Medicaid, Commercial, Medicare and Market Place Exchange Training and Education for Staff
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About The CEO
Jamie McPherson, Ph.D. Candidate,
Hello, my name is Jamie! I am often referred to as the Caring CEO because I genuinely care. I want to welcome you to the QPH 5.0 experience! I promise you will learn to enjoy quality while improving outcomes! Thank you in advance for considering QPH 5.0 as a partner. My core mission and vision, as an individual and on behalf of my company, are deep-rooted in “Serving Others.” I inherently believe "serving others" is my assignment in this life. My goal is to further the quality of life and care of all who need healthcare services through my company and while sharing my personal time in communities in need of services, especially the underserved communities. I, along with a team of Subject Matter Experts, truly understand healthcare operations.I am a dedicated Quality Executive and Six Sigma Black Belt professional with over 30 years of experience in managed healthcare systems, including integrated systems, and primarily in the Quality and Population Health Departments. I began my career as a member service representative, progressively given greater responsibility as my skill set expanded and evolved. Therefore, I understand how each business unit in a managed care organization works and how one team complements the next. I have held leadership positions at Anthem, Aetna, Optima, Virginia Premier, and the State of Virginia. At the Virginia Department of Health, I served as Supervisor/Program Manager, overseeing Quality Compliance for every managed care and peer review organization operating in the State of Virginia.
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Quality has its “own” language and utilizes many acronyms, which the CEO understands from personal experience. She has directed Quality Departments and programs that resulted in a local health plan receiving Excellent Accreditation for five consecutive years and ranking in the Top 25 Medicaid Managed Care Health Plans nationally. A regional plan ranking in the Top 25 nationally is no easy task! So she understands how to optimize State resources, health plan associates, State Pay for Performance, and CMS Star financials by achieving and, more crucially, “sustaining” member compliance, satisfaction, and overall quality of care.
Allow QIPH-iCare, LLC. to partner with you! We will succinctly demonstrate how to leverage the Annual Member Report Card tool, which genuinely works and eliminates waste when enhancing your company’s member outcomes, quality of care, and clinical measure outcomes, including HEDIS outcomes. You do not need to hire additional staff to administer the Annual Member Report Card because it is that efficient! A significant perk is that the Annual Member Report Card can be scaled to all products and/or lines of business (Medicaid, Medicare, Commercial, Exchange). It can also be scaled to accommodate both low-tech and high-tech quality teams. It is simple to adopt and has a major impact on your rates!
The CEO And Her Expert Team Of Quality Masters Have The Following Years Of Experience:
- “Efficiently” Closing Healthcare Gaps – 20+ years of experience
- Extraction of medical records – 20+ years of experience
- Quality Operations of Information Systems – 20+ years of experience
- Enhancing your HEDIS™ reporting procedure – 20+ years of experience
- Trilogy Document Preparation using Six Sigma with 100% on NCQA Audits
- Best Method to Focus on State, CMS, and NCQA Measures Concurrently
- Initiatives for Quality Improvement – 20+ years of experience
- NCQA Accreditation – 20+ years of experience
- Quality Department Structure – 20+ years of experience
- Quality Department Project management of internal audits – 20+ years of experience
QPH5.0 Healthcare Consulting Group, LLC is a Company Focused on:
- Improving Member Health Status
- Increasing Member Gap Closure Rates and Satisfaction based on science (i.e., Proven Motivation Theories such as the Economics Motivation Theory and Maslow’s Hierarchy of Needs Motivation Theory)
- Closing Member Gaps by 4th Quarterly Annually
- Decreasing Member Abrasion
Who Would Benefit:
- Quality Department Leaders at any of the organizations below:
- Managed Care Organizations & Leaders
- Accountable Care Organizations & Leaders
- Provider Owned Organizations & Leaders
- Patient-Centered Medical Home & Leaders
- Provider Offices & Leaders
Services:
- Consultative Services
- Leasing the Annual Member Report Card©
Quality is Everyone’s Responsibility William Edward Deeming
- So, how “exactly” does each department in the organization contribute? Every function we coordinate and manage in the Quality Department impacts all departments within the Company. Therefore, every department plays a role in the accreditation and regulatory audit processes, the HEDIS process, the Member Satisfaction (CAHPS) process, the Member Safety Processes, the Data Processes and Reports, and/or the Quality Project Management processes.
Medicaid, Commercial, Medicare and Market Place Exchange Training and Education for Staff
![A doctor and two women with a child.](https://bgz59a.p3cdn1.secureserver.net/wp-content/uploads/2023/06/image-2.png?time=1725718742)
Medicaid
![A doctor is checking the blood pressure of an older woman.](https://bgz59a.p3cdn1.secureserver.net/wp-content/uploads/2023/06/image-1-1024x682.png)
Medicare
![A doctor is examining the chest of a woman.](https://bgz59a.p3cdn1.secureserver.net/wp-content/uploads/2023/06/image-3.png?time=1725718742)
Commercial
![A woman sitting in front of a man holding a clipboard.](https://bgz59a.p3cdn1.secureserver.net/wp-content/uploads/2023/06/406993543_Edit.webp?time=1725718742)