Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Melissa Brown

Magee

Summary

Registered Nurse with over 6 years of focused HEDIS abstraction and clinical data experience. Expertise in medical record review, quality assurance, project leadership, and regulatory compliance. Demonstrates exceptional accuracy, exceeding 98–100% quality benchmarks across multiple projects. Proficient with major HEDIS platforms and EMRs, with the ability to manage large-scale remote review projects. Strong communication, leadership, and team collaboration skills. Actively licensed RN with a comprehensive clinical and administrative background.

Overview

8
8
years of professional experience
1
1
Certification

Work History

RN HEDIS Nurse Overreader

Centene
01.2025 - 04.2025
  • - Performed overreads and medical record validations across multiple HEDIS measures.
  • - Maintained HIPAA compliance and achieved 99%+ accuracy on abstractions.
  • - Utilized QMRM and QCAT to manage daily workflow.
  • Remote

RN HEDIS Nurse Overreader

Centene
03.2024 - 05.2024
  • - Executed overreads for CBP, WCC, HBD, IMA, CIS, PPC, COL, and more.
  • - Exceeded daily target with 85+ charts/day at 99% accuracy.
  • - Proficient in Reveleer, Cotiviti, RateLift, QMRM.
  • Remote

RN HEDIS Nurse Abstractor/Overreader

UnitedHealth Group
01.2024 - 03.2024
  • - Conducted overreads for WCC, PPC, COL, EED.
  • Remote

RN HEDIS Nurse Team Lead

CSI Companies
12.2021 - 01.2024
  • - Led HEDIS abstraction team, performed overreads on all major measures.
  • - Developed project timelines, trained abstraction staff, led workflow optimization.
  • - Monitored compliance with NCQA and client standards.
  • - Maintained 100% overread quality on vendor abstraction.
  • Remote

HEDIS Nurse

CSI Companies
10.2019 - 05.2021
  • - Abstracted clinical data for HEDIS measures, trained staff on compliance.
  • - Integrated and managed EMR data in cloud-based platforms.
  • - Performed facility audits and ensured HIPAA compliance.
  • - Delivered 100% accuracy across record reviews.
  • Remote & On-site

Remote HEDIS Nurse

CSI Companies
09.2017 - 09.2018
  • - Conducted medical record abstraction and facility audits for HEDIS reporting.
  • - Maintained daily abstraction goals with 100% accuracy.
  • - Trained facility staff on best practices for HEDIS compliance.
  • Remote & On-site

Education

Master of Business Administration - Business Administration

Franklin University

Bachelor of Science - Nursing

Mississippi University for Women
Columbus, MS
01.2013

Associate Degree - Nursing

Alcorn State University, School of Nursing
Natchez, MS
01.2007

Skills

  • HEDIS Medical Record Abstraction & Overread
  • HEDIS Measures: CBP, CDC, CCS, WCC, HBD, IMA, CIS, PPC, EED, COA, COL, CWP, LSC, TRC
  • Platforms: QCAT, RateLift, RateMax, QMRM, CIOX, Cotiviti, Reveleer, MRDB
  • EMR Systems: Epic, Cerner, McKesson, and more
  • Microsoft Office (Excel, Word)
  • HIPAA, NCQA, Joint Commission compliance
  • Clinical Quality Management
  • Project Planning & Team Leadership
  • Utilization Review, Case Management
  • Basic life support
  • Clinical judgment
  • Compassion and empathy
  • Quality improvement
  • Nursing informatics
  • Advanced cardiac life support
  • Team coordination
  • Strong clinical judgment
  • Staff supervision
  • Nursing staff leadership
  • Licensed RN
  • HIPAA education
  • EMR / EHR
  • Complex Problem-solving

Certification

  • ACLS – Advanced Cardiac Life Support
  • BLS – Basic Life Support

Timeline

RN HEDIS Nurse Overreader

Centene
01.2025 - 04.2025

RN HEDIS Nurse Overreader

Centene
03.2024 - 05.2024

RN HEDIS Nurse Abstractor/Overreader

UnitedHealth Group
01.2024 - 03.2024

RN HEDIS Nurse Team Lead

CSI Companies
12.2021 - 01.2024

HEDIS Nurse

CSI Companies
10.2019 - 05.2021

Remote HEDIS Nurse

CSI Companies
09.2017 - 09.2018

Bachelor of Science - Nursing

Mississippi University for Women

Associate Degree - Nursing

Alcorn State University, School of Nursing

Master of Business Administration - Business Administration

Franklin University

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