Hardworking and motivated Utilization Manager with 19 years of experience and record of success in the Healthcare industry. Solid history balancing team performance, customer service targets and business objectives. Decisive leader with good planning and organizational skills. Seeking a Directors position where my skills, education and experience can effectively contribute to a company’s growth and profit goals.
· Managed a team 90, which was composed of clinical registered nurses and patient care technicians in a 751-bed facility.
· Coached and trained staff how to care for patients on the Pulmonary Hypertension and Cystic Fibrosis unit.
Implemented hourly rounding, which improved our HCAHPS scores
UM Department Manger
Manager with 5 years’ experience in Utilization Management overseeing a department of 70 employees Manages the day-to-day operations of the Utilization Management Department in a tertiary teaching facility, which is the biggest service area in Kaiser Manage RN case managers, Travelers, and FMC clerical staff
FMC UBT Co-Lead
Reached Level 5 status, which is the first in Fontana Medical Center (FMC) Unit Based Team's (UBT) History Our UBT was selected to present our Medicare Meals project in the DA meeting Our project was Medicare Meals Our goal was for our case managers to improve the referral rate of ordering these meals from 53% to 70% When we finished our project, our referral rate was 100% Our UBT was selected to present our Medicare Meals project in the DA Meeting
Team Excellence Award Enhanced Care at Home
Team Excellence Award for our Enhanced Care at Home (ECAH) program This program’s goal was to provide an alternative for patients appropriate for skilled nursing facility (SNF) care The patients in this program are managed in the comfort of their home, and SNF related risks, such as infection, are reduced and allows for patients who need higher acuity to receive care in the SNF An estimated total of 54 million dollars has been saved from SNF diversion This also allows for decreased SNF discharge rate for SBC allowing lower acuity patients to be rehabbed at home, opening SNF bed capacity for higher acuity patients This program was started in SBC
Team Excellence Award Extended Length of Stay
Team Excellence Award for the strong work in reducing our extended length of stay (ELOS) Implemented daily follow-up on action items from CWD rounds and weekly ELOS meetings Implemented real time escalations Instructed case manager to escalate any issues in real time Worked with the interdisciplinary team, which resulted in an significant reduction from May 2023 to July 2023 in ALOS with an estimated 83 million dollars saved for SBC
Implemented On-site DME Hub
Partnered with Apria to implement a curbside pickup for COVID patients who needed oxygen when discharged When COVID was at its peak, this program allowed our patients and family members to drive up at curbside to receive their oxygen An Apria liaison would place the oxygen equipment in their trunk to aid in preventing the spread of COVID from person-to- person This partnership improved throughput and reduced DME delays from 1 week to 2 days
Kaiser Permanente Case Manager On-site Presence at St Mary’s Medical Center
Launched a new initiative that allows our Kaiser case managers to be on-site at Saint Mary’s to ensure that our patients have a safe and appropriate discharge plan This partnership has enabled Kaiser to have oversight over our patients’ care, ensuring that they are receiving quality care This partnership has also assisted in our reducing the length of stay and patient day rate (PDR) My role is to optimize discharge planning to decrease length of stay and eliminate discharge barriers by managing my staff efficiently
Advanced Medica Care at Home (AMCAH)
Collaborated with AMCAH Team in implementing the program at the height of COVID at FMC This program allows our patients to receive IV infusion in the comfort of their home instead of being discharged to a SNF Fontana Medical Center (FMC) did so well in implementing this program that the AMCAH template we used in SBC to launch this program is being utilized in all Kaiser medical centers
Managed members and non-members strike transfers when work stoppage was imminent in November 2021 Received acknowledgement from SBC senior leadership for critical performance in expatriating patients
Enhanced Rounds
Implemented Enhanced rounds to decrease our length of stay Our average length of stay has improved by- 522% December 2022 to December 2023 This was accomplished by increasing employee oversight and instructing staff to escalate in real time Implemented increasing the rounds frequency as well as doing sweeps has also assisted in decreasing our length of stay
American Nurses Association -#03371457
References available upon request.