Responsible for the implementation of the Quality Improvement (QI) Program for Commercial, Exchange and Medicare lines of business. The QI Program includes HEDIS, CAHPS, and HOS reporting as well as maintaining NCQA accreditation and implementing a Value Based Pay for Performance program.

Responsible the implementation of the QI Program and Health Education for Medicaid and Cal-MediConnect (MMP) lines of business. The QI Program included HEDIS, CAHPS, and HOS reporting and implementing Pay for Performance and Health Education programs to support the timely delivery of preventive care to plan members. For specific focus areas, implemented Performance Improvement Projects aimed at improving care by focusing on areas such as hypertension control, annual diabetic retinal eye exams, timely pap smears, transition of care calls to reduce readmissions, and timely prenatal care. Presented all QI and Health Education activities to California Department of Health Care Services and Department of Managed Health Care during onsite audits

Responsible the implementation of the Quality Improvement Program and Health Education for Medicaid, Medicare and Cal-MediConnect (MMP) lines of business. The QI Program included HEDIS, Facility Site Review, Pay for Performance, Health Education and Cultural and Linguistic Competency /Language Assistance Program. Presented all QI and Health Education activities to California Department of Health Care Services and Department of Managed Health Care during onsite audits

Responsible the implementation of the Quality Improvement Program for the Medicaid line of business. The QI Program included HEDIS and CAHPS reporting, Facility Site Review, and developing and rolling out a Pay for Performance Program. For specific focus areas Quality Improvement Projects were developed to reduce avoidable emergency room visits, reduce readmission, increase well care visits in adolescents, and increase timely post-partum care. Presented all QI activities to California Department of Health Care Services and Department of Managed Health Care during onsite audits.

Responsible the implementation of the Quality Improvement Program for the Medicaid and Medicare lines of business. The QI Program included HEDIS reporting and implementing Health Education and Pay for Performance programs. For specific focus areas, Quality Improvement Projects were developed to increase preventive services such as timely mammograms and annual well child visits for three to six year old children.

Responsible for post hoc analysis, using SAS, of HEDIS and CAHPS data, and presenting findings and recommendations to senior leadership.

Responsible for Quality Improvement Projects aimed at controlling congestive heart failure and diabetes. Also responsible for HEDIS reporting tasks of performing quality assurance on SAS code used in HEDIS report and medical records, as well as annual training to facility QI departments on latest technical specifications.