QM Nurse - Healthcare Resume Search
QM Nurse - Healthcare Resume Search
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QM Nurse Resume


Desired Industry: Healthcare SpiderID: 71213
Desired Job Location: Los Angeles, California Date Posted: 1/9/2014
Type of Position: Full-Time Permanent Availability Date:
Desired Wage:
U.S. Work Authorization:
Job Level: Experienced with over 2 years experience Willing to Travel:
Highest Degree Attained: Willing to Relocate:


Objective:
Sherwyn Todd- Uyalor
3546 West Blvd., Los Angeles, CA 90016
Home Phone 323) 294-3134  Cell Phone 323) 396-1498
Okokwo@aol.com

MEDICAL RECORDS REVIEW

SKILLS


• HEDIS/Core Measures
• NCQA/JCAHO
• Prior authorizations/ Case Management
• Peer Review
• Revenue Defense
• Workmen’s comp
• Oversight delegation audits
• Grievances and appeals


EXPERIENCE

Peer Review Coordinator
Cedars Sinai Medical Center (Contracted) 2011-2012
• Managed Care Resources
• Case review and abstraction preparation for physician peer review

Quality Management Coordinator
Valley Community Clinic (Granted position) 2010-2011

• QM reports
• Audit prep
• Vaccine management
• Nursing education


Coordinator/Manager Performance Improvement
Centinela Hospital Medical Center 2008-2010

• Core Measures abstraction
• CCORP abstraction
• JCAHO prep
• Employee Satisfaction surveys
• Hospital Wide Periodic Perform Reviews


Quality/Risk Management Coordinator
Hollywood Community Hospital
VN Hollywood Community Hospital 2007 – 2008
• Responsible for Joint Commission preparation

• Peer Review
• Hospital wide QI Compliance
• Core Measures review
• Surgical risk indicator review
• Recredentialing
• Mortality review
• Op and invasive review
• sentinel events
• Dashboard
• PI reports

• Occurrence report review, logging and statistics
Facility Administrator (SB 739)
National Healthcare Safety Network
• Contract evaluations
• Recalls coordination
• PPR facilitator







Quality Management Coordinator (Full Time/ Part Time)
Good Samaritan Hospital 2005-2008
• Responsible for peer review
• Medical staff committee meeting data submission and presentation
• Special studies
• Core measures reviews
• Sentinel Event and Risk Management meeting facilitator. Full time - Per Diem position

Quality Analyst
Suburban Medical Center Promise Hospital of East LA 2005-2007
• Responsible for op and invasive chart review, blood utilization review, case summaries peer review preparation.

Audit Manager, Revenue Defense
UCLA Medical Center/ IntegraSolutions (Contractual) 2004-2005
• Responsible for revenue defense audit management, reviewed in excess of
• One million in revenue monthly.
• Negotiated settlements with contracted health plans, maintaining less than 5% revenue loss per quarter.
• Supervised staff of two, prepared departmental policies.

Manager, Quality Improvement
Garfield Medical Center 2002-2004
• Responsible for medical record review, peer review coordination, hospital quality management/improvement activities.
• Facilitator for Improving Organizational Performance Committee, JCAHO compliance.
• Prepared reports for various medical staff committee meetings, special studies.
• Case management, utilization management and discharge planning activities as indicated.

Previously employed with Network Medical Management as Manager/Quality Management/Health Education (3/2000-3/2002); Santa Monica Bay Physicians Health as Quality Improvement Coordinator (4/1999-2/2000); Harriman Jones Management as Quality Management Coordinator (4/1998-3/1999); BPS HealthCare/HMO as Quality Management Specialist (10/1997-4/1998); Cedars Sinai Health System/Medical Group of Beverly Hills as Quality Management Coordinator (2/1996-10/1997); Managed Care Resources as Nurse Independent Contractor (9/1995-3/1996); California Medical Review as Review Coordinator (9/1990-1/1995).

EDUCATION

Indiana State University
BS Nursing candidate, 2012 - Present

Paramedical Occupational Center
LVN, 1982

East LA College
EMT, 1981

Pepperdine University, Malibu
Bachelor’s Degree, Natural Science


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