Cheryl Monnell
Clinical Quality Program Director
- Role
- Director of Quality at Anthem, Inc
- Location
- Columbia, SC, US
- LinkedIn followers
- 500 followers
About Cheryl Monnell
Dynamic Healthcare Leader with a successful track record resulting in URAC and NCQA accreditation and successful HEDIS/CAHPS project management with resultant increase in STAR scores and return of state withhold. Leadership experience in private as well as government health plans, delegation oversight, utilization management and pharmacy benefit management. Proven ability to manage HEDIS call center, develop Case Management programs, lead utilization management unit, and create benchmarking statistics. Additional experience in developing and negotiating pharmacy benefit plans.
Experience
Director of Quality
Jan 2017 — Present · Columbia, SC, US
Education
University of Phoenix
MHA/MHI, Informatics
2014 — 2016
Saint Joseph's College
BSPA, Health Care Administration
1988 — 1995
Onondaga Community College
AS, Nursing
1984 — 1985
Skills
- Hmo
- Provider Relations
- Pharmacy
- Healthcare Management
- Data Analysis
- Healthcare Industry
- Insurance
- Calocus
- Employee Benefits
- Health Insurance
- Managed Care
- Leadership
- Healthcare
- Call Centers
- Team Building
- Management
- Electronic Medical Record (Emr)
- Credentialing
- Healthcare Effectiveness Data and Information Set (Hedis)
- Network Development
- Clinical Research
- Medicare
- Provider Network Development
- Case Management
- Analysis
- Medicaid
- Pharmacy Benefit Management
- Disease Management
- Ncqa
- Customer Service
- Utilization Management
- Quality Improvement
- Medical Terminology
- Software Documentation
- Medical Coding
- Process Improvement
- Strategic Planning
- Quality Assurance
- Informatics
- Healthcare Information Technology (Hit)
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