Quality Improvement Value-Based

MAHOGANY SMITH, MHA

Atlanta, GA, ***** 678-***-****

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

linkedin.com/in/mahogany-smith

Healthcare Performance Improvement Professional

Dedicated and results-driven healthcare professional with extensive experience in value-based care operations, quality improvement, and provider practice management. Proven expertise in identifying, developing, and implementing practice improvement plans that drive performance in value-based contracts. Strong ability to work collaboratively with healthcare teams, providers, and leadership to achieve measurable outcomes. Skilled in utilizing resources and tools to support transformation activities and improve network-wide performance. Exceptional communication, problem-solving, and relationship-building skills, with a strong passion for optimizing healthcare processes and enhancing the quality of patient care.

CORE COMPETENCIES

Value-Based Care Operations Quality Improvement & Project Management Provider Practice Support & Development

Data Analysis & Monitoring Tools Performance Improvement Strategies Cross-Functional Team Collaboration Relationship Building with Providers & Stakeholders Reporting & Presentation of Actionable Insights Problem-Solving

& Barrier Identification Healthcare Transformation Initiatives Staff & Leadership Engagement TECHNICAL SKILLS

Microsoft Office Suite Database analysis/management Electronic Health Records Software Smart Sheets Population Health Tool Patient Ping

HIGHLIGHTS

• Extensive experience in accreditation and quality improvement initiatives

• Expertise in quality assurance processes and test development measurement

• Proficient in providing technical assistance and support to staff to enhance operational efficiency

• Exceptional multitasking and prioritization abilities, ensuring timely and effective task completion

• In-depth experience in risk analysis documentation and mitigation strategies

• Strong background in research management, program development, and continuous improvement

• Skilled in HEDIS abstraction and research for accurate reporting and compliance

• Experienced in designing, developing, and delivering effective training materials to staff and stakeholders EXPERIENCE

Collaborative Health Systems (Centene), Atlanta, GA 07/2019 - 10/2024 Various Roles Overlapping

Lead Practice Transformation Coach (Value Based Care), 08/2021 - 10/2024

• Assists practices with onboarding and operationalizing value-based care foundational elements, including EHR optimization, quality improvement and reporting, pre-visit planning, Annual wellness visit (AWV) workflow, HCC recapture and suspect conditions, and transitions of care.

• Led and implemented provider practice improvement plans within value-based contracts, guiding practice teams in achieving project-specific goals and timelines.

• Prepare and deliver regular reports that provide actionable recommendations for practices to enhance performance, utilizing professional expertise to improve healthcare delivery.

• Collaborate with practice teams to develop, implement, monitor, and track improvement activities that optimize performance.

• Foster strong relationships with practice staff and providers, acting as a trusted resource for value-based care operations and transformation activities.

• Access and utilize available resources (IT, clinical, analytic, and education tools) to support initiatives and address barriers to practice achievement.

• Contribute to organizational transformation project teams as assigned, supporting strategic initiatives across practices.

• Developed and implemented Medicare handbooks, standard operating procedures (SOPs), and training materials to ensure providers' comprehensive understanding of Medicare policies. Practice Transformation Coach (ACO - FQHC), 07/2019 - 08/2021

• Prepared tailored reports and presentations for providers, translating data insights into actionable steps for operational improvement.

• Monitored and guided quality improvement initiatives to ensure compliance with CMS standards, facilitating continuous improvement in healthcare delivery.

• Educated community physicians on quality measures and documentation guidelines, regularly updating training materials to reflect Medicare regulatory changes and best practices, ensuring alignment with organizational goals.

• Conducted training for providers and practice staff on how to leverage Collaborative Health Systems (CHS) population health tool.

• Achieved a 5-10% increase in provider Annual Wellness Visit rates through targeted improvement initiatives and provider support.

• Abstracted and documented Medicare Fee-for-Service quality reporting through Web Interface, ensuring accuracy and compliance with CMS guidelines.

MANAGED STAFFING (contracted with Aetna Better Health, Inc.), Addison, TX 01/2019 - 05/2019 Contingent HEDIS Abstractor/Researcher

Conducted data collection and abstraction of medical records for HEDIS projects.

• Collaborated with vendors and participated in meetings to ensure efficient record collection processes. MOLINA HEALTHCARE, INC., Doral, FL 02/2013 - 01/2019 Quality Improvement Specialist, 12/2016 - 01/2019

• Developed comprehensive plans for 25-35 provider groups to improve provider performance and generated HEDIS Medicaid gap reports monthly.

• Educated providers on appropriate documentation and coding, improving compliance.

• Developed comprehensive, provider-specific plans to improve performance. Medicare Risk Adjustment/HEDIS & STARS, 12/2016 - 01/2019

• Managed the Medicare STARS program, targeting provider education for improved Risk Adjustment Factor scores.

• Developed comprehensive, provider-specific plans to improve quality performance. Community Connector, 02/2013 - 12/2016

• Oversaw administrative operations, maintaining effective communication with clients and providers. ADDITIONAL RELEVANT EXPERIENCE

RUTH RALES JEWISH FAMILY SERVICE, Boca Raton, FL

Case Manager, Nursing Home Diversion

• Completed assessments and coordinated care services for elderly individuals.

• Collaborated with discharge planners, physicians, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care and long-term care services. EDUCATION

Master of Health Administration

University of Phoenix, Miramar, FL

Bachelor of Science (BS), Gerontology

Bethune Cookman University, Daytona Beach, FL

Contact this candidate