Marie Shea
Manager of Clinical Quality Assurance at Mass General Brigham Health Plan at Mass General Brigham Health Plan
Based in Malden, United States
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Seniority
Manager
Department
Other
Location
Malden
Industry
Insurance
Company size
467
Contact information
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m•••••••@massgeneralbrighamhealthplan.org
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Background
About Marie Shea
Consults with all Clinical Operations’ directors and managers to identify key areas of focus and develops a QA plan that includes auditing, reporting, situational analysis, strategizing and developing programs and process refinement through the quality improvement platform. Conducts program and quality benchmarking and research to support initiatives to support UM, CM, and Quality. InterQual Certified Instructor, administrator for Interqual sites, schedules IRR for UM staff and proctors IRR testing. Designs and develops IRR for Medical Directors, works with CMO to review results and training as needed with medical directors. Prepares chart files for NCQA site review and presents to NCQA auditors. Primary responsible for writing IRR reports. Healthcare Data Analytics
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