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Julie Mansfield

Julie Mansfield

Clinical Reviewer

Fidelis Care New York

Port Jefferson, NY

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Fidelis Care

QM Clinical Nurse Reviewer

Clinical nurse in the quality management department at this managed care health insurance company. Includes working closely with other plan departments to perform annual QARR/HEDIS. Other responsibilities in this position included provider relations in Nassau

Medassurant/Inovalon

Field Reviewer

HCC's, CRG's, Data Extraction & Medical Record Reviews.

Self Employed

LPN/Medicaid Provider

Private Medicaid Provider for pediatric patient in home care setting. Included performing all ADL's, G/T feeding and care, ROM, seizure precautions, administering medications and charting

Career medium 05
Career

Briarcliffe College

AAS, Criminal Justice

GPA 4.0 - Dean's List
Internship with Suffolk County Sheriff's Dept.
SIFE- Regional champions

Eastern Suffolk BOCES

LPN, Nursing

License current NYS

BOCES - Brookhaven

Certification in NYS, Nursing Assistant

Dulce Almanzar MD PC

QM Clinical Consultant

Quality management and clinical nurse in a private family practice. Responsibilities included but were certainly not limited to liaison between patient and physician, EMR configuration and training of all staff including clinicians and office managers. ACO reporting for Medicare and PQRS for Medicaid. Also reported in insurance portals for annual incentives and supplemental data throughout the year. Educated staff and providers regarding preventive health care measures and the quality of care and documentation that was required.

Career medium 06
Career

Outcomes/Altegra Health

LPN/Field Reviewer Specialist

Onsite chart reviews and audits as a third party to health insurance companies. Projects include HEDIS, CMS Risk Adjustment

Career medium 05
Career

Aetna

Quality Management Nurse Associate

Remotely review medical records to assess quality of care and documentation of services in a managed care setting. QR and IRR for HEDIS project and supplemental data throughout the year. Working in the quality department with all of Aetna departments to ensure members receive the highest quality care.

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