Healthcare Quality Management Regulatory Compliance Coordinator in Denver CO Resume Mary Friscia

May 28, 2016 | Author: MaryFriscia | Category: Types, Resumes & CVs
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Mary Friscia is a CPHQ-trained Licensed Practical Nurse and current Bachelor of Science in Nursing & Healthcare Admi...

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MARY V. FRISCIA Highlands Ranch, Colorado 80126 Telephone: (303) 918-3259

Email: [email protected]

QUALITY MANAGEMENT

http://www.linkedin.com/in/maryfriscia

HEALTHCARE ADMINISTRATION

CPHQ-trained Licensed Practical Nurse and current Bachelor of Science in Nursing & Healthcare Administration student with 15+ years of quality management and healthcare administration experience and a talent for creatively transforming operations to produce superior outcomes and enhance the patient experience. Design, implement and monitor performance metrics. Develop policies and procedures and deliver compliance training. Lead performance improvement teams, leveraging clinical expertise and in-depth knowledge of regulations to continuously improve outcomes. Performance-oriented healthcare leader with proven ability to build and manage productive relationships and ensure appropriate coordination and utilization of resources; dedicated to delivering high-quality patient care with a reputation as a direct, honest and approachable professional with impeccable integrity and a strong commitment to assisting organizations to achieve goals and set standards.

KEY SKILLS: Quality Management Performance Improvement - PDCA & PDSA Processes - Lean Six Sigma High Reliability Organizational Strategic Planning Regulatory Compliance Audits Accreditation Standards Mock Surveys Project Management Process Improvement Case Management DMHC Meeting Facilitation Peer Quality Reviews Leadership Nursing Care Cross-Functional Teams Problem Solving Clinical Data Abstracts & Medical Correlation JACHO Patient Safety Registry Reporting Corrective Action Plans Staff In-Service Clinical Work Plans & Evaluations Presentations Interpretation of Statistical Process Control Chart Quality Metrics Medical Coding & Terminology EMTALA / NCQA / HEDIS / CSG / CMS / JACHO Core Measures

PROFESSIONAL EXPERIENCE MEDASSURANT, INC., Bowie, Maryland 6/2011- Present A leading healthcare data analytic solutions organization operating a nationwide infrastructure in leading technological health care solutions that is provider focused on objective improvement in clinical and quality outcomes care management and financial performance of health plans and health care organizations. Site Review Consultant: Field Consultant Improving the clinical and quality outcomes of patient care management and the financial performance of health plans and healthcare organizations to ensure that effective and efficient patient centered care meets regulatory compliance standards in support of Quality Management Programs, achieving continuous quality improvement, focused on patient safety, evidence based patient centered care, and measuring clinical services and processes to identify outcomes for best practices in delivering patient care. [Continued next page]

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MARY V. FRISCIA Page 2

[email protected] http://www.linkedin.com/in/maryfriscia

KAISER FOUNDATION HOSPITALS, Panorama City, California 8/1999- 3/2011 Not-for-profit health care organization operating medical centers in California, Oregon and Hawaii and other outpatient facilities in regions served by the Kaiser Permanente Consortium. Quality Analyst: Coordinated quality initiatives in the Quality Improvement / Management Department. Created quality framework to ensure regulatory compliance and maintenance of JCAHO accreditation, designing and rigorously enforcing policies and procedures to promote patient safety and efficient operations. Established quality metrics and continuous improvement plans, tracking and trending results and creating reports. Reviewed utilization, monitored patient-staff interactions and conducted medical records reviews, making adjustments as necessary and directing organizational change. High Reliability Organizational Strategic Planning and managed, high-profile projects. Key Accomplishments: Successfully designed and implemented numerous quality improvement initiatives to ensure compliance and promote delivery of patient-centered care. Developed & implemented Extraordinary Customer Service Training Program, successfully training medical center staff concerning Extraordinary Customer Service & Patient Safety Awareness throughout the medical center significantly improving the customer service experience to internal & external customers with measurable effectiveness. Realized 25% cost savings by securing and continuing key contract for foundation. Led innovative efficiency projects that reduced costs & Realized 25%+ cost savings by securing and continuing key contract for the foundation, playing a key role in retaining important government contract program. Was instrumental in securing 4-year re-accreditation with commendation from the Institute of Medical Quality (IMQ) and California Medical Association (CMA) via major quality improvements. Spearheaded annual HEDIS and CSG audits, receiving commendation for excellence, and identified and mitigated risks to ensure successful Accreditation Regulatory Compliance Survey performance. Played a key role in establishing a unique pneumonia pilot study that was subsequently adopted for wider use due to measurable effectiveness and used as a best practice at other medical centers. Was instrumental in securing that facility passed Accreditation Regulatory Compliance Surveys by identifying and reducing areas of vulnerability as a participant in mock surveys. Enhanced success by providing high quality, well-timed service for internal and external clients. . MIRAFLOR & ASSOCIATES, Diamond Bar, California 5/1997- 8/1999 Leading managed health care consulting and medical / quality control personnel staffing company. Medical Facility Certification Auditor / Certified Medi-Cal DHS Auditor: Supervised audits and created detailed reports, including recommendations to improve quality. Gathered and assessed [Continued next page]

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MARY V. FRISCIA Page 3

[email protected] http://www.linkedin.com/in/maryfriscia

clinical data, identifying regulatory compliance gaps. Studied organizational objectives and surveyed staff to ensure goals were understood and individual efforts contributed to realization of objectives. Worked closely with management teams to interpret regulations and apply guidelines to practices. Key Accomplishments: Selected to salvage contract with important client, conducting audits and successfully bringing medical facilities up to standard with action plans that enabled successful survey outcomes. Leveraged extensive knowledge of local, state and federal regulations to accurately assess status and develop plans to achieve compliance. Received job offer from client due to outstanding performance during consulting engagement. ADDITIONAL POSITIONS Quality Assurance Compliance Auditor: PYRAMID BIOLOGICAL CORPORATION Medical Site Certification Auditor / Certified Medi-Cal DHS Auditor: CARE FIRST HEALTH PLAN – LA CARE Medical Administrative & Clinical Instructor - MA Program: UNITED EDUCATION INSTITUTE Client Services Manager / Servicing Skilled Nursing Facilities: WEST-VAL CARE PHARMACY Consultant / Medical Practice Management & Consulting Services: MED-PRO MANAGEMENT INC. Administrator / General & Forensic Neurology & Psychiatry: VALLEY PSYCHIATRIC CENTER GP Administrator / Internal Medicine / Family Practice / Mufti-Specialties: NORTHRIDGE INTERNAL MEDICINE MULTI-SPECIALTY MEDICAL GROUP Administrator / Internal Medicine / Multi-Specialties: VALLEY INTERNAL MEDICINE MULTI-SPECIALTY MEDICAL GROUP EDUCATION Ongoing: Bachelor of Science Degree in Nursing & Healthcare Administration The College Network – Regis University, Denver, Colorado – Distance Learning Program (Expected graduation: 2013) Vocational Nursing Program Los Angeles Valley College – Concorde Career Institute

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[email protected] http://www.linkedin.com/in/maryfriscia

School of Public Health – Management & Administration of Health Care Organizations University of Southern California Los Angeles - UCLA Master of Business Administration Mini Program University of Southern California – Graduate School of Business Administration - USC LICENSURE & CERTIFICATIONS Licensed Practical Nurse: State of Colorado Licensed Vocational Nurse: State of California IV & Blood Withdrawal Certified & CPR Certified Certified Professional Medical Auditor (CPMA Certified Professional in Healthcare Quality (CPHQ) - Course Completed PROFESSIONAL AFFILIATIONS & HONORS Elite American Health Professionals – 2011 Cambridge Who’s Who: Professional of the Year for Healthcare Regulatory Compliance - 2011 Cambridge Who’s Who: Professional of the Year for Healthcare Regulatory Compliance - 2010 CMSA – Case Management Society of America AAPC – American Academy of Professional Coders NAMAS – National Alliance of Medical Auditing Specialists Founder |Healthcare Quality Management & Regulatory Compliance Leaders. Highlands Ranch CO Former Occupational Specialist for Re-Accreditation, North - West Colleges - 4 Campuses REFERENCES Available upon request

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