Dean of Nursing and Allied Health

• Nov 2021 - Present

Health Services Manager-Louisiana/Mississippi Market

• Apr 2019 - Nov 2021

⏺ Awarded Market of the Year 2019. ⏺ Implemented enhanced workflows and telemedicine visits, enabling 65% of high risk patient population to have primary care visits during CoVid-19 Social Distancing Initiative. ⏺ Play a key management role in managing contract with Humana for the LA & MS markets with a census of 5,000 full-risk patients. ⏺ Awarded quarterly bonuses based on Market Performance, Claims Data & Quality Data. ⏺ Accountable for Jan. 2021 Annual Performance Evaluations for 16 Nurse Case Managers, Case Coordinators, and Ambassadors. ⏺ Meet weekly with the Market Leadership Team, including Health Services Director, VP of Market, Physician Advisor for Market, LA Physician Advisor, MS Physician Advisor, Lead Community Health Advisor, and Office Manager. ⏺ Achieved 5-Star Market status for 2019 quality initiatives. ⏺ Executed a total role redesign for Ambassadors, connecting 50% of low income patients to community resources. ⏺ Selected to oversee a critical special project to convert from Facetime and WhatsApp platforms to a new Landmark Telemedicine App. ⏺ Serve on a high profile initiative to close Landmark’s quality gaps. ⏺ Designed a new in-home visit process to conduct diabetes and retinopathy screening. ⏺ Coordinate closely with Community Health Advocates (CHA) for new engagement. ⏺ Launched a program to educate and audit Nurse Case Managers for NCQA Compliance. ⏺ Supervise a Care Coordinator for patient engagement, as well as a new telephone-based clinical triage process. ⏺ Utilize a variety of software programs, including Ubiquity Electronic Medical Records software, Tableau database software, Excel, Sharepoint, and other digital tools to ensure efficiency, quality, and compliance.

Manager HCMS

• 2018 - 2019

⏺ Developed and implemented Enhanced Inpatient Member Interaction (EIMI) team focusing on social determinants of health and transitions of care resulting in decreased length of stay and decreased readmissions. ⏺ Directed daily operations for the medical management staff performing initial intake, including local call center. ⏺ Personally led the ABA/Chisholm Outreach Team for Coordination of Care. ⏺ Selected as Guest Speaker at the Healthcare Leadership Conference (Atlanta, GA), presenting on the topic, "Partnering with Insurance Payors & Healthcare Providers to Better Serve Patients.”

System AVP, Complex Care Manager

• 2011 - 2018

⏺ Served in a key leadership position following promotion from Director Care Management to System AVP in June 2016. ⏺ Directed Ambulatory Care Management Dept. for 150,000+ capitated patients, 11 hospitals, and 38 health centers. ⏺ Recognized for “Clinical Innovation of the Year” for Post-Surgical Home Program. ⏺ Prepared and delivered reports to Executive Team, physician leads, and payors. Cultivated positive internal and community relationships. ⏺ Played a key role in development of the Population Health Strategic Plan & Budget for Ochsner Health Network. ⏺ Named to Population Health Core Team, Primary Care Council, Quality Improvement Committee & Opioid Steering Committee. ⏺ Accountable for annual NCQA audits for Delegated Case & Disease Management Programs. ⏺ Decreased ED admits by 20%, readmissions by 25%, and total cost of care by $1,500 PMPM for high risk population. ⏺ Oversaw training, successful data abstraction, and submission of quality data measures to CMS. ⏺ Served on EPIC's National Care Management Braintrust as subject matter expert for social determinants of health documentation modules. ⏺ Authored 3-day SNF waiver for Accountable Care Patients enabling direct admits to SNF facilities from home settings. ⏺ Partnered with Federally Qualified Health Care Centers to provide long-term behavioral health services.

Regional Field Supervisor

• 2006 - 2011

⏺ Directed daily operations, case management, preauthorization, initial/continued stay reviews, denials, and appeals for a Medicare Advantage Plan. ⏺ Supervised 40 clinical care managers (RNs, LCSWs, Admin Assistants). ⏺ Coordinated case management for Medicare Advantage Plan members admitted to 6 acute care hospitals, 4 long-term acute care hospitals, 5 inpatient rehabilitation hospitals, and 15 SNF facilities. ⏺ Led monthly staff meetings and training sessions for nurses, social workers, and staff. ⏺ Conducted annual performance review evaluations. ⏺ Played a key management role in developing and enforcing budgetary guidelines for staff. ⏺ Monitored 30 day readmission rates performing root cause analysis, including implementing strategies to reduce readmission for 22% to 10% for Region. ⏺ Increased STAR rating from 3.5 to 5 stars for Region ⏺ Negotiated Letters of Agreement with strategic post-acute partners to care for high risk patient population. ⏺ Personally redesigned care management workflows using LEAN strategies to create efficiencies in case management services.

Lead In-Patient Case Manager

• 2005 - 2006

Inpatient Case Manager

• 2002 - 2005

Lead Inpatient Case Manager

• 2000 - 2002

Director Of Nursing

• 1996 - 2000

Surgical Intensive Care Charge Nurse

• 1993 - 1996