Coach of the Quarter – Michelle Charping

Michelle Charping has been working as a Medical Review Supervisor for almost a year now. She excels at creating a comfortable and positive work environment while providing excellent support and guidance to her team. In the rare event that a team member makes a mistake, Michelle uses it as a teachable moment and treats the team member with respect. Her team has described her as one of the most positive and empowering supervisors they have ever had. Michelle ensures that everyone is informed of updates and changes, keeping everyone on the same page. We are proud to announce Michelle Charping as our Coach of the Quarter for her strong leadership and exceptional work ethic.

Team of the Quarter – Quality Assurance and Training and Medical Review III Team

The Home Health Review Choice Demonstration is aided by the Quality Assurance and Training and Medical Review III (MR IIIs)Team. They contribute educational materials and oversee the quality control of reviews. The MR IIIs also assist providers via the Provider Contact Center, addressing their review-related queries. The team works seamlessly and supports each other, as well as those they serve. Their efforts ensure that providers and medical reviewers have access to the best available resources, ultimately leading to improved care for home health beneficiaries. We thank them for their exceptional quality service. Congratulations to the Quality Assurance, Training, and Medical Review III Team for winning the Team of the Quarter award.

Team Members: Stephanie Cannady, Alicia Choice, Angela Gibson, Tiffani Heyl, Morgan Johnson, Kellie Kirby, Joni Mahon, Kerri Martin, Susan McAnnally, Rose Noce, Deborah Ratliff, Diane Rodgers, Daleisha Rowell, Rachel Rueff, Katie Rummel, Deanna Stevens, Laura Strutko, Emily Tidwell, Kasey Williams, and Carly Zelinsky

Process Improvement of the Quarter – Implementation of Outpatient Department Prior Authorization Training Manual

To review prior authorization submissions, the Outpatient Department (OPD) team uses various websites and resources, including the Centers for Medicare & Medicaid Services (CMS), Palmetto GBA website, Local Coverage Determinations (LCDs), and National Coverage Determinations (NCDs).
The OPD Prior Authorization Training Manual was created in March 2023 and published on QMS360 to provide a comprehensive resource to medical reviewers in one location. The manual aims to provide medical reviewers with the most up-to-date policies, information, and resources needed to excel in the review process and reduce errors. It also promotes consistency among reviewers and saves time by having one resource in one location. The training manual will improve customer service quality for both internal and external customers, benefiting providers by increasing the quality and consistency of the review process. Congratulations to the OPD team.

Team Members: Nicole Falbe, Kathi Lacy, Sarah Medeiros, Cassie Mills, Rachel Payne, and Lendi Watkins

Associate of the Month (January) - Kaitlyn Herrera

Kaitlyn Herrera, a Medical Reviewer II, showcased exceptional leadership on the Tally Sheet improvement project. She effectively communicated with team members, addressed questions, and utilized feedback to ensure the project was on track. Kaitlyn represented her team with responsibility and kept everyone informed and educated. Additionally, Kaitlyn serves as a positive influence on others and embodies the qualities of an Associate of the Month. Congratulations Kaitlyn!

Associate of the Month (February) - Sherry Gerald

Sherry Gerald is an outstanding member of her team as a Medical Reviewer II. She is genuine, kind, helpful, and accurate. Sherry never turns away anyone's queries and instead takes the time to research and provide the correct answer. Her team commends her for her selflessness and willingness to serve others, which reflects her desire to support the entire team and make everyone better. Congratulations, Sherry, on providing exceptional customer service and supporting the team.

Associate of the Month (March) - Deanna Stevens

Deanna Stevens, a Training and Quality Assurance Coordinator, is an outstanding leader and educator who is always available to answer questions and provide helpful feedback during training. Deanna's teaching style is unique, as she relates herself to her classes and includes real-world experiences in the curriculum, which has greatly contributed to the success of her students. One participant expressed their appreciation, stating that Deanna's approach has made a significant impact on her learning. Thank you, Deanna, for your commitment to quality and for being a valuable member of our team.