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Kristen Presleigh

Senior Quality Improvement Specialist

Summary

Forward-thinking and results-focused Senior Quality Improvement Specialist with nearly a decade of experience and expertise in managing quality assurance programs such as HEDIS and Performance Improvement Projects (PIPs). Articulate communicator able to relay complex concepts to the team and train staff on innovative enhancements to internal systems. Highly proficient in analyzing performance metrics, identifying trends, and implementing advanced processes that allow team to meet objectives. Effective problem-solver with a sharp focus on quality outcomes.

Skills

  • Operations Management
  • Quality Improvement Programs
  • Team Leadership
  • Written & Oral Communication
  • NCQA HEDIS Performance
  • Data Analysis & Reporting
  • External Partnerships
  • Collaboration & Strategic Planning
  • Qualitative Research
  • Performance Assessments
  • Healthcare Systems
  • Advanced Microsoft Excel

Work experience

Apr. 2018Present

Senior Quality Measurement Specialist

CenCal Health, Quality Measurement & Improvement Department
  • Oversee planning for the Performance Improvement Project (PIP) that would focus on behavioral health systems. Formulate a Children’s Health and Disability Prevention Program surveillance. Analyze outcomes to identify what areas still need revitalization and communicate strategic plans with cross-functional team members. Direct activities of vendors in relation to quality assurance initiatives and provide insight on desired results. Prepare for transition into a new customer service design.

    Additional Key Contributions:

    • Mobilize new team members and equip them with the tools needed to thrive and support new programs.
    • Conceptualize, develop, and launch new quality improvement initiatives and pilot testing phases.
Sept. 2016Apr. 2018

Supervisor, Quality Improvement & Population Health

CenCal Health, Quality Measurement & Improvement Department

Thoroughly reviewed established work plans and new quality initiatives descriptions for several departments to present to the internal Quality Committee. Displayed top public speaking and communication skills to articulate details and secure approvals. Organized department readiness testing and for health plan system conversion. Prepare the department for audits and reviews by ensuring that all documentation is accounted for.

Additional Key Contributions:

  • Seated as an advisor on the Integrated Healthcare Associate Standardizing Med-Cal P4P Advisory Committee.
  • Extended insight on strategies as a quality subject matter expert of the Delegation Oversight and Healthcare Operations committees.
  • Integral in the development, measurements, frameworks, and design of the Provider Incentive Program.
  • Revitalized and managed the department Quest Orientation training of new employees.
Jul 2015Sep 2016

Senior Quality Measurement Specialist

CenCal Health, Decision Support Department

Oversaw reporting, documentation, planning, and collaboration for multiple internal programs including the RFP for CenCal Health’s NCQA Certified HEDIS Software vendor, the NCQA HEDIS audit, and the PCP incentive RFP vendor selection. Demonstrated expertise in acquiring the needed medical records and information to effectively converse with providers and obtain cooperation with new projects and processes that will improve workflow.

Additional Key Contributions:

  • Recognized as the top HEDIS medical record abstracter for nearly 2,500 records with 100% accuracy.
  • Developed and distributed informative and comprehensive newsletter, articles, memos, quality documents and reports for company’s provider network.
Jan 2014Jun 2015

Quality Measurement Specialist

CenCal Health, Decision Support Department

Worked with colleagues to measure quality and accuracy of 9,000+ medical records and reviewed staff performances as part of the NCQA HEDIS auditing process. Checked accuracy of entered data when it related to rater reliability. Familiar with multiple EHR systems. Maintained open communication with partnering providers to ensure positive working relationships and provided them with newly refined Provider Performance Reports.

Additional Key Contributions:

  • Presented written memos and oral presentations to internal committees regarding updates and annual review statistics related to HEDIS performance.
  • Cultivated an understanding among staff on implementing new procedures with accuracy for positive results.
  • Answered any questions and offered insight into strategic plans for upcoming projects and adjustments.
Jun 2013Sep 2013

Research Assistant

UTHealth School of Biomedical Informatics, Health Informatics Department

Hired by School of Biomedical Informatics (SBMI) for increased hours on the original research project from UTHealth Medical School.

  • Observational data collection, coding, and analysis of Attending, Nurse, and Resident workflow, task transitions and health information use during Emergency Department trauma shifts.
  • Collaborated with students, faculty, and staff between the School of Biomedical Informatics (SBMI), Medical School at UTHealth, Memorial Hermann-Texas Medical Center Hospital (MH-TMC) and Lyndon B. Johnson General Hospital.
  • Presented "Qualitative Research Methods: Opportunistic Decision Making" at UTHealth School of Nursing with Vickie Nguyen, M.S. in June 2013.
May 2012Sep 2012

Graduate Research Assistant

UT MD Anderson Cancer Center, Center for Health Equity and Evaluation Research (CHEER)

Master's Degree Practicum, assisting Primary Investigator with focus groups and survey data study to identify patient characteristics associated with provider trust in connection to Emergency Room use. Research collaboration between CHEER and the Memorial Hermann Healthcare System.

  • Recruited self-pay, uninsured and Medicaid survey participants assigned to Patient Navigators.
  • Performed data entry on all recruited surveys and collaborated on qualitative analysis on focus group questionnaire and transcripts. 

Education

Organizations

Member, National Alliance of Mental Illness (NAMI) (2016 – Present)

Member and Secretary, NAMI Public Policy Committee (2016 – Present)

Member, American Public Health Association (Active)

Publications and Academic Posters

Kristen Presleigh, MPH, Vickie Nguyen, MS, Nnaemeka Okafor, MD, MS, Amit Mehta, MD, Jiajie Zhang, PhD, and Amy Franklin, PhD. Task Transition Decision Making During Downtime: Impact of EHR systems on Performance. Poster presented at the Workshop on Interactive Systems in Healthcare (WISH) on November 16, 2013 in Washington, DC. 

Kimberly Enard, Stephen Duckett, Kristen Presleigh, Lovell Jones. Among vulnerable populations, high trust in emergency department physicians associated with higher primary care-related ED use. Poster presented at the 2013 American Public Health Association 114th Annual Meeting and Expo, Boston, MA. 

Seronello S, Montanez J, Presleigh K, Barlow M, Medina M, Choi J (2011). Ethanol and Reactive Species Increase the Sequence Heterogeneity of Hepatitis C Virus RNA and Positive Selection Contributing to Antiviral Resistance.   PLoS ONE 6(11).

Seronello S, Presleigh K, Barlow M, Choi J (2010). Ethanol and both Endogenous and Exogenous Reactive Species Accelerate the Mutation Rate of Hepatitis C Virus RNA. FASEB J. URL: http://www.fasebj.org/cgi/content/meeting_abstract/24/1_MeetingAbstract/lb 74

Presentations

  • Presented Diabetic Retinal Eye Exam Performance Improvement Project to Quarterly DHCS Medical Directors Meeting in 2017.
  • Presented "Qualitative Research Methods: Opportunistic Decision Making" at UTHealth School of Nursing with Vickie Nguyen, M.S. in 2013.
  • Presented “Functional genome annotation of replication, recombination and repair and inorganic ion transport and metabolism (274 gene models) of Sporobolomyces roseus” at the Joint Genome Institute in Walnut Creek, CA with Emily Wilson in 2008.