Deborah Flynn
Sturbridge,MA
Summary
Dynamic healthcare leader with over 16 years of experience in care management and organizational development. Expertise in decision-making and people management, driving initiatives that optimize healthcare delivery and improve patient outcomes.
Overview
22
22
years of professional experience
1
1
Certification
Work History
Director, Care Management
UMass Memorial Health Care
Southbridge, MA
05.2016 - Current
- Led strategic initiatives to enhance patient care quality across multiple departments.
- Developed and implemented operational policies to improve efficiency in healthcare delivery.
- Collaborated with multidisciplinary teams to align organizational goals with clinical programs.
- Analyzed data trends to inform decision-making and optimize resource allocation.
- Mentored staff, fostering professional growth and knowledge sharing within the team.
- Established performance metrics to monitor outcomes and drive continuous improvement initiatives.
- Developed high-performing teams by providing mentorship, guidance, and opportunities for professional growth.
- Enhanced team collaboration through regular communication, goal setting, and performance evaluations.
- Established a culture of continuous improvement by fostering open communication channels and empowering employees to voice their ideas.
- Denials Management: Collaborated with cross-functional teams to resolve complex claims and improve approval rates.
- Denials Management: Analyzed denial trends to identify root causes and implement corrective action plans.
- Denials Management: Reviewed and appealed denied claims, ensuring compliance with regulations and policies.
- Utilization Review: Conducted comprehensive utilization reviews to ensure compliance with regulatory standards.
- Utilization Review: Improved patient outcomes by recommending appropriate levels of care based on clinical assessments.
- Utilization Review: Mentored junior staff in utilization review processes and best practices for efficiency.
- Developed training materials to support staff education on utilization review protocols and compliance requirements.
- Ensured compliance with regulations and accreditation standards by maintaining accurate documentation of all utilization review activities.
- Maintained professional competence by staying current on industry trends, best practices, and regulatory requirements specific to utilization review nursing.
Case Manager- Discharge Planner/Utilization Review Nurse
UMass Memorial Health Care - Harrington Hospital
Southbridge, MA
04.2011 - 05.2016
- Conducted comprehensive assessments to determine patient needs and develop tailored care plans.
- Coordinated multidisciplinary team meetings to ensure holistic patient support and resource allocation.
- Monitored patient progress, adjusting care strategies based on evolving health conditions and feedback.
- Facilitated communication between patients, families, and healthcare providers to enhance care continuity.
- Conducted comprehensive utilization reviews to ensure compliance with regulatory standards.
- Improved patient outcomes by recommending appropriate levels of care based on clinical assessments.
- Ensured compliance with regulations and accreditation standards by maintaining accurate documentation of all utilization review activities.
Cardiac Clinical Trial Nurse
Dr Jang B. Singh
Worcester, MA
05.2004 - 07.2014
- Monitored participant responses and collected data for accuracy and compliance in clinical studies.
- Collaborated with research teams to develop trial procedures and optimize workflow efficiency.
- Evaluated potential participants for eligibility based on inclusion/exclusion criteria, enhancing recruitment efforts.
- Coordinated communication between participants, investigators, and regulatory bodies to address concerns effectively.
- Mitigated risks associated with clinical trials by continually assessing patients for eligibility criteria changes or contraindications to participation.
- Increased participant retention rates through proactive communication, creating a positive experience for patients throughout the trial process.
- Expedited IRB approval process through careful preparation and submission of required documentation in a timely manner.
- Ensured proper handling and storage of investigational products, maintaining compliance with regulatory standards.
- Reduced study deviations by closely adhering to clinical trial protocols and communicating effectively with the research team.
Endocrinology Office Nurse Manager
Wing Memorial Hospital
Palmer, MA
06.2004 - 11.2009
- Coordinated patient intake processes, improving operational efficiency in admissions.
- Educated patients on health management plans, fostering better adherence to treatment protocols. Educated patients on self-care techniques, empowering them to manage their own health effectively.
- Provided compassionate care
Education
Bachelor of Science - Nursing
Anna Maria College
Paxton, MA05-1997
Associate of Science - Nursing
Quinsigamond Community College
Worcester, MA12-1988
Skills
- Relationship building
- Strategic planning
- Verbal and written communication
- Decision-making
- Team management
- Creativity and innovation
- Employee development
- Organizational development
- Goal setting
- Budget management
- Hiring and retention
- Legal and regulatory compliance
Certification
- CCM- Certified Case Manager
- RN - Registered Nurse
- BLS
Timeline
Director, Care Management
UMass Memorial Health Care
05.2016 - Current
Case Manager- Discharge Planner/Utilization Review Nurse
UMass Memorial Health Care - Harrington Hospital
04.2011 - 05.2016
Endocrinology Office Nurse Manager
Wing Memorial Hospital
06.2004 - 11.2009
Cardiac Clinical Trial Nurse
Dr Jang B. Singh
05.2004 - 07.2014
Bachelor of Science - Nursing
Anna Maria College
Associate of Science - Nursing
Quinsigamond Community College