Angie L. Pacley
Milwaukee,WI
Summary
Diligent clinical healthcare professional with robust background in streamlining clinical operations and enhancing workflow efficiency. Successfully managed cross-functional teams, ensuring seamless project execution and adherence to regulatory standards. Demonstrated leadership and strategic planning skills, fostering collaboration and driving continuous improvement.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Clinical Operations Manager
Hema-Tec Inc
Milwaukee, WI
06.2025 - Current
- Ensure the compliance, support and execution of all relevant company and contracted hospital policies and procedures.
- Cultivate and sustain strong relationships with hospital partners through proactive and timely communication.
- Conduct site visits at least monthly at all five hospital programs to promote and observe Joint Commission readiness through mock audits.
- Evaluate nurse to clinical technician ratios during patient care to maintain effective staffing levels and improve patient outcomes.
- Developed and implemented 'Early Start Initiative' focused on driving process improvements, elevating operational efficiency, and ensuring the highest standards of patient safety.
Clinic Manager
Innovative Renal Care
Milwaukee, WI
01.2025 - 06.2025
- Monitored and reinforced staff compliance with all organizational policies and relevant state, local, and federal healthcare regulatory standards to ensure operational integrity.
- Monitored and maintained high standards of care in collaboration with medical director and physician partners, ensuring optimal service delivery for 60 patients.
- Oversaw hiring initiatives. Led performance evaluations and managed disciplinary procedures for a team of 20 employees.
- Oversaw facility’s technical department, ensuring that all equipment was maintained according to manufacturer’s recommendations, company policies and regulations, RO water met AAMI standards, and the facility maintained in good condition.
Senior Operations Claim Appeal Specialist (Compliance Department)
Fresenius Medical Care North America
Milwaukee, WI
10.2019 - 11.2024
- Achieved compliance with HIPAA standards while efficiently processing reimbursement claims from providers across the country. Facilitated the acquisition of medical records, supporting or denying claims with precision and accuracy. Enhanced documentation review processes, contributing to improved claim resolution outcomes.
- Achieved annual savings exceeding $500,000 by implementing CMS rules and regulations on ESRD consolidated billing.
- Partnered with clinical and laboratory professionals to effectively resolve payment inquiries, ensuring accurate and timely responses to requests.
- Analyzed and submitted response letters to external providers for reimbursement claims related to ESRD services, safeguarding company revenue by clarifying payment responsibilities under Medicare regulations.
Project Manager (Operations Integrity Department)
Fresenius Medical Care North America
Nashville, TN
05.2015 - 10.2019
- Evaluated claims from more than 200 hospitals for end stage renal disease (ESRD) and non-ESRD providers, focusing on laboratory tests, drugs, and supplies relevant to ESRD consolidated billing.
- Provided temporary approval for non-formulary medications, dialyzers, and concentrates for acquisition facilities which ensured 100% of patient care through transition periods.
- Evaluated and verified all received bills for potential ESRD-related services in accordance with contractual agreements with external entities, including rehabilitation pharmacies, to ensure timely reimbursement.
- Consulted with FMS legal counsel and team members to ensure compliance and informed decision-making.
Operations Integrity Staff Auditor (Operations Integrity Department)
Fresenius Medical Care North America
Nashville, TN
11.2008 - 05.2015
- Conducted comprehensive internal audits to ensure compliance with established regulatory standards and organizational policies.
- Formulated comprehensive audit plans and conducted risk assessments to pinpoint opportunities for enhancement.
- Analyzed data and prepared audit summary reports to inform decision-making across facility, regional, divisional, and presidential tiers.
- Facilitated collaboration with billing groups and cross-departmental teams to address reimbursement issues stemming from regulatory noncompliance during claim-filing processes.
- Administered comprehensive knowledge of ESRD regulations, insurance billing rules, and company policies and procedures.
- Conducted in-person presentations and conference calls with Clinical Managers, Regional Quality Managers, Area Managers/Directors of Operations, Educators, and Regional Vice Presidents to discuss details of findings relating to algorithms, billing errors, physician orders, etc.
Area Manager (aka Director of Operations) (Vanderbilt - Managed)
Fresenius Medical Care North America
Nashville, TN
05.2005 - 10.2008
- Designed comprehensive action plans to achieve financial and clinical goals, focusing on decreasing hospitalizations to improve patient outcomes and drive revenue growth for multiple clinics.
- Engaged with Vanderbilt University staff to uphold JCAHO standards while leading team training efforts that fostered professional development and ensured zero deficiencies in Medicare and JCAHO evaluations.
- Cultivated a high-performance environment that enhanced team effectiveness and exceeded stakeholder expectations.
- Engaged with the Regional Vice President to meet expectations of Fresenius Medical Care, CMS conditions for coverage and JCAHO regulations.
- Presented and analyzed clinical and financial outcomes to support strategic decision-making during monthly governing body meetings with Vanderbilt’s nephrology leadership and Fresenius Medical Care team.
Clinical Manager (Vanderbilt - Managed)
Fresenius Medical Care North America
Nashville, TN
05.2003 - 04.2005
- Directed operations for Vanderbilt's new clinic during grand opening, facilitating Medicare certification and patient admissions.
- Spearheaded coordination of educational training programs alongside staff educator, focusing on all aspects of ESRD for both patients and staff.
- Established standards for maintaining a safe and functional physical environment for the patients, staff, and public.
- Collaborated with medical director and director of clinical services to formulate and execute policies enhancing patient care quality.
- Coordinated and scheduled nursing staff to guarantee adequate coverage and support for patient needs.
- Coordinated and led monthly educational programs and staff meetings to foster continuous learning and team engagement.
- Managed clinical operations with a focus on maintaining compliance with regulatory standards and industry best practices.
- Developed and implemented quality improvement initiatives focused on improving patient care outcomes and increasing operational effectiveness.
Education
Associate in Science (Nursing) - Nursing
University of The State of New York, Regents College
Albany, NYPractical Nursing Diploma - Nursing
Mississippi Delta Community College
Moorhead, MSAssociate of Arts - Pre-nursing
Mississippi Delta Community College
Moorhead, MSSkills
- Healthcare Management
- Financial Reporting
- Data Analysis
- Process Improvement
- Quality Assurance
- Team Leadership
- Physician Relations
- Patient Safety and Education
- HIPAA
- Microsoft Office
- ESRD Medicare Regulations
- EMR Documentation Auditing
- Customer Service
Certification
- Certified in Healthcare Compliance (CHC)
- Basic Life Support (BLS)
Additional Experiences
- Manager, Education, and Training (Fresenius Medical Care/Vanderbilt - Managed)
- Team Manager (Fresenius Medical Care/Vanderbilt - Managed)
- Staff Licensed Practical Nurse (Fresenius Medical Care/Vanderbilt – Managed)
- Licensed Practical Nurse (Bolivar County Hospital, Mississippi; Walter B. Crook Nursing Home, Mississippi)
Timeline
Clinical Operations Manager
Hema-Tec Inc
06.2025 - Current
Clinic Manager
Innovative Renal Care
01.2025 - 06.2025
Senior Operations Claim Appeal Specialist (Compliance Department)
Fresenius Medical Care North America
10.2019 - 11.2024
Project Manager (Operations Integrity Department)
Fresenius Medical Care North America
05.2015 - 10.2019
Operations Integrity Staff Auditor (Operations Integrity Department)
Fresenius Medical Care North America
11.2008 - 05.2015
Area Manager (aka Director of Operations) (Vanderbilt - Managed)
Fresenius Medical Care North America
05.2005 - 10.2008
Clinical Manager (Vanderbilt - Managed)
Fresenius Medical Care North America
05.2003 - 04.2005
Associate in Science (Nursing) - Nursing
University of The State of New York, Regents College
Practical Nursing Diploma - Nursing
Mississippi Delta Community College
Associate of Arts - Pre-nursing
Mississippi Delta Community College