Juane L. Tyler

** ****** *******

Pittsburgh, PA 15221

412-***-****

aducl9@r.postjobfree.com

Objectives

As a compliance, quality, and risk professional, I will utilize my leadership skills, case management, risk management, project management, investigative training, and nursing education to provide quality services for persons served in the community.

Experience

Quality Manager, Pittsburgh Mercy

May 2021- present

• Evaluate and monitor goals, objectives, and indicators for a 4-million-dollar SAMHSA Grant.

• Analyze behavioral health program successes, barriers, and challenges.

• Spearhead organizational quality initiatives and projects.

• Provides support, coaching, and training for behavioral health teams.

• Evaluate and monitor fraud, waste, and abuse for behavioral health programs.

• Assist with redesigning workflow to focus on clinical and patient outcomes.

• Collect and analyze metrics for grant requirements and state requirements.

• Conduct investigation interviews, educational research, to report and evaluate findings.

• Enter and extrapolate data from various databases and platforms i.e., SPARs, ERA Commons, Innovaccer, Powerbi, AVATAR, and HCSIS.

• Evaluate evidenced base practices.

• Complete and submit all reports for SAMHSA and CCBHC.

• Continue to collaborate with internal teams and external stakeholders.

• Review organizational and programmatic policies and procedures.

• Monitor Integrated Care Wellness Center (ICWC) framework and model.

• Assist with quality improvement plans and oversee audit committees.

• Support departments with licensing and audit preparation.

• Support and provide program updates to the Director of Compliance, Quality and Risk, Vice Presidents, and the Chief Operating Officer.

Chief Quality Officer, EIG Services, LLC

October 2020- April 2021

• Serves as an internal consultant to administration and staff in the areas of regulatory processes, staff performance, statistical analysis, and continuous quality improvement.

• Focus on healthcare quality and improvement, individual experience, individual safety, costs, revenue, productivity, efficiency, employee satisfaction, and process reliability.

• Organize quality management meetings and make recommendations to the committee based on best practices and regulatory standards.

• Conduct internal audits, quality reviews, and risk analysis.

• Analyze areas for opportunities and areas for improvement.

• Make recommendations for process improvement, system improvement, procedure development, and operational changes to improve overall quality of the organization.

• Assist with performance measurements and monitor patterns and trends. Juane L. Tyler

64 Garden Terrace

Pittsburgh, PA 15221

aducl9@r.postjobfree.com

2

• Monitor key performance indicators to evaluate effectiveness, reliability, and efficiency.

• Work on strategic initiatives for the organization and assist with the redesign of programs that support vulnerable populations.

Chief Operating Officer, Quality Adult Care Services March 2020- October 2020

• Create COVID-19 policies and procedures, implement protocols, and mitigate risk.

• Update internal policy and procedure manual to reflect state regulations and best practices.

• Train staff on incident management policy and procedures.

• Develop and implement New Employee Orientation for the organization.

• Manage all incidents, investigations, and health risk screening tools for the group homes.

• Collaborate with external stakeholders, Allegheny County, and Office of Developmental Programs.

• Create new programs for the agency and implement strategies for organizational growth.

• Write and implement quarterly quality management plans and complete incident analysis.

• Oversee day-today operation for the residential habilitation programs.

• Supervise four leadership staff and a team of 85 direct care specialists along with work closely with the CEO to ensure quality services and supports are provided persons served. Incident Risk Manager, InGenesis

October 2018- March 2020

• Attend regional meetings and provide technical assistance to stakeholders in the Western Region.

• Provide training and education for stakeholders, families, and individuals that receive services and supports through the Office of Developmental Programs.

• Serve as the incident management lead, which includes reviewing and closing incidents in the EIM system.

• Oversee the incident management process for the Western Region that includes 19 counties.

• Collaborate with Adult Protective Service (APS).

• Analyze incident management data and provide oversight to administrative entities.

• Process neglect of care dependent reports as needed, which includes notifying the Attorney General and District Attorney Office.

• Conduct Investigation as needed.

• Analyze incident management data.

EPSDT Coordinator/ Billing Specialist, Donnelly Boland, and Associates March 2017- September 2018

• Reconcile all bills received from various medical companies and Managed Care Organizations for children that are in care/custody of Children Youth & Families.

• Ensure that EPSDT (Early, Periodic, Screening, Diagnostic, and Treatment) screenings are completed and monitor compliance.

• Attend quarterly meetings with the four Managed Care Organizations - Aetna Better Health, Gateway, United Healthcare, and UPMC for You.

• Provide EPSDT trainings and education for stakeholders in the Community. Juane L. Tyler

64 Garden Terrace

Pittsburgh, PA 15221

aducl9@r.postjobfree.com

3

Program Specialist II, Human Services Administration Organization August 2007- February 2017

• Implement daily operations Enterprise Incident Management system (EIM) reviewing incidents within 24 hours of submission.

• Approve and/or disapprove incidents based on minimum expectations within 30 days of finalization.

• Provide technical assistance and support to stakeholders.

• Coordinate and lead the Independent Monitoring for Quality project (IM4Q) and provide trainings.

• Offer trainings on a quarterly basis and training as needed on the incident management bulletin and report writing.

• Conducts and completes investigations as assigned.

• Participate in quarterly meetings.

• Serve as the incident management liaison for 62 contracted providers. County Monitor, Donnelly Boland, and Associates

September 2006- July 2007

• Perform on-site scheduled monitoring visits and unannounced visits for contracted providers.

• Monitor the health and safety of individuals registered with the Office of Intellectual Disability.

• Write follow-up monitoring reports and plans of corrections.

• Operate within the federal, state regulations, and county guidelines as it relates to licensing.

• Provide technical assistance for providers as needed.

• Attend monthly, quarterly, and annual meetings.

• Review provider contracts.

Supports Coordinator, Family links

August 1999 - August 2006

• Coordinate, locate, and monitor services in the community for individuals with intellectual disabilities.

• Provide community outreach for individuals that do not receive waivers within the Commonwealth of Pennsylvania.

• Provide case management for a cohort of 45 individuals with different waivers and funding streams.

• Advocate for individuals and families who need services within Allegheny County and surrounding counties.

• Attend and facilitate individual service plan meetings for individuals on an annual basis or as needed.

• Monitor individuals needs, document in case notes, and enter monitoring tools in (HCSIS).

• Authorize services for vendors and oversee individuals’ budgets. Program Specialist Supervisor, Mercy Behavioral Health August 1995- June 1999

• Supervise four full-time employees and one part-time employee.

• Supervise the daily operations of a group home serving three individuals with intellectual and developmental disability along with mental health disorders.

• Monitor and maintain a safe physical site for individuals.

• Supervisory duties included the following: hiring, coaching, counseling, and on-call. Juane L. Tyler

64 Garden Terrace

Pittsburgh, PA 15221

aducl9@r.postjobfree.com

4

Education

Duquesne University, Pittsburgh Pennsylvania

Bachelor Science in Nursing (BSN)

Geneva College, Pittsburgh Pennsylvania

Master’s in organizational leadership (MSOL)

Skills

• John Maxwell Speaker, Trainer, and Coach

• DISC Trainer

• ODP Certified Investigator

• ODP Quality Management Certified

• Proficient with Microsoft products

• Entrepreneur for Tyler Consulting and Associates, www.tylerconsultingandassociates.com Memberships

• Board Member for Emmaus Community

• Member of Alpha Wives of Western Pennsylvania

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