Nahema I.
Clinical Performance Consultant @Aetna, A Cvs Health Company
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WORK HISTORY
Clinical Performance Consultant @Aetna, A Cvs Health Company
Led a quality and analytics team to enhance claims processing, coding accuracy, and customer service operations. • Designed and implemented enterprise-level quality programs to boost customer satisfaction and reduce medical cost leakage. • Conducted complex quality management initiatives, including audits and operational risk assessments, to strengthen regulatory compliance.
EDUCATION
Nassau Community College
A.A.S, Health Information Technology
Nassau Community College
Certificate, Health Information/Medical Records Technology/Technician
CUNY School of Professional Studies
Bachelor of Science - BS, Health Information Management
ABOUT NAHEMA I.
As an Outpatient CDI Specialist at GuideHealth, I leverage my skills and certifications in coding, clinical documentation improvement, and risk adjustment to optimize healthcare data management and integrity. I develop relationships with clinical providers and staff, conduct provider training on health plan coding initiatives and guidelines, and perform chart reviews to ensure correct and specific coding and documentation. I also track, monitor, and report on crucial program performance metrics for coding initiatives, supporting quality improvement and compliance objectives.I hold a Bachelor of Science in Health Information Management from CUNY School of Professional Studies, and I am a Certified Coding Specialist (CCS), a Registered Health Information Administrator (RHIA), and a Certified Risk Adjustment Coder (CRC) and a Certified Clinical Documentation Specialist (CCDS-O). These credentials reflect my commitment to excellence and continuous learning in healthcare information management. I am passionate about enhancing the accuracy, completeness, and usability of healthcare data, and I strive to contribute to the delivery of high-quality, cost-effective, and patient-centered care.
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