michelle martinez

director of quality improvement

About

Experienced Quality Improvement Manager with a demonstrated history of working in the hospital & health care industry. Skilled in Communication, Medicaid, Grievances, Customer Relationship Management (CRM), and People Management. Strong quality assurance professional with a Bachelor of Arts (B.A.) focused in Sociology from University of Oregon.

Country

united states

City

oak park

Industry

hospital & health care

Skill

healthcare, nursing, pediatrics, acute care, critical care, hospitals, patient safety, bls, jcaho, ambulatory care, disease management, infection control, medical education, nrp, registered nurses, home care, healthcare management, emr, cpr certified, nicu, hipaa, medication administration, medicaid, customer service, meditech, utilization review, utilization management, managed care, healthcare industry, pharmacy, quality improvement, microsoft office, policy, accreditation, management, medicare, microsoft excel, communication, employee management, workflow diagrams, cross functional team leadership, ncqa, urac, crm, organization skills, hedis, process improvement, project coordination, meeting facilitation, appeals, grievances, event planning

Experience

case manager ii

illinicare health

2014-11 - 2017-10 · 3 yrs

utilization review nurse

illinicare health

2019-7 - Present · 7 yrs 3 mos

registered nurse clinical manager

loving care agency, inc

2013-8 - 2014-9 · 1 yr 2 mos

registered nurse

mcallen medical center

1997-5 - 2004-8 · 7 yrs 4 mos

supervisor

illinicare health

2017-10 - 2019-7 · 1 yr 10 mos

registered nurse

rush university medical center

2004-8 - 2004-12 · 5 mos

rn-family birthplace

vanguard westlake hospital

2005-1 - 2013-8 · 8 yrs 8 mos

RN- Special Care Nursery and Mother/Baby Chair of the Process Improvement Committee

director of quality improvement

centene corporation

2016-7 - Present · 10 yrs 3 mos

Centene Corporation, a Fortune 500 company, is a diversified, multi-national healthcare enterprise that provides a portfolio of services to government sponsored healthcare programs, focusing on under-insured and uninsured individuals. Many receive benefits provided under Medicaid, including the State Children's Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and Long Term Care (LTC), in addition to other state-sponsored/hybrid programs, and Medicare (Special Needs Plans). The Company operates local health plans and offers a range of health insurance solutions. It also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health management, care management software, correctional healthcare services, dental benefits management, in-home health services, life and health management, managed vision, pharmacy benefits management, specialty pharmacy and telehealth services.

Education

lane community college

1994-1 - 1996-1 · 2 yrs 1 mo

Enrolled to get basic requirements out of the way and explore options for my major. In addition to basic math and English requirements, I studied criminal justice, psychology, sociology, and child development.