Administrator - Pediatric Specialty Care Services

• Jan 2021 - Present

Director Ambulatory Care Clinics

• Aug 2019 - Jan 2021

Director Primary Care

• Jan 2019 - Aug 2019

Senior Consultant

• Mar 2016 - Dec 2018

Senior Consultant for revenue cycle revitalization projects and operations assessments. Assess, document and educate leadership regarding current state barriers to patient satisfaction, productivity, operations and transition to new EMR environments. Assessments inclusive of clinical workflows, appointment scheduling, insurance eligibility and verification, call outreach, call management, nurse triage, transfer center operations, care and utilization management, and specialty hospital operations. Create written reports of findings and recommendations for current state initiatives that create EMR implementation and transition readiness. Project management transition and process improvement initiatives. Show less

Administrator Care Coordination

• Jul 2009 - Mar 2016

Ensured continuity of care and cost effectiveness by integrating functions of admitting operations, utilization review, precertification and authorization management, denial management, care coordination and social services Oversight of length of stay, cost per case and utilization compliance. 97%+ reimbursement rate for inpatient days, with a 23% decrease in inpatient length of stay Revenue cycle management: referral, precertification, registration, admission, continued stay/visit authorization management, denial management, discharge coordination for inpatient and outpatient service lines. 95%+ reimbursement rate for outpatient services Business intelligence reporting (Business Ob jects) – compiled, dash boarded, monitored, analyzed and reported facility and service line key performance indicators Interim Quality & Patient Safety Administrator, Patient Safety Officer: June 2014 – March 2015: Provided program and personnel oversight, performed regulatory driven responsibilities of the Patient Safety Officer, completed global re-assessment of the quality program and affiliated committees, completed re-assessment and re-design of the occurrence report process, and completed re-assessment, survey re-design, and reimplementation of the patient satisfaction program and initiatives. Cerner EMR Implementation Subject Matter Expert: key member of the design, build, and implementation project management team. Responsible for areas and workflows pertaining to referral and registration management, admission and discharge management, authorization and denial management, and clinical documentation management for Care Coordination and Social Services. Ongoing key resource for the change control board and clinical documentation improvement. Show less

Clinical Director

• Jul 2008 - Mar 2009

Enhanced existing disease and complex case management clinical practice model to represent changing national guidelines and standards of care with the intent to scale from a regional to a national program. Designed programs to result in decreased inpatient length of stay and emergency room utilization while increasing utilization of physician based services Key account management, product management, compliance and client relationship management Improved care delivery, continuity of care, and clinical outcomes through the enhancement and implementation of policies, procedures, workflows, and the reengineering of nursing care plans Business intelligence reporting (Business Objects) – monitored, analyzed, and reported program effectiveness, patient satisfaction, and identified areas for further program enhancements Show less

Vice President Clinical Operations

• Jul 2003 - May 2008

Clinical oversight, growth and development of telehealth disease management and symptom triage demand management programs Moved breakeven business unit to profitability, developed and managed a $10M+ annual budget and strategic plan that resulted in continuous positive annual business unit margins Developed a business plan to maintain satisfaction and barriers to exit among twenty key accounts resulting in an average client satisfaction rating of 95% Established and maintained strategic relationships with healthcare executives, medical directors, nursing leaders, clinical guideline/content authors, and other strategic partners which resulted in key contributions to content and resource development as well as content oversight and testing Subject matter expert for the proprietary triage and case management software program Business intelligence reporting (Business Objects) – compiled, dash boarded, monitored, analyzed, and reported program effectiveness, patient satisfaction, and identified areas for further program enhancements Developed and implemented telehealth clinician pay-for-performance initiative based on quality, satisfaction and proficiency measures resulting in the stabilization of nursing turnover and a 15% increase in practice and proficiency metrics Developed and implemented nurse recruitment program and candidate screening tools resulting in a nursing candidate pipeline of 200+ nurses Show less

Staff Nurse – Inpatient Post-anesthesia Care Unit

• Oct 2002 - Jun 2003

Recovery of inpatient post-operative adult and pediatric patient, coordination of the evening call schedule and continued education process. Recovery of inpatient post-operative adult and pediatric patient, coordination of the evening call schedule and continued education process.

Administrator

• Jul 2001 - Sep 2002

Growth and development of $1.8M bi-state private duty home care agency Growth and development of $1.8M bi-state private duty home care agency

Director Corporate Health Services

• Jun 1999 - Jul 2001

Design, sales and implementation of corporate health and wellness programs. Patient Services Representative - physician sales, marketing, and account management for Medicare and managed care home care services Design, sales and implementation of corporate health and wellness programs. Patient Services Representative - physician sales, marketing, and account management for Medicare and managed care home care services

Nurse Manager

• Mar 1996 - May 1999

Operations and clinical oversight for the pre-operative and post-operative care areas Operations and clinical oversight for the pre-operative and post-operative care areas

Registered Nurse

• Mar 1988 - Mar 1996

CCU / CVR 1990-1996, OB/GYN Surgical Division 1989-1990, Nurse Assistant 1998-1989 CCU / CVR 1990-1996, OB/GYN Surgical Division 1989-1990, Nurse Assistant 1998-1989