Donisha Franklin
@donishafranklin
Healthcare data and care management leader driving process improvement and compliance.
United StatesWhat I'm looking for
I am a results-driven healthcare professional with extensive experience in care management, data integrity, and business analysis across Medicaid and Medicare environments. I have led teams, supervised program coordinators, and supported enterprise projects using SQL, Teradata, EMPI systems, and Excel pivot tables.
My background includes supervising remote teams, performing audits and documentation review, resolving EMPI and duplicate record issues, and supporting user acceptance testing and implementation of new systems. I have served as a content expert and preceptor, contributed to quarterly state audits, and supported provider and member-facing processes to maintain PHI integrity and regulatory compliance.
I seek to bring analytical rigor, operational leadership, and a focus on quality to a remote, third-shift role where I can continue improving processes, mentor staff, and support successful system implementations that benefit members and stakeholders.
Experience
Work history, roles, and key accomplishments
Business Analyst I
Sunflower Health Plan
Mar 2023 - Dec 2025 (2 years 9 months)
Supported business initiatives through data analysis, user acceptance testing, and process improvements, using SQL and Teradata to inform implementation recommendations and documentation review.
Afterhours Supervisor
Saint Francis Ministries
May 2022 - Apr 2023 (11 months)
Managed afterhours staff and field teams, oversaw scheduling and placements, resolved staff conflicts, and reported incidents to risk management to maintain program quality and client safety.
Supervisor, Care Management
Sunflower Health Plan
Sep 2021 - Mar 2023 (1 year 6 months)
Supervised a team of 23 Program Coordinators, led scheduling, coaching, QA audits and onboarding, and ensured PHI integrity and regulatory compliance for Medicaid/Medicare care management.
Afterhours Placement Coordinator
Saint Francis Ministries
Feb 2018 - May 2022 (4 years 3 months)
Located emergency and planned out-of-home placements, managed referrals and documentation in CMS/CareMatch/SharePoint, and maintained provider and foster parent relationships to ensure timely placements.
EMPI Data Integrity Specialist
HCA Healthcare
Sep 2021 - Apr 2022 (7 months)
Remediated duplicate patient records and maintained EMPI integrity across MEDITECH, OnBase and enterprise systems, executing merge/link decisions and meeting productivity and quality standards.
Program Coordinator II Team Lead
Sunflower Health Plan
Jul 2020 - Sep 2021 (1 year 2 months)
Led 16 Program Coordinators, conducted trainings and audits, managed scheduling and HCBS authorizations, and completed quarterly state audits and TruCare testing support for Medicaid/Medicare programs.
Program Coordinator II
Sunflower Health Plan
Jan 2016 - Jul 2020 (4 years 6 months)
Managed member outreach, eligibility screening, authorizations and documentation, supported providers, and performed HEDIS-related tasks and weekly meeting minutes for Medicaid programs.
Program Coordinator I
Sunflower Health Plan
Dec 2013 - Dec 2015 (2 years)
Handled authorizations, home modification coordination, claims research, PHI maintenance, HEDIS measures and administrative office support for Medicaid members.
Data Integrity Analyst
Via Christi Health
Jun 2013 - Jan 2015 (1 year 7 months)
Monitored and resolved duplicate MRNs across Quadramed Smart I/X and other clinical systems, linking patient records to support one MRN/one EMPI and participating in quality reviews.
Education
Degrees, certifications, and relevant coursework
University of Arizona
Master of Healthcare Administration, Healthcare Administration
2025 -
Enrolled in a Master of Healthcare Administration program beginning October 2025.
University of Arizona
Bachelor's, Health Information Management
2023 - 2025
Completed a Bachelor's degree in Health Information Management from April 2023 to September 2025.
Ashworth University
Diploma, Billing and Coding
2020 - 2020
Completed a Billing and Coding diploma program from February 2020 to July 2020.
Kaplan University
Associate, Health Information Technology
2009 - 2013
Completed an Associate degree in Health Information Technology from August 2009 to March 2013.
Vernon's Cosmetology
Diploma, Cosmetology
1991 - 1992
Completed a cosmetology diploma program from September 1991 to June 1992.
Southeast High School
Diploma, General Studies
1988 - 1991
Graduated with a high school diploma in May 1991.
Availability
Location
United StatesAuthorized to work in
Job categories
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