Josean C.
Clinical Quality Compliance Specialist @Compass Health Systems, Pa
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WORK HISTORY
Clinical Quality Compliance Specialist @Compass Health Systems, Pa
US
Development, implementation and overseeing clinical quality compliance programs to mitigate risk and ensure adherence to healthcare laws and regulations. Conducting compliance audits, creating corrective action plans, liaison between healthcare providers, regulatory agencies and stakeholders.Management of various healthcare quality programs such as Merit-based Incentive Payment System (MIPS), Patient-Centered Medical Home (PCMH) and Healthcare Effectiveness Data and Information Set (HEDIS), Management of healthcare analytical dashboards, key quality performance measurements, activities, risk management, attestation and submissions, state and federal regulations, quality incentive programs, quality planning, quality accreditations and certifications. Management principles and methodologies to improve healthcare operations, Enhance Clinical Documentation Workflows to achieve specific organizational goals.Delegating tasks to staff members and evaluating their workflow performances to me strategic goals.Healthcare Laws and Regulations, HIPAA, management of clinical referrals, patient engagement, EHE HIV prevention programs.Proficiency:Change Management StrategiesClinical Data ManagementClinical Decision Support Systems Clinical Informatics Compliance Reporting Data Analytics Dashboard and PortalsData Integration and Integrity Interoperability, Optimization and Standards Key Performance IndicatorPatient Engagement and OutreachPopulation and Public HealthPublic and Clinical RegistriesQuality Improvement Methodologies Risk Management TechniquesStakeholders CollaborationTraining and DevelopmentTransformation Management.Microsoft Office 365, SharePoint, CRM, Medical Terminology, SNOMED CT, ICD CODES/ CPT CODES, SQL, AI, EBO Business Intelligence, HL7 FHIR compliance.
EDUCATION
Nova Southeastern University
Master of Science
Nova Southeastern University
Bachelor of Science
ABOUT JOSEAN C.
Clinical Quality Compliance Specialist | CPHQ, Lean Six Sigma | EHR Workflow Optimization | CMS, MIPS, ACO, HIPAA | Medicaid/Medicare Compliance & Policy | NCQA, HEDIS, PCMH,| General Medicine, Behavioral Health | Data Analytics & Population Health | Risk Management | Driving Regulatory Excellence. With over 10 years of experience in healthcare quality improvement, Josean is a Clinical Quality Compliance Healthcare Specialist, where she guides clinical providers and staff on quality, interoperability, and improvement activities initiatives. Josean has a Master Degree in Biomedical Informatics, also known as Healthcare Informatics. Josean also has certifications in health information technology, executive project management, and lean six sigma. She is also an Electronic Medical Records (EMR) SME for various healthcare specialties. In her current role, as a Healthcare Quality and Telehealth Consultant at Compass Health Systems, PA, she collaborates with providers, staff, and insurance companies to optimize clinical workflows and to meet specific patient care gaps and performances. Furthermore,she serves as a Faculty Advisor at NSU Dr. Kiran C. Patel College of Osteopathic Medicine, where she mentors and advise students on healthcare informatics and analytics topics. Her mission is to leverage her passion and expertise in healthcare informatics, quality improvement, and telemedicine to enhance the better health outcomes and experiences of patients, clinicians, and organization’s growth. This is done by her continuing to manage and to oversee clinical quality compliance at all stages. Proficiency: The ACO REACH Model (Accountable Care Organization Realizing Equity, Access, and Community Health) Value-Based Care Merit-based Incentive Payment System (MIPS) Patient-Centered Medical Home (PCMH) Healthcare Effectiveness Data and Information Set (HEDIS) EHE HIV Prevention Program Clinical Quality Data Compliance Clinical Decision Support (CDSS) Clinical Registries. Clinical Data Analytics High Risk Patient Care Management Electronic Health Record (EHR) Electronic Medical Record (EMR) eClinicalWorks EPIC CERNER Nextgen Patient Engagement #OpenToWork #Hiring #Data #Informatics #Informaticist #Analyst #Consultant #Contract #Remote #Healthcare #Quality #Improvemet #Assurance #Clinical #Compliance #PCMH #HEDIS #CMS #MIPS #QPP #Medicare #Medicaid #Patient #Behavioralhealth #Mentalhealth #EHR #EMR
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