BRIDGETTE Y. RUTLEDGE

• Develop and integrate strategies to enhance care coordination, transition of care communication, enhance quality of care for patient satisfaction and quality health outcomes.
• Oversight of department and corporate goal setting of strategic plans centered on team building, staffing development, hiring and retention.
• Increased case management staffing compromised of RN, SW and case management technicians from 50% to 100% with a retention rate of 90%. Department turnover rate of less than 10%.
• Work collaboratively with central utilization department to decrease denials and reduction of readmission by 50% through early identification of risk factors, proactive appropriate care transition identification by initiation of case management presence in the emergency department, increased knowledge base of unit case managers through monthly educational sessions, spearheaded physician and case management daily discharge discussions to decrease discharge stagnation, early identification of potential discharge barriers to increase throughout.
• Ensure compliance with government and regulatory agencies.
• Evaluation of patient care data to ensure care coordination is provided in accordance with clinical guidelines and best practice organizational standards.
• Development and improvement of clinical pathways for clinical documentation integrity that enhances cost effectiveness while providing quality care documentation compliance.
• Spearheaded and work collaboratively with hospital executives regarding budget, hospital throughput initiatives, and building interdisciplinary interdepartmental relationships for increased care transition discussions with appropriate timely discharge execution from 25% to 75%.
• Increased provider relationships 80% from 40% through collaborative efforts centered on service improvement, patient advocacy, and activities associated with continuum of care.

• Steered care management team in goals and initiatives that were congruent with department metrics related to length of stay, observation compliance, and patient satisfaction. Identified and implemented strategies to reduce access days and improve department compliance metrics. Restructured utilization review team that resulted in 50% reduction in denials, increased authorizations and reduced monthly AR from 3 million first quarter of 2021 to consistently below 1.2 million. Built and sustained relationships with post-acute care providers and payer contracts for improved continuity of care.
• Fostered positive relationships through transformational/servant leadership and promotion of collaborative culture, transparency, accountability, fostering innovation, and encouraging professional growth.
• 10% reduction in staff turnover in last quarter of 2020 by partnering with corporate education leadership for improved training and development of a structured onboarding process. Appointed RN leads and implemented a professional case management counsel involved in interviewing, hiring and retention process.
• Spearheaded and co-piloted with corporate leadership the development of the Child Advocacy Protection Committee to streamline the workflow process for APS, childcare and family welfare issues.

• Performed organizational leadership in alignment with hospital mission, vision, and strategic goals.
• Development and management of quality improvement programs related to care transition.
• Management of utilization with aversion of loss of Medicare status through restructuring of staff.
• Monitored and improved key performance indicator trends related to LOS, and revenue cycle management.
• Increased attendance of interdisciplinary rounds from 30% to 100% of care team.
• Implemented monthly CEU sessions that fostered employee professional growth and development.
• Developed and lead staffing strategies that improved employee engagement and retention initiatives.
• Built and sustained positive collaborative relationships with physicians and corporate leadership team.
• Skillfully managed contract, appeal, and denial negotiations.
• Co-Piloted initiatives for physician education with Clinical Documentation Integrity to reduce denials.
• Developed and lead CHF readmission reduction committee.
• Developed and lead community outreach programs in form of health and job fairs.
• Developed strategic planning initiatives focused on discharge planning, care transition, utilization management, best practice quality initiatives and regulatory requirements.

• Program manager for HAP Embedded Case Manager Program. Piloted and lead population health management of high-risk readmissions in fast paced internal medicine clinic. Program geared towards Medicare beneficiary population.
• Developed education, care coordination and telephonic monitoring of chronic disease management population.
• Performed skillful knowledge of NCQA & CMS guidelines.
• Identified and effectively managed gaps in care initiatives.
• Identified and managed HEDIS initiatives within the assigned population.
• Built and sustained collaboration with clinical care team and physicians with multidisciplinary rounds.
• Provided patient empowerment with a 60% reduction in overuse of ED and improved cost containment.
• Preceptor and team builder of new hires.
• Facilitated staff meetings, reviewed readmission trends, quality metrics.
• Increased outpatient satisfaction scores from 50% to 85% with the implementation of transitional care management program.

• Performed leadership initiatives in alignment with company vision, mission, and strategic goals.
• Increase efficiency of quality health care services, developed patient/family centered care initiatives.
• Developed and managed staffing strategies for hiring, training with a 50% increase in staff retention.
• Managed revenue cycle management, decreased denials, and improved authorizations by 75% from 45%.
• Chaired the Ethics committee.
• Proactively identified and resolved operational issues.
• CMS/TJC Regulatory Compliance management.

Company unexpectedly moved location

• Emergency team collaboration for appropriate patient status and placement.
• Performed utilization management in collaboration with payers.
• Effective management of observation hours.
• Skillful use of InterQual criteria.
• Developed and lead team rounds in emergency room and fostered team collaboration.
• Reduced stagnation of patient flow and throughput.
• Built collaboration with registration team to increase timely identification of payer and patient disposition.