Experienced Case Management Director driven to cut department costs and boost hospital revenuethrough innovative management techniques.
Organized and diligent, with excellent written, oral and interpersonal communication skills.
Leadership skills guide others in today's rapidly transforming health care environment
Unique perspective gained from hospital-based, QIO-based and Payor-based experience
Education and Training
Bachelor of Science: Nursing LIBERTY UNIVERSITY ONLINE － Charlotteville, VA
Coursework in Acute Care Nursing
External Degree: Healthcare Administration ST. JOSEPH'S COLLEGE － WINDHAM, ME
Associate of Applied Sciences: Registered Nurse CORNING COMMUNITY COLLEGE － CORNING, NYGPA: Dean's List honors
Dean's List Honors
Coursework in Biology, Clinical Chemistry and Microbiology
Problem resolution ability
04/2007 to Current
Director of Case ManagementFANNIN REGIONAL HOSPITAL － Blue Ridge, GA
Five direct reports for rural 50-bed hospital
Managing the Discharge Planning and UR/Case Manager roles
Coordinate the integration of case management functions into the patient care, discharge, and home planning processes with other hospital departments, external service organizations, agencies and healthcare facilities.
Conduct concurrent medical record review using specific indicators and criteria as approved by medical staff, JCAHO, CMS, and other state agencies
Facilitates interdisciplinary patient care rounds and/or conferences to review treatment goals, optimize resource utilization, provide family education and identified post-hospital needs.
Collaborates with clinical staff in the development and execution of the plan of care, and achievement of goals
Directs and participates in the development and implementation of patient care policies and protocols in order to provide advice and guidance in handling special cases or patient needs.
Coordinates the provision of services to patients, families, and significant others to enable them to deal with the impact of illness on individual family functioning and to achieve maximum benefits from healthcare services
11/2001 to 04/2007
Case Manager/Lead Case ManagerINTRACORP/CIGNA － Norcross, GA
Responsible for average caseload of 20 - 25 telephonic and on-site files for North Atlanta /North Georgia
Performed case management within the scope of licensure for injured workers with complex and chronic care needs.
Identified specific case management plan to address objectives and goals as identified during assessment.
Implemented care plan and coordinates internal and external resources available to meet identified needs.
Surpassed clinical outcome goals as evidenced by random audit scores of ~100% with at least four direct referrals every month.
Developed meaningful cost benefit advantage with consistent 100+% productivity
10/1995 to 11/2001
Case Manager/ Cost Containment SupervisorCOMPFIRST, INC － Dalton, GA
Launched start-up program for Case Management, Repricing and Claim Reporting Departments with eleven staff
Managed integral Case Management and Repricing Departments during period of 175% company growth annually
Oversaw annual savings for both departments of over a million dollars annually
Responsible for Case management activities, billing and reporting
Promoted from Case Manager to Supervisor within the WC/MCO
Reported to Vice President of company
Led development of Dispute Resolution Committee comprised of community medical providers
04/1993 to 10/1995
Nursing SupervisorBET INC./NI HEALTHCARE SERVICES － ATLANTA, GA
Launched start-up of Injury Reporting Center and Case Management program for work-related injuries for large self-insured employer with over 100,000 covered lives in the United States.
Provided direct telephonic case management services nationally with oversight of field case managers in twenty-six individual states.
Provided utilization review, telephonic and supervised on-site medical management
Spearheaded development of employer's modified duty programs
Documented positive cost-benefit savings to support expansion of program
Registered Nurse - State of Georgia
Certified Case Manager (CCM) - Expires 6/1/2011
Served as key contributing member to Leadership team.
Oversaw Fannin Regional Hospital being named to the Top 5 CHS rural hospitals for Discharge Planning based on HCAHPS (Q3-2014)
Improved Department Compliance Audit scores to >95%
Ensured successful MAC Probe account outcomes (2014)
Developed CHS best practice for records submission (Q4-2014)