Gina Ashby

Experienced Quality Management Nurse Consultant with expertise in clinical auditing, utilization management, and EMR navigation. Skilled in regulatory compliance, abstraction best practices, and workflow optimization, with a proven record of leading audits, policy development, and team mentorship at CVS Aetna Healthcare. Dedicated to advancing quality benchmarks, enhancing patient care, and driving continuous improvement across healthcare operations.

I bring extensive expertise in quality management, clinical auditing, and utilization review, with a proven record of driving strategic improvements and elevating clinical standards. My background includes leading claim review operations, directing offshore vendor audits, and developing evidence-based policies that enhance patient care and regulatory compliance. I have managed multidisciplinary teams, mentored staff, and facilitated cross-functional collaboration to implement actionable quality enhancements. Skilled in clinical chart review, discharge planning, and care coordination, I ensure accurate reimbursement, reduce unnecessary hospitalizations, and improve patient outcomes. My experience spans acute care delivery across telemetry, cardiology, medical/surgical, and gynecology/urology units, supported by strong data analysis and documentation practices that inform clinical decisions and optimize resource allocation.

• Capella University — BSN, Minneapolis, MN 

• Health Sciences Center School of Nursing — Associate Degree (RN), Winnipeg, Manitoba, Canada