We are pleased to announce the advancement of two internal candidates filling the roles of Program Directors. Congratulations to Christopher Mabile and CJ Porter.
Difficult Conversations About Director Performance
Every board must discuss difficult issues from time to time – and the right approach can have a positive impact on the outcome.
https://lnkd.in/gVgJb2Zp
Navigating HEDIS®: A Guide for Stars Leaders - Part 1 🌟
HEDIS® reporting is annually an extremely challenging task and always has a fundamental impact on a Health Plan’s Star ratings. Here's a closer look at the process and how Stars Leaders can play a pivotal role:
🔍 Data Capture & Accuracy: The HEDIS® team works year-round, with efforts peaking from January to June, to ensure all data is captured and accurately mapped. This meticulous process is fundamental to the integrity of HEDIS® reporting.
👍 Embracing Data Issues: Health care data is always a messy challenge. Uncovering data issues shouldn't be seen as a fault but a sign of diligence. It means the HEDIS® team is actively improving data completeness. For me, more issues shared out by the HEDIS® team - identified and resolved, the more confidence I have in their work. If you never hear of data problems from your HEDIS® team – I’d be worried.
🎯 Focus During Audit Season: HEDIS® staff must concentrate on outlier measures and those flagged by auditors. This is where Stars Leaders come in: you should question and delve deeper into the measures critical for Star ratings within the HEDIS® measure set – even if they ‘look’ good.
📊 Beyond Software Limits: Stars Leaders have the opportunity to extend the scrutiny given to outlier measures to star measures. By manually re-evaluating noncompliant members, outside of the HEDIS® software, for key measures like Diabetic Eye Exams, you can uncover missed compliant cases, ensuring no stone is left unturned.
💡 Collaborative Support: Recognizing the high demands on your HEDIS® team, especially during peak season, offering support rather than criticism is crucial. Your proactive involvement can lead to significant improvements in STAR measures.
This is just the beginning of understanding HEDIS® reporting and STAR ratings. Stay tuned for more insights, as we continue to explore how Stars Leaders can effectively navigate this landscape.
#HEDIS#STARratings#HealthcareLeadership#DataQuality#Teamwork
It’s nomination time! Nominations for the 13th annual BLOOM (formerly INTOUCH) awards are now open!
The Excellence Awards were created in 2011 by BLOOM (formerly INTOUCH) as a platform on which to recognize the best-of-the-best performance of professionals working within the workers’ compensation industry.
The Excellence Awards are open to anyone working within the workers’ compensation industry. This includes insurance companies, third-party administrators, agents, brokers, attorneys, consultants, employers, physicians, claims specialists, vendors, etc.
The categories for the 13th annual BLOOM (formerly INTOUCH) Excellence Awards are listed below (at the link). Please select the category that best matches your nomination, some categories are ONLY referring to a company or an individual.
If you have any questions about what category your nominee belongs to, please email samantha@ommktg.com.
JOIN BLOOM TO NOMINATE: https://lnkd.in/ev7g8Z2x
All submissions must be received by 11:59 p.m. ET on September 1st, 2024. There is no cap on the number of submissions per person. If you have more than one person you would like to nominate. Please fill out another form.
Good luck to everyone! :)
#bloom#justbloom#formerlyintouch#inspiredbypurpose#poweredbypeople#thrive#grow#justbloomcollective#onlinecommunity#timetobloom#workerscompensation#workcomp#onlyworkcompcommunity#community#wearebloom#bloomawards#13thbloomawards
🍲 Reposting with a Dash of Flavor and Insight
Hey everyone! I stumbled upon a gem of a post from Dwight Pattinson about making healthcare better, and it got me thinking in the kitchen—where I do a lot of my best thinking. Here’s the scoop, served up easy like Sunday morning pancakes:
🎯 Main Ingredient: Focus During Audit Season. Dwight says it’s like when you’re cooking a big meal for a crowd. You gotta keep an eye on the dishes that need the most attention—those are your outlier measures and flagged by auditors in the healthcare world. It’s like making sure your soufflé doesn’t fall while you’re also grilling the perfect steak.
And here’s where the seasoning comes in. As Stars Leaders, we’re the chefs tasting and adjusting, making sure every dish (or healthcare measure) is just right, especially the ones that make our meal a Michelin-star experience (or in real life, boost those Star ratings).
🔍 Mixing in My Ingredients: Being in the kitchen has taught me a lot about preparing for big moments, just like audit season. Here are some tools I keep in my apron for keeping the kitchen running smoothly, which I think of as programs for data collectors, providers, tech tools, and helpful partners:
• Providers are like sous chefs, crucial for prepping everything just right.
• Technologies and EHRs are our high-end kitchen gadgets, making tasks easier and more efficient.
• Vendors are like the food suppliers, giving us the quality ingredients we need.
By using these tools wisely, we can avoid a messy kitchen (or end-of-year chart chasing) and instead have a well-oiled machine ready to serve up excellence.
From one data nerd to another, it’s all about preparing your kitchen for success, so when the dinner rush comes, you’re ready to serve up quality care without breaking a sweat.
Big shoutout to Dwight for sparking this idea. Let’s keep sharing these recipes for success!
#Healthcare#HEDIS#AuditSeason#SimplifyingComplexity#DataNerd 🍳
Elevating Healthcare Excellence: Quality, HEDIS, and STAR Ratings Expert
Navigating HEDIS®: A Guide for Stars Leaders - Part 1 🌟
HEDIS® reporting is annually an extremely challenging task and always has a fundamental impact on a Health Plan’s Star ratings. Here's a closer look at the process and how Stars Leaders can play a pivotal role:
🔍 Data Capture & Accuracy: The HEDIS® team works year-round, with efforts peaking from January to June, to ensure all data is captured and accurately mapped. This meticulous process is fundamental to the integrity of HEDIS® reporting.
👍 Embracing Data Issues: Health care data is always a messy challenge. Uncovering data issues shouldn't be seen as a fault but a sign of diligence. It means the HEDIS® team is actively improving data completeness. For me, more issues shared out by the HEDIS® team - identified and resolved, the more confidence I have in their work. If you never hear of data problems from your HEDIS® team – I’d be worried.
🎯 Focus During Audit Season: HEDIS® staff must concentrate on outlier measures and those flagged by auditors. This is where Stars Leaders come in: you should question and delve deeper into the measures critical for Star ratings within the HEDIS® measure set – even if they ‘look’ good.
📊 Beyond Software Limits: Stars Leaders have the opportunity to extend the scrutiny given to outlier measures to star measures. By manually re-evaluating noncompliant members, outside of the HEDIS® software, for key measures like Diabetic Eye Exams, you can uncover missed compliant cases, ensuring no stone is left unturned.
💡 Collaborative Support: Recognizing the high demands on your HEDIS® team, especially during peak season, offering support rather than criticism is crucial. Your proactive involvement can lead to significant improvements in STAR measures.
This is just the beginning of understanding HEDIS® reporting and STAR ratings. Stay tuned for more insights, as we continue to explore how Stars Leaders can effectively navigate this landscape.
#HEDIS#STARratings#HealthcareLeadership#DataQuality#Teamwork
This upcoming Saturday, December 16, will be my 10-year anniversary on the agency/broker & sales consulting side.
Ten years ago like it happened yesterday. I vividly recall early conversations with several consultants around what the secrets were to a successful career in sales consulting. A few milestones since:
- Tied the knot! Nicole ❤️
- First of two agency acquisitions, AFG/Ahmann Martin, forming ABRC. Joined Children's Defense Fund's Advisory Board (2015)
- Blessed with two healthy boys (2015 & 2018)
- Multi-year Leaders Club & President's Club Award Winner (2016-2019) 📈
- Survived a global #pandemic. Second of two agency acquisitions, USI Insurance Services (2020)
- Chubb Rising Stars Nominee; took 2nd place nationwide only to Lockton with $2.23M GWP (2021)
- Promoted to Vice President. Named to USI's National Diversity & Inclusion Council. Joined Minnesota Homeownership Center's Board of Directors (2022)
- Completed CPCU Designation through The Institutes CPCU Society (2023) ✔
I learned to fall in love with the process; that the joys of sales consulting begin by engaging with high-quality clients. Equally critical entails partnering with dedicated teammates to provide client-service excellence. And by consistently recognizing the imperative to continually evolve consulting beyond its conventional norms, risk management consulting cements its position as a crucial and valuable asset to prospects & clients.
These, exercised by balancing the depths of loss and gain bring it home, mostly.
But the key element has been, and always will be, losing one's self in the service of others -- with its vital application across contexts. For me, this means learning NEW ways of:
- Being a loving partner
- Raising mentally aware, emotionally equipped, and justice-driven children
- Fostering the right relationships
- Enhancing one's faith ☪
- Transforming as a thought leader
If we pay close enough attention, we are all contributing to this complex system, which offers unlimited opportunities for meaningful discovery beyond individualized success.
I'm profoundly fortunate for everything these last 10 years. A heartfelt acknowledgement to those who make these moments possible; you know who you are.
Here's to another #decade in the world's greatest industry.
#free#gratitude#agency#zen#anniversary#global#resilience#broker#insurance#riskmanagement#CPCU#USIOneAdvantage
🚀 Heading to the USAA San Antonio Mothership for an Epic Adventure! 🌟
Hey LinkedIn Community! 🌐
Get ready to board the excitement express as I’m off to San Antonio for the USAA Inaugural PI Planning Event with our newly minted PnC Sales and Service IP Enablement Team! 🎉 This isn’t just a trip; it’s a leap into the future of business process innovation. 💡
What’s cooking, you ask? 🍳
We’re shaking things up in the world of sales and service experiences at P&C. It’s not just about processes; it’s about revolutionizing them! Imagine crafting solutions that aren’t just smart, but are super intuitive and member-centric. We’re talking high-tech meets high-touch - a blend that’s as exciting as your favorite sci-fi meets reality show! 🌐💡
My role as a Business Process Owner? It’s like being the architect of an exciting new world where every process is a masterpiece tailored for efficiency and effectiveness. 🌍🛠️ I’ll be collaborating with fellow Business Process Owners to whip up some groundbreaking strategies. From process discovery to implementing change that matters, we’re on a mission to empower our insurance professionals with the tools and training that make them Agents of the Future. 🚀💼
Key takeaways:
• 🌟 Reinventing Sales & Service: No more old-school methods. We’re talking digital, dynamic, and downright awesome!
• 🛠️ Tools & Training: Equipping our team with the latest and greatest to deliver stellar member experiences.
• 🤝 Collaboration & Innovation: Working hand-in-hand with underwriting and product management maestros to create solutions that dazzle.
• 📈 Risk Management: Keeping it all smooth and secure, because that’s how we roll.
Stay tuned for more updates from San Antonio as we embark on this thrilling journey! Don’t forget, in the world of PnC Sales and Service, it’s all about delivering experiences that are not just great, but legendary! 🌟
#InnovationInAction#BusinessProcessGuru#SalesServiceRevolution#PandCTeam#SanAntonioAdventure#MemberExperienceMatters#USAA#USAAwesome#USAAEmployee#UnitedServicesAutomobileAssociation#Leadership#Culture#MilitaryCulture#FinancialServices#VeteranSupport#ProjectManagement#IPEnablement#DanielRuizIsasi
Let’s blaze some new trails together! 🌟🚀
President, Qlarant Integrity Solutions
1moMoving forward!