Angela Carter
Greensboro,NC
Summary
Dedicated healthcare professional with over 30 years of experience. Strong history of leading successful teams to meet established goals and objectives. Skilled in working under pressure and adapting to new situations and challenges. Strength in building and maintaining relationships with diverse range of stakeholders in dynamic, fast-paced settings. Eager to grow and support any team to achieve outcomes.
Overview
35
35
years of professional experience
1
1
Certification
Work History
Senior Director, Corporate Case Management
Novant Health
11.2012 - Current
- Responsible for strategic direction and operational oversight for case management at 6 acute care facilities in the Greater Winston Salem Market and 1 facility Eastern NC (2012-2019). Acquired Greater Charlotte Market responsibilities (2019). Acquired Additional Coastal Market responsibilities (2022). Currently oversee >300 FTE's and 15 acute care facilities.
- Led corporate redesign of case management which resulted in $1.8 million dollar expense reduction.
- Improvement in length of stay Vizient metrics for all acute care facilities in 2023.
- Remote centralized resource centers created to support discharge planning tasks which allowed for expansion to support community hospitals in addition to large medical centers.
- Assisted in creation of organizations first post-acute skilled nursing facility and home health network which resulted in over 70% of patients consistently discharged to higher quality facilities.
- Develop and maintain relationships with key industry partners, fostering collaboration and mutual growth opportunities.
- Creates strategy and provides leadership to achieve highest level outcomes including but not limited to quality, safety, financial vitality, employee and customer satisfaction.
- Executed ride share platform (education/training, scripting, criteria development.
- Developed comprehensive case management score card to monitor leading indicators aligned with system goals.
- Reviews quality data and implements standardized process improvements for departments under my leadership.
- Fosters work culture of collaboration and inclusion to increase morale and reduce turnover.
- Navigate complex regulatory environments to ensure compliance with state and federal laws, standards, and regulations.
- Leverages professional networks and industry knowledge to strengthen relationships.
- Active recruitment top-tier candidates from diverse backgrounds while implementing robust training programs for skill development across all levels of staff members.
- Cultivate positive environment with team to maintain high morale and promote employee retention.
- Perform continuous evaluations of business, teams and policies to keep operations efficient, effective and consistent.
- Evaluate best practice performance and implement in all areas of organization to optimize performance.
- Formed strategic partnerships and connected with internal and external customers to enhance service line.
- Implemented cost-saving measures through effective resource allocation and budget management.
- Negotiate contracts with DME suppliers, securing favorable terms that improve overall quality of care and customer satisfaction.
- Achieved departmental goals by developing and implementing strategic plans and initiatives.
Director, Case Management / Utilization Management
Novant Health
11.2011 - 11.2012
- Operational leader for 6 acute care facilities for care coordination and utilization management.
- Created nursing hand-off process for patients discharging to SNF which is now system wide.
- Co-developed level of care algorithm with interdisciplinary team to support patients being evaluated for least restrictive environment.
- Year over year improvement of employee engagement Press Ganey scores.
- Standardized case management workflows.
- Managed budgets effectively to ensure optimal use of resources while maintaining financial stability.
- Strengthened internal controls by reviewing existing policies and procedures, ensuring compliance with regulatory requirements.
Interim Director, Case Management/Utilization Management
Novant Health
01.2011 - 11.2011
- Oversaw development of department specific goals, ensuring alignment with goals of business units.
- Maintains compliance with regulatory standards, Medicare conditions of participation.
- Spearheaded change management initiatives, guiding staff through transitions smoothly and efficiently.
- Oversaw daily operations, ensuring smooth workflows and timely completion of tasks.
Supervisor, Utilization Management
Novant Health
06.2006 - 01.2011
- Oversaw development of department specific goals, ensuring alignment with system goals.
- Maintain compliance with regulatory standards.
- Development of corporate utilization management plan and utilization management committee structure.
- Reduction of 3 million dollars in medical necessity denials.
- Designed and implemented new skill mix model.
- Streamlined operations for increased efficiency through regular process reviews and implementing necessary changes.
- Solicited customer feedback to identify and improve on areas of weakness.
- Established performance metrics for team, consistently tracking progress towards goals and making adjustments as needed.
- Handled customer concerns to resolve issues and adjust policies and practices in accordance.
- Developed provider education and presented educational material to various provider groups.
- Led major initiatives within department that drove innovation or addressed critical business challenges.
- Evaluated staff performance and provided coaching to address inefficiencies.
- Audited for compliance and provided individual and team member coaching to improve in areas of performance gaps.
- Mentored newly hired employees and developed training manual to use as reference.
- Cultivated positive relationships with vendors to deliver timely and meet needs of our patients.
Utilization Management Nurse
Novant Health
09.2002 - 06.2006
- Performed admission, concurrent and retrospective reviews based on medical necessity criteria for multiple units including pulmonary, oncology, med-surg, critical care etc.
- Promoted positive work environment by mentoring new nurses and serving as resource for clinical questions and concerns.
- Maintained up-to-date knowledge of payer-specific guidelines to ensure accurate authorizations for medically necessary services.
- Facilitated communication between healthcare providers, patients, families, and insurance carriers to optimize outcomes.
- Participated in team projects, demonstrating ability to work collaboratively and effectively.
Utilization Management Nurse
Medcost
08.1995 - 09.2002
- Performed admission, concurrent and retrospective reviews for medical necessity.
- Trained new utilization review nurses.
- Quality audits.
- Consulted with physician advisor for best practices and second level reviews.
- Maintained up-to-date knowledge of payer-specific guidelines to ensure accurate authorizations for medically necessary services.
- Provided authorizations for hospitals across entire US.
Staff Nurse, Mother-Baby Unit
Forsyth Medical Center
08.1991 - 08.1995
Staff Nurse
Whitaker Rehabilitation
08.1990 - 08.1991
Student Nurse Technician
Forsyth Medical Center
05.1990 - 08.1990
Certified Nurse Assistant
Forsyth Medical Center
01.1989 - 05.1990
Education
Master of Health Administration -
Pfeiffer University
Meisenheimer, NC05.2009
Bachelor of Science in Nursing -
Winston-Salem State University
Winston-Salem, NC05.1992
Associate Degree in Nursing -
Forsyth Technical Community College
Winston-Salem, NC05.1990
Skills
- Creativity and Innovation
- Team member and Leader Development
- Relationship Management
- Strategic Planning
- Budget Management
- Excellent verbal and written communication skills
- Key Performance Indicators
- Policy Implementation
- Managing Operations and Efficiency
- Process Improvement
- Hiring and Retention
Certification
- Accredited Case Manager (ACM)
- InterQual Certified Instructor (IQCI)
- Case Manager Administrator Certified (CMAC)
Personal Information
Title: RN, BSN, MHA, IQCI, ACM-RN, CMAC
References
Available upon request
Certifications / Awards
Accredited Case Management Certification (ACM) -2017 to current
Case Management Administrator Certification (CMAC) -2021 to current
InterQual Certified Instructor Program (IQCI) -2006 to current
Crystal J. Redding Award- 2011
Affiliations
- North Carolina Case Management Association
- National Case Management Association
- Crisis Control Ministries Member at Large
- National ACMA Board Member
- NC ACMA, Secretary
Timeline
Senior Director, Corporate Case Management
Novant Health
11.2012 - Current
Director, Case Management / Utilization Management
Novant Health
11.2011 - 11.2012
Interim Director, Case Management/Utilization Management
Novant Health
01.2011 - 11.2011
Supervisor, Utilization Management
Novant Health
06.2006 - 01.2011
Utilization Management Nurse
Novant Health
09.2002 - 06.2006
Utilization Management Nurse
Medcost
08.1995 - 09.2002
Staff Nurse, Mother-Baby Unit
Forsyth Medical Center
08.1991 - 08.1995
Staff Nurse
Whitaker Rehabilitation
08.1990 - 08.1991
Student Nurse Technician
Forsyth Medical Center
05.1990 - 08.1990
Certified Nurse Assistant
Forsyth Medical Center
01.1989 - 05.1990
Master of Health Administration -
Pfeiffer University
Bachelor of Science in Nursing -
Winston-Salem State University
Associate Degree in Nursing -
Forsyth Technical Community College