Vice President of Medical Management; Louisiana Healthcare Connections @ Centene Corporation
Vice President, Clinical Development @ Amedisys
Demonstrated, professional achiever with knowledge of clinical programs, healthcare and business operations, quality improvement processes, risk management, and insurance. Skilled at learning new concepts very quickly, working well under pressure, as well as organizing and communicating ideas clearly and effectively. Excellent computer skills, including knowledge of most major software programs. Enthusiastic leader and professional supervisor, and able
Demonstrated, professional achiever with knowledge of clinical programs, healthcare and business operations, quality improvement processes, risk management, and insurance. Skilled at learning new concepts very quickly, working well under pressure, as well as organizing and communicating ideas clearly and effectively. Excellent computer skills, including knowledge of most major software programs. Enthusiastic leader and professional supervisor, and able to organize time and energy well among several duties. Outgoing personality and ability to enthusiastically and professionally represent an organization in the community.
Chief Operating Officer, Louisiana Healthcare Connections @ From June 2014 to Present (1 year 7 months) Baton Rouge, LouisianaVice President of Medical Management; Louisiana Healthcare Connections @ Responsible for oversight and management of the Medical Management Department of a Louisiana BAYOU HEALTH Medicaid Managed Care Organization. Oversee medical operations and function for Case Management, Utilization Management, Quality (including grievances and appeals, NCQA Accreditatiaon, Medical Home Program, HEDIS & EPSDT management), Pharmacy, and Member Connections field representatives. Staffing includes over 120 employees, and member volume ranges from 150,000-170,000. In addition to day to day management of the clinical operations of the plan, serve as a member of the plan Executive Team and most plan level Medical Management, Pharmacy and Quality Committees, Corporate Policy Committee, as well as the clinical liaison for Centene Corporate involvement. From December 2011 to June 2014 (2 years 7 months) Baton Rouge, LABoard Member @ Baton Rouge Youth Coalition strives to inspire and challenge hardworking teens to dream of and build bold futures, by providing holistic leadership, college, and support services From February 2013 to March 2014 (1 year 2 months) Baton Rouge, LABoard Member @ Health Centers in Schools makes sure kids are well so they can learn well. As a nonprofit, we provide free health services in collaboration with East Baton Rouge public schools. Our primary care doctors, nurses and counselors are on the spot with immunizations, screenings, mental health services and emergency care children need. Under performing kids get special attention, as so kids with special needs.
In East Baton Rouge Parish public schools, Health Centers in Schools provides on-site medical and mental health services with health centers on 11 school campuses. The HCS health center is like a pediatrician’s office, where medical doctors and nurse practitioners provide more extensive medical care. Social workers at the centers also provide behavior counseling and other mental health services. HCS also manages the traditional school nurse program at schools without health centers.
Most private schools do not have capability for medical care due to high costs. So, many of these children attend public schools where law requires that the school systems care for them. From December 2010 to December 2011 (1 year 1 month) Vice President, Clinical Development @ Responsible for oversight and management of the Chronic Care Management Department that provides corporate support to over 500 home health and hospice locations across the country. This includes telemedicine and telehealth initiatives, advanced chronic care management programs, development and execution of disease-specific programs, behavioral health initiatives, advanced wound care programs, nurse and customer service call center, and clinical research initiatives. Also responsible for hospital and payor partnership clinical programs and initiatives as part of Corporate Development. Serve as subject matter expert and tester for clinical IT development projects, assist in due diligence evaluation, participate in vendor evaluation and selection, and manage department budget. Member of Information Technology Executive Committee, Policy and Procedure Committee, Chronic Care Management Taskforce, IT Project Steering Committee, and several others. From July 2009 to December 2011 (2 years 6 months) Vice President, Risk Mangement & Education @ Managed all risk management and insurance lines and functions for corporate office and 250+ locations in 18 states. Facilities included home health, hospice, outpatient therapy clinics, inpatient LTAC and Rehabilitation hospitals, private duty, and pharmacy. Specialty insurance line management included policies and programs related to the corporate aircraft, a public gym, and a gun and rod club. Functioned as liaison between all insurance carriers, TPAs, legal counsel, and the company. In addition to clinical risk issues, managed Infection Control, Employee Health, Fleet Program, OSHA, Department of Labor, employee injury, and Worker’s Compensation program. Conducted on site clinical and environmental risk assessments and educational programs for the facilities as needed. Reviewed surveys from regulatory agencies and worked with the agencies to formulate corrective action plans and implement preventative measures as needed. Worked directly with Directors and Managers of each division to ensure risk management systems were utilized effectively. Lead Corporate Risk Management and Safety meetings as well as divisional sub-committee meetings and the internal Nursing and Therapy Peer Review Programs. Implemented online event reporting system in 2007. Over all education functions for the 250+ locations as well, including maintenance of legacy LMS (learning management system) and creation of new LMS that went live in July 2008. Responsible for management of some, and review and approval of all educational materials before release for employee viewing. Lead Corporate Education Committee. From October 2006 to July 2009 (2 years 10 months) Chief Nursing Officer @ CNO over general acute care hospital. Manage all Nursing Units (Medical/Surgical, ICU, ER, Surgery, Outpatient, Labor & Delivery, and Anesthesia) as well as Cardiopulmonary, Infection Control/Employee Health, Education, Core Measures, Quality, Risk Management, and Utilization. JCAHO accredited facility. Worked with Human Resources and Marketing for Nursing recruitment on retention programs. Responsible for Nursing Department budget and participated in facility capital budgeting process. Worked directly with the Board of Directors and participated in Board meetings each month. Represented hospital and Nursing department in the community. From January 2006 to October 2006 (10 months) Director of Risk Management @ Created position and systems and processes to oversee risk management functions in 90+ locations. Facilities included home health, hospice, outpatient therapy clinics, inpatient LTAC and Rehabilitation hospitals, private duty, and a supplemental staffing agency. Functioned as liaison between all insurance carriers, TPAs, legal counsel, and the company. In addition to clinical risk issues, oversee OSHA, Department of Labor, employee injury, and Worker’s Compensation program management. Conducted on site clinical and environmental risk assessments and educational programs for the facilities as needed. Reviewed surveys from regulatory agencies and work with the agencies to formulate corrective action plans and implement preventative measures as needed. Worked directly with Directors and Managers of each division to ensure risk management systems are utilized effectively, and formally report to Senior Management on a quarterly basis. Lead Corporate Risk Management and Safety meetings as well as divisional sub-committee meetings and the internal Nursing and Therapy Peer Review Programs. Also involved in the Corporate Compliance Committee and Start-up Committee. From June 2004 to December 2005 (1 year 7 months) Healthcare Risk Consultant @ Worked directly with professional liability clients to assess, identify, and manage risk. Created individualized service plans and recommendations based on risk and quality assessments. Managed an account list of over 100 clients, including acute care hospitals, sub-acute care facilities, behavioral health facilities, surgery centers, long-term care facilities, and other miscellaneous facilities. Participated in internal educational publications for long-term care clients and staff, and was one of two nationwide long-term care resource specialists for AIG consultants. Worked directly with community-level staff all the way to the management staff of national accounts. Routine regional travel to over 7 states. From 2002 to 2004 (2 years) Vice President, Clinical Operations @ Healthcare Risk Management Consultant and then VP of operations for start-up long-term care consulting company. Worked directly with assisted living and skilled nursing clients across the nation. Conducted onsite visits to assess and identify risk and quality issues, prepared reports and recommendations for client as well as insurers and brokers. Assisted with set up and conducted risk management seminars across the country for clients and insurers. Assisted with creation of all policies and procedures for other nurses as well as hired and evaluated nursing staff. Published article in Assisted Living Today, March 2002.
Prior to these positions, was a Director of Nursing for Amelia Manor Nursing Home; Was ADON in long term care and worked in rehab, LTC, home health, and private duty as an RN, LPN, and CNA before this. From January 2000 to January 2002 (2 years 1 month) Director of Nursing @ Direct responsibility for nursing staff of more than 80 members, including hiring, evaluating, organizing and participating in training, management of schedules and budgeting for nursing department. Participated in management meetings, JCAHO FMEA studies, and root cause analyses when needed. From 2002 to 2002 (less than a year)
MBA, Business and Healthcare Administration @ University of Louisiana at Lafayette From 2005 to 2008 15 Graduate Hours, Educational Psychology @ Texas A&M University-Commerce From 2002 to 2004 BSN, Nursing @ University of Louisiana at Lafayette From 1995 to 1998 LPN, Nursing @ Louise Obici School of Nursing From 1994 to 1995 Kendra MBA is skilled in: Home Care, Healthcare, Nursing, Medicare, Hospitals, Disease Management, Management, Acute Care, Healthcare Management, Medicaid, Clinical Research, Managed Care, Inpatient, Insurance, Utilization Management