Priscilla Martinez
@priscillamartinez
Dynamic healthcare professional with expertise in quality management.
United StatesWhat I'm looking for
I am a dynamic healthcare professional with over 10 years of experience leading quality initiatives across various Medicare programs, including MSSP, ACO REACH, and Medicare Advantage. My expertise lies in aligning clinical operations with CMS regulations, optimizing EMR systems, and driving measurable improvements in STAR, HEDIS, and MIPS performance. I thrive in cross-functional collaboration, provider education, and utilizing QRDA1 and eCQM data for gap closure and compliance improvement.
In my current role as a Quality Care Coordinator at On Belay Health Solutions, I lead quality improvement efforts across 35 ACO clinics, educating providers on CMS measures and optimizing documentation practices. My previous experience as a Care Coordinator at Valora Medical Group allowed me to design and implement workflows for STAR and HEDIS quality measures, significantly improving EMR documentation practices and reducing readmissions. I am passionate about enhancing patient care and ensuring compliance through effective quality management strategies.
Experience
Work history, roles, and key accomplishments
Quality Care Coordinator
On Belay Health Solutions
Dec 2023 - Present (1 year 5 months)
Led quality improvement efforts across 35 ACO clinics. Educated providers on CMS measures, optimized documentation practices, and used QRDA1 and eCQM data to close gaps in care and improve compliance by 15%.
Care Coordinator
Valora Medical Group
Dec 2022 - Dec 2023 (1 year)
Designed and implemented workflows for STAR and HEDIS quality measures. Improved EMR documentation practices and coordinated transitional care, leading to a reduction in readmissions and improved audit readiness.
Clinical Operations Manager
Redwood Family Health Center
Dec 2021 - Dec 2022 (1 year)
Managed clinical operations including staffing, workflow design, and budgeting. Led EMR optimization initiatives to improve documentation, billing accuracy, and patient outcomes.
Certified Medical Assistant
Redwood Family Health Center
Mar 2021 - Jun 2021 (3 months)
Provided direct patient care and contributed to quality initiatives through accurate charting and clinical data management. Supported patients in an FQHC setting, participating in preventive care and quality reporting aligned with HRSA and CMS guidelines.
Certified Medical Assistant
Community Health Center of Central Wyoming (CHCCW)
Jan 2020 - Dec 2020 (11 months)
Supported patients in an FQHC setting, participating in preventive care and quality reporting aligned with HRSA and CMS guidelines.
Education
Degrees, certifications, and relevant coursework
CCCasper College
Certified Clinical Medical Assistant (CCMA), Clinical Medical Assisting
Completed a comprehensive program to become a Certified Clinical Medical Assistant. Gained practical skills and theoretical knowledge essential for clinical support roles.
Tech stack
Software and tools used professionally
Availability
Location
United StatesAuthorized to work in
Job categories
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