuse, neglect and exploitation reporting and management to identify safety risks to members

•Conducted quality analyses and audits of network providers to identify risk to organization

•Developed and presented trend reports on identified quality issues to quality committees

•Supervised the performance and tasks of quality and administrative support staff

•Integral member of accreditation readiness team, including the development of policy, manuals and programs and auditing

Family Health Network, Chicago, IL

SENIOR MANAGER, QUALITY AND RISK 2014 to 2016

•Managed member grievance and complaint processes to improve member satisfaction, including the maintenance of incident tracking systems, and training to medical management department staff.

•Identified, evaluated and presented quality of care cases to peer review committee to assess and mitigate risk to organization.

•Researched/reviewed evidence based clinical practice guideline to provide recommendations to the quality and professional peer review committees

•Supervised the performance of accreditation and risk management staff.

•Oversaw the implementation of NCQA quality standards for the medical management team to achieve accreditation readiness, including the facilitation of team meetings; and the development of policies, procedures and program plans, training, and audit processes.

•Managed the risk delegation oversight process for medical groups, including supervision of audits and implementation of corrective action plans to achieve performance goals .

Hospira, Lake Forest, IL

RISK MANAGEMENT SPECIALIST 2012 to 2013

•Actively monitored complaint trends for medical device product groups.

•Generated weekly reports detailing product complaints and events to identify and evaluate trends.

•Performed comprehensive risk evaluations of products and presented data at complaint investigation review board meetings.

Norwegian American Hospital, Chicago, IL

QUALITY IMPROVEMENT MANAGER 2008 to 2011

•Directed all requirements related to core measures submission to the Joint Commission and Centers for Medicaid and Medicare, including abstraction, concurrent review, and monthly data analysis and reporting to quality committees.

•Identified, facilitated and drove performance improvement projects to strengthen internal and publicly reported core measures scores.

•Provided in-service education to new employees and nursing staff on core measures.

•Participated in vendor selection, training and implementation of risk management incident reporting system project.

•Assisted Risk Manager with adverse/sentinel event investigations and root cause analyses.

•Served as a member of Joint Commission accreditation survey preparation and continued readiness team

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