Fatima Crawford
AVONDALE
Summary
Results-driven healthcare professional with over 10 years of experience in HEDIS performance improvement and risk adjustment coding. Proven ability to build relationships and guide clients towards informed decisions that enhance quality metrics and improve provider performance. Multilingual in Portuguese and Spanish, with a strong focus on educating stakeholders and implementing actionable plans to elevate patient care standards.
Overview
15
15
years of professional experience
Work History
Practice Performance Manager & Medicare Consultant
United Healthcare Group
01.2022 - Current
- Spearhead provider performance optimization across assigned territories using 4-STAR gap closure metrics and coding accuracy benchmarks.
- Develop and implement customized action plans to improve HEDIS scores and address suspect medical conditions through data analysis.
- Collaborate with cross-functional teams to align provider performance with organizational quality goals.
- Train clinical staff on risk adjustment coding (ICC) and EIIR documentation improvements.
- Increased HEDIS scores by 22% in assigned region within the first year through targeted provider education and gap closure initiatives.
- Conduct on-site and virtual audits to identify performance gaps and recommend corrective strategies.
Site Data Collector
Innovation
08.2016 - 04.2021
- Independently collected, reviewed, and submitted 500+ medical records annually for HEDIS and regulatory compliance audits.
- Coordinated with healthcare facilities to resolve discrepancies in medical record submissions.
- Ensured data integrity by validating EHR documentation against quality measure requirements.
- Generated detailed reports to highlight trends in care gaps and documentation errors.
- Trained 15+ site staff on proper medical record retrieval and data submission protocols.
- Reduced record retrieval errors by 35% by implementing a standardized data collection checklist adopted company-wide.
Medical Assistant Lead
Optum-Southwest Medical Associates
11.2011 - 06.2016
- Led a team of 8 medical assistants in clinical tasks, including phlebotomy, injections, and vital sign monitoring.
- Streamlined patient flow by redesigning appointment scheduling systems, reducing wait times by 20%.
- Conducted training sessions for new hires on EHR documentation and clinic workflows.
- Managed referral coordination and prior authorizations for 50+ daily patient cases.
- Improved patient satisfaction scores from 82% to 94% within 6 months by implementing a patient communication initiative.
- Performed diagnostic tests (EKG, glucose monitoring) and ensured accurate results reporting.
Education
Business Administration & Management -
Touro University
CaliforniaCertified Medical Assistant -
Westbury BOCES
Westbury, NYSkills
- HEDIS Compliance
- Risk Adjustment Coding
- Cross-Functional Collaboration
- Provider Education
- Time Management
- Bilingual Communication
- STAR Ratings Improvement
- Data-Driven Strategy Development
- Performance Metrics Analysis
- Community Engagement
- Client Relationship Building
References
Available upon request.
Timeline
Practice Performance Manager & Medicare Consultant
United Healthcare Group
01.2022 - Current
Site Data Collector
Innovation
08.2016 - 04.2021
Medical Assistant Lead
Optum-Southwest Medical Associates
11.2011 - 06.2016
Business Administration & Management -
Touro University
Certified Medical Assistant -
Westbury BOCES