Sharon Soucy
Nashua,NH
Summary
Forward-thinking Senior Manager adept at managing teams of employees with direct reports in multiple platforms to accomplish challenging objectives. Imparts clear vision to guide cohesive, high-performing teams.
Overview
29
29
years of professional experience
Work History
Senior Manager-ICM-Nursing
Point32Health
08.2022 - Current
- Achieved operational excellence by streamlining processes and implementing best practices including checklists for both documentation platforms to initiate standardization.
- Improved team performance by providing comprehensive training and fostering a collaborative work environment including work with Senior Care Manager on continuous open office hours for staff in both documentation platforms to be able to attend and ask questions or listen to staff with other questions. .
- Led cross-functional teams to achieve clinical metrics and deliver high-quality customer service.
- Attend multiple migration meetings weekly to foster processes across multiple departments for successful member migration across the continuum. Which included migration of GIC in July 2023
- Implemented innovative solutions to overcome challenges, ie. downtime cybersecurity event from April to June 2023 leading to enhanced productivity levels albeit manual care management process.
- Mentored new manager in Commercial for skill development and career progression within the organization.
- Instituted collaborative triage process across both MHK and Jiva including coordinators supporting both.
- Collaboration with MCIS team and Clinical Data and Analytics for continued work in Stratifying member data for multiple platforms including HSOR
- Oversee multiple employer groups including USFHP
Manager, ICM-Nursing
Point32Health
08.2019 - 08.2022
- Oversee a team of 8 individual contributors/Care Managers (CM) on the Commercial Care Management Team
- Assist in day-to-day function of the referral process of members discharged from inpatient and extended care admissions
- Perform numerous medical chart audits as it relates to members enrolled in care management including high-cost analysis, medical condition management, continuity of care with providers and NCQA requirements
- Expert in MHK, the clinical documentation system for care management
- Expert in usage of the Enterprise Segmentation and Stratification Tool and Tableau as it relates to metrics and analyzing data for the department
- Directly oversee USFHP Team for Tufts Health Plan in Commercial Care Management which includes attending a collaborative weekly huddle to discuss members with the Medical Director, Manager of Care Coordination and Utilization Management (UM)
- Attend weekly Interdisciplinary Team (IDT) rounds with UM/CM for collaboration on members to ensure effective/safe discharge
- Instrumental with the ongoing integration of Tufts Health Plan and Harvard Pilgrim for Point32Health
- Led Map and Gap sessions with both organizations related to clinical assessments to meet business requirements
- Participate in 3 integration meetings weekly for Commercial Care Management
- Lead transition of insourcing disease management from Optum which included collaboration with analytics to develop a monthly report of members that have chronic conditions and need for care management
- Assisted with education for the team in relation to the development and execution of this Chronic Condition program.
Care Manager Relationship Manager
Tufts Health Plan
07.2018 - 08.2019
- Review of Tufts Health Freedom Plan and Granite Health member Inpatient Admissions on a daily basis
- Monitors and expedites clinical information to Granite Health entities on attributed members receiving care at facilities outside of attributed provider groups
- Care management of non-attributed THFP members and attributed members as needed, based on clinical capabilities of each Granite Health entity
- Run monthly CM meetings with each Granite Health entity to discuss current attributed members being followed by THP, review high cost claimant list, look at avoidable ED visits per each group’s request
- Attend quarterly Care Coordination meetings
- Discuss potential clinical areas of opportunity by practice and attend practice staff meetings at least annually.
Clinical Quality Specialist
Genesis HealthCare
02.2011 - 07.2018
- Responsible for evaluating and enhancing professional nursing staff knowledge and skills required
- Maintaining high standards of resident care through advising, observing, evaluation and recommendations
- Thorough chart reviews encompassing not only for regulatory standards but medical and condition management
- Participated in the development, implementation, and ongoing evaluation of clinical priorities in ten nursing centers in NH, MA and VT
- Maintained nursing policies and procedures to ensure compliance with state, federal and Joint Commission guidelines
- Supported the implementation of quality improvement through the use of outcomes data.
Director of Nurses
Westford House
02.2006 - 02.2011
- Managed a 100 employee nursing staff
- Implemented policies and procedures to ensure compliance with Federal and JCAHO regulations
- Developed, planned, and implemented quality improvement programs for the nursing department including skin committee, weight/ hydration team, and falls/ restraints committee
- Significant work with rehospitalization rates and CMS guidelines as it relates to provider engagement in the Preferred Provider Networks including Tufts Medicare Preferred groups ie Riverside Practice
- Planned, monitored, and controlled the approved nursing budget
- Provided guidance and support to the nursing team
- Obtained two deficiency free CMS surveys.
Unit Manager
Westford House
01.2005 - 03.2006
- Responsible for MDS, care plans, consultation with dietary, rehabilitation, and social service departments for interdisciplinary action
- Skin champion responsible for skin rounds on all units in center, including tracking and managing in house acquired and community acquired pressure ulcers
- Promoted to Assistant Director of Nurses 5/05
- Other duties include admissions, discharges, skilled nursing procedures, and quality improvement.
Staff Development Coordinator
Westford House
11.2003 - 01.2005
- Responsible for completing and coordinating the orientation for all new employees
- A member of the management team that planned, coordinated, and implemented educational programs for all employees
- Responsible for planning and coordinating a disaster drill with Westford Fire Department and Medstar Ambulance in the local area
- Skin Champion and IV coordinator for the facility
- Infection Control Nurse responsible for the surveillance, data collection, and analysis of community and nosocomial infections.
Unit Manager
Westford House
05.2002 - 11.2003
- Responsible for a staff of 4 nurses and 4 certified nurse’s aides
- Responsible for care plans, consultation with dietary, rehabilitation, and social service departments for interdisciplinary action
- Coordinating patient education to return successfully to the community
- Other duties include admissions, discharges, skilled nursing procedures, and quality improvement.
Regional Case Manager
Genesis HealthCare
05.2000 - 05.2002
- Coordinate with interdisciplinary team at centers, assessing patient’s needs with their families in medical diagnosis, treatment, rehabilitation needs and discharging planning
- Collaborated with physicians and insurance case managers in patient care planning, management, and streamlining patients through the care continuum
- Participated in Secure Horizon exclusive contract in Andover, MA homes
- Participated in Harvard exclusive contract at Westford House
- Managed a case load of 25 patients.
Staff Development Coordinator
Westford House
03.1998 - 04.2000
- Member of management team that planned, coordinated, and implemented educational programs for every department throughout the center
- Planned yearly in-service education fair
- Participated in interviewing and hiring employees in all departments.
Sub-Acute Staff Nurse
Westford House
05.1995 - 03.1998
- Provided medical care to those in need including but not limited to diabetic teaching, wound care, physical restrictions related to cardiac and respiratory status, care of the patient requiring TPN, medications, and care of the terminally ill
- Assisted medical director with coordination of protocols for patients on Heparin drips.
Education
Bachelor of Science Nursing -
Rivier College
Nashua, NH01.1995
Associates Degree in Nursing RN -
Rivier College
Nashua, NH01.1993
Skills
- Excellent management and leadership abilities
- Ability to manage and prioritize daily work effectively
- Excellent communication skills
- Fast learner
- Familiar and comfortable with Human Resource concepts of management
- Broad knowledge of regulatory and accreditation standards including NCQA and CMS
Timeline
Senior Manager-ICM-Nursing
Point32Health
08.2022 - Current
Manager, ICM-Nursing
Point32Health
08.2019 - 08.2022
Care Manager Relationship Manager
Tufts Health Plan
07.2018 - 08.2019
Clinical Quality Specialist
Genesis HealthCare
02.2011 - 07.2018
Director of Nurses
Westford House
02.2006 - 02.2011
Unit Manager
Westford House
01.2005 - 03.2006
Staff Development Coordinator
Westford House
11.2003 - 01.2005
Unit Manager
Westford House
05.2002 - 11.2003
Regional Case Manager
Genesis HealthCare
05.2000 - 05.2002
Staff Development Coordinator
Westford House
03.1998 - 04.2000
Sub-Acute Staff Nurse
Westford House
05.1995 - 03.1998
Bachelor of Science Nursing -
Rivier College
Associates Degree in Nursing RN -
Rivier College
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