Process Improvement Data Analysis

Raphael Imogoh

Houston, TX *****

********@*****.***

Interview availability (Monday – Friday8:00am to 5:00pm ) No shift restriction’s

PROFESSIONAL SUMMARY

Experienced healthcare IT professional with over 5 years in the healthcare industry, specializing in HEDIS measures, medical record review, and data analysis. Proven track record in leading teams, process improvement, and collaboration with interdisciplinary teams to achieve organizational goals. Adept at using advanced Microsoft Office tools and telecommuting effectively to drive success in managed care environments.

RELEVANT SKILLS

• Team Leadership: Over 3 years of experience leading and mentoring teams in a healthcare setting, ensuring productivity and high-quality outcomes.

• HEDIS Expertise: Extensive experience with HEDIS measures, including FUH, TRC, IMA, BPD, and more, ensuring accuracy and compliance in medical records review.

• Data Analysis & Presentation: Skilled in analyzing performance data to identify gaps and optimize workflows, with experience in presenting data-driven insights to stakeholders.

• Process Improvement: Proven ability to develop and implement workflow modifications to improve efficiency and meet HEDIS goals.

• Technical Proficiency: Advanced skills in Microsoft Word, Excel (PivotTables, VLOOKUP, IF statements), PowerPoint, and Outlook. Strong troubleshooting abilities in system issues and providing end-user support.

• Telecommuting: Effective remote worker with a dedicated home office setup, ensuring confidentiality and secure handling of sensitive information. PROFESSIONAL EXPERIENCE

CSI Group – Houston, Texas

HEDIS Abstractor

OCT 2023 – Present

• Led a team in achieving Follow Up after Hospitalization (FUH) and HEDIS goals by ensuring aftercare appointments were secured and documented for psychiatrically hospitalized members.

• Utilized data analysis to monitor performance, identify gaps, and implement workflow improvements, resulting in enhanced team productivity and adherence to quality metrics.

• Collaborated with case management, utilization management, and provider networks to optimize discharge planning and improve patient outcomes.

• Conducted root cause analysis and developed actionable solutions to address issues impacting FUH, driving continuous process improvement. Healthcare IT Leaders LLC

Senior Application Support Specialist & HEDIS Abstractor November 2022 – May 2023

• Led a team of HEDIS abstractors, ensuring adherence to FUH and HEDIS goals through accurate data abstraction and record review.

• Analyzed team performance data, identifying areas for improvement and implementing workflow changes to enhance productivity.

• Collaborated with cross-functional teams, including case management and utilization management, to improve patient outcomes.

• Conducted weekly meetings to discuss progress, address challenges, and ensure compliance with NCQA standards.

• Achieved a 97% accuracy rate while consistently exceeding chart review expectations. CSI Group – Kansas City, MO

HEDIS Abstractor & Overreader

January 2022 – March 2022

• Supported healthcare facilities in securing and documenting aftercare appointments for psychiatrically hospitalized members, contributing to improved FUH rates.

• Conducted root cause analysis and data research to identify and mitigate issues impacting HEDIS measures.

• Provided training and consultation to healthcare providers on optimizing electronic medical record (EMR) workflows.

Various EPIC Go-Live Consulting Roles

Consultant

July 2022 – December 2022

• Assisted healthcare providers and staff during EPIC Go-Live implementations, providing training and support in workflow optimization, order entry, and documentation.

• Supported multiple modules within ambulatory and acute care settings, ensuring smooth transitions and minimal disruption to patient care. EDUCATION & CERTIFICATIONS

• Certified Anti-Money Laundering Specialist (ACAMS), 2023

• Bachelor of Science in Accounting and Finance 2012

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