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Millicent A. O. Edusei

Millicent A. O. Edusei

Lives in Bronx, New York United States · 52 years old
Basic Info
Relationship status:
Single
Gender:
Age:
52
Location:
Last Login:
July 1, 2021
Member Since:
October 21, 2018
RSS Subscribers:
54
Smoker:
No
Drinker:
No
Nursing Title
Nurse
Current Nursing Specialization
Utilization Management, Healthcare Reimbursement
Work Name (Hospital, Practice, Clinic, etc...)
Executive Kings, Inc.
Years in Nursing
1990/2001
Work Description / Areas of Expertise / Job Duties
• Healthcare Reimbursement HEDIS project competencies and on the job training via employer contract. • Maintained a 95% accuracy rate of abstracting quality data for all projects and based assessments offered by the company regarding the latest trends in a medical specialties
• Research captured primary claims systems and risk management data mining via abstraction of an analytical process that can be used in retrospective and prospective chart review for RO, FRO I, FRO II, CARA FRO I, CARA FRO II, HEDIS and can inform, enhance data use for future prospective projects yielding higher risk score accuracy and ensured maximum improvement in financial, clinical and quality outcomes
• Clinical Diagnosis Related Group (DRG) Reimbursement reviewed of electronic health records during inpatient hospital stay to determine the clinical diagnosis hospital admission to discharge timeline for revenue cycle management performance
• Provided outpatient services via telephone to Affinity Health Plan members and their access of care management and transition care management services at participating healthcare facilities
• Completed as a project management champion with Six Sigma Green Belt for the pilot program, Transition Care Management program
• Transition Care Management program assisted members with day 1 – 31 after post discharge
• Management and consultation of health insurance member's related to inpatient stay according to the DRG, Interqual and Millman guidelines for clinical documentation
• Manage external contract agreements with PAR and non-PAR hospital representatives who submits for review of an inpatient admission for clinical documentation for health plan members of Amerigroup
• Authorized inpatient, outpatient and pre-certification of durable medical devices request for admission and post discharge.
• Evaluated clinical documentation based on DRG of inpatient stay for acute and chronic care illness
• Compared medical information to approve or deny medical necessity
Brief summary of your nursing background
Practice Manager in Doctor Offices, Clinical Case Management, Healthcare Financial Reimbursement - Risk Adjustment, Utilization Review, Healthcare Billing/Coding, CCA examination prepratory for future date exam, Clinical Documentation specialist Exam Prepratory, Consultation Masters in Business Administration MBA/Healthcare Management, Home Care Approvals, Pre-Certification, Inpatient/Outpatient Appeals, Root Cause Analysis in Grand Rounds with HMO/MCO physicians, Rare Disease Populations in home care.
What made you choose a career in nursing?
In my youth, I always wanted to be a Physician. My parents, in 1990, placed me at Hospital for Special Surgery Nursing school for their LPN program. I never utilized the skills. I took a refresher in 2001 and my mother stated that the only way you can truly know that you are a love of the medical field is to become a nurse. Once you achieve this accolade you can increase your level of learning to become a physician. My dad stated that every medical specialty is a ethical business venture....pay attention and gain confidence that there is always more to learn. I am ready to pursue my personal goals and dreams.
What Do You Attribute Your Success To?
My mom is a retired RN and she encouraged me to start from the bottom and work my way up. My true dreams and aspirations are attainable as I developmentally grow in the medical field. My dedication and interest in my selected field of interest. I like working in the administrative positions without patient care because their is a sense of ethics placed with the patient to pursue and advocate for the best care provided at the selected facility.
What motivates you at the start of each day?
The high priority list of patients who need attention from reading the documented medical report by the internal and external medical care team places a standard of motivation to complete the daily tasks of the day for the patient, colleagues and staff.
How do you make a difference in the lives of your patients?
Listening
Advocacy
Stewardship
Leadership
Drive
Perseverance
Wisdom
Network
Consultation
Research Interests
Maximization of Stakeholders Wealth in Medical Economics and Actuarial Science: Population Health Strategy in Medical Malpractice Risk Factors for Medical Litigation
Clinic and Hospital ROI
Chief Nursing Officer
Chief Financial Officer
Chief Medical Officer
Data Communities
Informatics
Data Abstraction of mostly any topic
Board of Trustee
Leadership
Program Planning
1 - Article
Her Thesis was Published
1 - Faculty Appointment
Local Public Speaking
High School Name
Saint Barnabas
High School Degree
Regents
High School Grad Date
May 1989
Nursing School Name
Hospital for Special Surgery/OCM BOCES Syracuse
Nursing Degree In
LPN
Grad Date - Nursing Degree
1990/2001
University - Associate's
Not Applicable - Transfer to Bachelors program
Associate's Degree In
Not Applicable
Grad Date - Associate's Degree
Not Applicable
University - Bachelor's
Excelsior College
Bachelor's Degree In
BS in Sports Medicine
Grad Date - Bachelor's Degree
2004
University - Master's
University of Phoenix
Master's Degree In
MBA in Healthcare Management
Grad Date - Master's Degree
August 2006
Certificates
LPN (Licensed Practical Nurse), PhD - Doctor of Philosophy
1 - Professional Society Membership
American Health Information Management Association
2 - Professional Society Membership
Healthcare Financial Management Association
3 - Professional Society Membership
American Nurses Association
4 - Professional Society Membership
American College of Healthcare Executives
Personal Website
medusei@email.phoenix.edu
Place of birth
Manhattan
More About Me
I like leisure and recreational activities. I like to read. I am interested in becoming a physician, and I like the study of Actuarial Science - Healthcare Insurance HMO/MCO, Healthcare Risk Adjustment and Healthcare Finance. I am a quiet person who communicates often when spoken to. I like self respect and dignity for all. I believe in marriage more now than ever. I believe woman should really think about abortion. I am strong advocate for immunization and inoculation, family planning and medical tourism for countries health population all over the world.
Movies
Passion of Christ
Show me the Money
Fugitive
Documentaries
Romance
Action
Music
Classical
R & B
Hip Hop
Ghanaian Music
African Music
Zen music
Who I'd Like to Meet
Successful, Wealthy Healthcare Owners

Real Estate Guru's - HREIT

Medical Malpractice CEOs and Presidents

Chief Actuararies

Successful Physicians - TBI, Sports Medicine, Orthopedist, Neurologists, Surgeons....

"Above Mentors"