Marissa Bocanegra
Hastings
Summary
Experienced Clinical Consultant and Nurse with over two decades of healthcare expertise across clinical operations, quality improvement, utilization management, and patient care. Proven leadership in managing multi-site teams, driving HEDIS performance, and enhancing healthcare delivery through strategic provider engagement and data-driven decision-making.
Overview
24
24
years of professional experience
1
1
Certification
Work History
Clinical Consultant – Value Performance Team
Blue Cross Blue Shield of Minnesota
08.2017 - Current
- Serve as subject matter expert in HEDIS and quality administration for market and regional initiatives.
- Conduct provider outreach and education to improve quality measure performance.
- Perform medical record reviews, analysis, and documentation.
- Lead Quality of Care (QOC) reviews and determinations.
Clinical Nurse Liaison
Complete Care Group
05.2017 - 08.2017
- Coordinated healthcare services for residents in independent, assisted living, and memory care communities.
- Promoted resident safety and reduced ER/hospital visits through proactive care planning.
Annual HEDIS Abstractor
Blue Cross Blue Shield of Minnesota
01.2017 - 05.2017
- Collected and abstracted medical records to meet clinical data requirements for HEDIS reporting.
East Region Clinical Supervisor
Metro Urology
07.2016 - 01.2017
- Supervised clinical operations across three regional clinics.
- Managed 20+ direct reports and ensured high-quality patient care delivery.
Fitness for Duty / Access Authorization Nurse
Xcel Energy
07.2015 - 07.2016
- Conducted federally mandated testing including respirator fit tests, physicals, and drug screenings.
Utilization Management – Home Health Manager
Univita Healthcare
12.2012 - 07.2015
- Oversaw operations for Home Health, DME, and IV infusion services across multiple states.
- Applied evidence-based guidelines (URAC, InterQual, MCG, CMS) for utilization decisions.
- Collaborated with Medical Directors and health plan stakeholders; attended JOC meetings.
- Managed HR functions and departmental compliance.
Clinical Liaison
Hospira
08.2012 - 12.2012
- Partnered with Field Service Engineers to coordinate hospital equipment upgrades nationwide.
Licensed Practical Nurse
Transitional Care Units
01.2011 - 12.2011
- Delivered skilled nursing care, medication reconciliation, wound care, and team supervision.
- Served as Charge LPN with strong patient outcomes.
Obstetrics Technician
Wayne Hospital
01.2002 - 12.2010
- Provided direct patient care and assisted in surgical procedures (C-sections, tubal ligations, etc.).
- Managed lab draws, chart preparation, and birth documentation for the State of Ohio.
Skills
- Healthcare Leadership
- Team Management
- HEDIS
- Quality Improvement
- Utilization Management
- Clinical Review
- Program Development
- Clinic Operations
- Provider Education
- Outreach
- Strong Communication
- Collaboration
- HEDIS reporting
- Quality administration
- Medical record analysis
- Care coordination
- Compliance management
- Data collection
- Utilization management
- Healthcare analytics
- Clinical best practices
- Disease management
- Evidence-based practice
- Quality assurance
Certification
- Licensed Practical Nurse (LPN)
- Certified Risk Adjustment Coder (CRC)
- Infusion Certification
- Basic Life Support (BLS)
- Certified Phlebotomist
References
- Crystal Swarbrick, Manager, HEDIS & Quality Improvement, (612) 581-8175
- Jamie Gore, NP, (651) 214-1949
- Laurie Holte, RN, (651) 983-5745
Timeline
Clinical Consultant – Value Performance Team
Blue Cross Blue Shield of Minnesota
08.2017 - Current
Clinical Nurse Liaison
Complete Care Group
05.2017 - 08.2017
Annual HEDIS Abstractor
Blue Cross Blue Shield of Minnesota
01.2017 - 05.2017
East Region Clinical Supervisor
Metro Urology
07.2016 - 01.2017
Fitness for Duty / Access Authorization Nurse
Xcel Energy
07.2015 - 07.2016
Utilization Management – Home Health Manager
Univita Healthcare
12.2012 - 07.2015
Clinical Liaison
Hospira
08.2012 - 12.2012
Licensed Practical Nurse
Transitional Care Units
01.2011 - 12.2011
Obstetrics Technician
Wayne Hospital
01.2002 - 12.2010