Delizia Cappellini Gallivan
San Antonio,TX
Summary
Experienced leader with strong background in guiding teams, managing complex projects, and achieving strategic objectives, while maintaining set budget. Excels in developing efficient processes, ensuring high standards, and aligning efforts and meeting organizational goals. Known for collaborative approach and commitment to excellence.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Healthcare Director
HURON CONSULTING GROUP
05.2018 - Current
- Perform gap analysis and assess for opportunities for improve performance
- Assess for opportunities that drive improvement for standard work while maintaining a set budget
- Seek opportunities and advancements utilizing data analytics and AI that can facilitate with operations and efficiencies
- Provide design solutions and lead implementation
- Oversee the implementation of action plans and monitors progress toward goals assisting with addressing barriers and challenges and making adjustments as needed in a supportive, synergistic manner
- Evaluate processes and adjust processes as needed
- Ensure sustainability and accountability standards are in place
- Lead work groups and training sessions
- Build client relationships
- Spearheaded and implemented new projects to expand scope of engagement.
- Collaborate with executive leadership to ensure leading practice is in place
- Assess for reimbursement from payors and review clinical denials
- Coordinated with external partners such as insurance companies and government agencies to secure funding for essential health programs
- Enhanced patient care quality by implementing innovative health programs and services
- Monitored and completed health policy mandates and program directives
- Ensured compliance with federal, state, and local regulations related to healthcare delivery and patient privacy
- Streamlined operational processes for increased efficiency in delivering healthcare services
- Developed policies and procedures on accountability metrics stressing department-wide compliance to state and federal laws
- Managed budgets and resources, ensuring optimal allocation of funds for departmental needs.
- Delivered recommendations and requests to senior leaders to improve ease and effectiveness of daily health services operations
- Facilitated open communication channels among team members, fostering collaboration towards shared goals in patient care outcomes
- Implemented staff training programs focused on enhancing clinical skills and improving service delivery standards
- Reduced hospital readmission rates through effective discharge planning and follow-up procedures
Regional Director Case Management, Market
BAPTIST HEALTH SYSTEM
11.2015 - 05.2018
- Collaborate with the Corporate Director for Performance Excellence and oversee hospital case management operations for the San Antonio Market
- Serves as a member of the Regional Performance Excellence team to improve patient throughput and implement standard work
- Lead continuous improvement initiatives and case management revenue cycle and patient throughput best practice strategies in the assigned region to achieve organizational goals through standardized processes
- Key focus on redesigning case management work to improve quality, service and throughput while achieving cost efficiency and productivity targets in the San Antonio Market
- Facilitate the assessment, planning and implementation of consistent standardized processes based on identified opportunities that drive improved patient care and capacity
- Develop and implement best practices to achieve organizational goals through effectively leading and managing change in a matrix environment
- Oversee the implementation of action plans and monitors progress toward goals assisting with addressing barriers and challenges and making adjustments as needed in a supportive, synergistic manner
- Collaborate with medical and nursing leadership, PE team members, resource management, case management/social work, discharge planning and utilization management to develop and implement methods to optimize use of hospital services
- Work with hospital and regional administrative team to recruit and onboard excellent candidate for key leadership and case management positions
- Provide analysis and education regarding regulatory and clinical changes impacting inpatient throughput process and hospital reimbursement
- Provide education and tools for educating physicians regarding inpatient throughput process standards
- Provide guidance to ensure patient throughput goals - including length of stay and care variation - are met by working with interdisciplinary teams and entities to coordinate patient flow into and through the hospital
- Work in alignment with assigned Regional leadership team and consistently demonstrates ability to:
- Lead and collaborate with teams
- Build trusting relationships with hospital and regional leaders
- Build collaborative partnerships
- Achieve labor targets and meet budget or each hospital in the San Antonio Market
- Identify process inefficiencies via root cause analysis and design work flow to address
- Conduct financial analysis and provide budget input as needed
- Develop and implement action plans managing follow up to achieve outcomes
- Implement targeted process changes including ongoing metric monitoring and management to achieve goals and drive improvement
- Overall responsibility for the hospital assigned for utilization performance improvement and operational management of the Case Management Department in order to promote effective utilization of hospital resources, ensure processes support appropriate reimbursement for services rendered, support efficient patient throughput, and ensure compliance with all state and federal regulations related to case management services
- Responsible for oversight to integrate national standards for case management scope of services including:
- Utilization Management supporting medical necessity and denial prevention
- Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction
- Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care
- Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy
- Centralization of utilization review team to reduce denials and develop consistent workflow and procedures in accordance with our policy
- Manage 100+ FTEs
Director of Case Management-Northeast Methodist Hospital
METHODIST HEALTHCARE SYSTEM
12.2012 - 11.2015
- Operationalized the MHS model of Case Management at facility level, taking into account demographic difference, yet still achieving consistent application of policies/procedures
- Leveraged data analytics insights for informed decision-making in critical areas such as sales forecasting, budgeting set by CFO
- Optimized staff performance by designing comprehensive training programs tailored to individual needs.
- Developed high-performing teams by providing mentorship, guidance, and opportunities for professional growth.
- Improved project efficiency with strategic planning, resource allocation, and time management practices.
- Identify trend of practice utilization, or reimbursement that may subject system to the financial risk
- Collaborate with administration, inpatient directors and other ancillary departments for resource management
- Establish and maintain and effective communication and reporting process with the Medical staff, administration, nursing and other ancillary departments that will allow them to participate in achieving clinical and financial performance goals
- Understand and communicates business ethics, state and federal regulatory requirements to department staff to ensure compliance
- Implemented new case management model for staff to create efficiency and streamline process for workflow
- Serve as an expert witness for ALJ cases
- Received People Pillar Award for Employee engagement scores for 2014 for 97%
- Interim Director for ICU/PCU from May 2013-Aug 2013
- Process improvement and decrease of ambulance bills of up to 6% from 2013 to 2014
- Co-chair of throughput committee
- Utilize DMAIC to organize work flow process
- Manage 12.0 FTE
- Engagement Scores for 2015 94%
Director of Cardiovascular Transitional Service Unit
METROPOLITAN METHODIST HOSPITAL
09.2010 - 12.2012
- Successfully opened and Directed care of Cardiac Telemetry/Post-Catheterization Unit at Metropolitan Methodist Hospital
- Instituted budget and staffing ratio to ensure productivity guidelines were met
- Developed and implemented a plan of care for patient and patient flow for admissions
- Cultivated a positive work environment that fostered employee engagement, increased retention rates, and boosted overall team morale
- Developed high-performing teams by providing mentorship, guidance, and opportunities for professional growth
- Established a culture of continuous improvement by fostering open communication channels and empowering employees to voice their ideas.
- Strengthened internal controls by reviewing existing policies and procedures, ensuring compliance with regulatory requirements
- Negotiated favorable contracts with vendors for reduced costs and improved service quality
- Implemented an educational residency program for development of nursing staff
- Collaborated with administrative team regarding admission criteria for unit
- Initiated performance improvement plan for unit and service excellence initiatives and collaborated with quality department to ensure measures of success
- Developed and implemented productivity budget and staffing ratio plan with approval from CFO
- Patient satisfaction committee for special project
- Standards of Excellence committee
- Received Pillar Award for patient satisfaction scores in the 95th percentile in 2011
- Manage 60.0 + FTE
Director of Cardiovascular Unit
NORTHEAST BAPTIST HOSPITAL
02.2007 - 04.2009
- Opened Cardiovascular Unit at Northeast Baptist Hospital
- Educational and residency program for development of nursing staff
- Collaborated with physicians regarding admission criteria for unit
- Cultivated a positive work environment that fostered employee engagement, increased retention rates, and boosted overall team morale
- Instituted budget and staffing ratio to ensure productivity guidelines were met
- Ensured productivity was made every month
- 99% patient satisfaction scores
- Initiated performance improvement plan for unit and service excellence initiatives
- Created code of conduct for unit to coincide with mission of Baptist
- Success with Core Measures and outcomes above benchmark
- Six Sigma Lean Experience
- Heart Care Trainer
- Cultivated a positive work environment that fostered employee engagement, increased retention rates, and boosted overall team morale
- Manage 30.0 + FTE
- Developed high-performing teams by providing mentorship, guidance, and opportunities for professional growth.
Education
Master's - Health Administration
Webster's University
St. Louis, MO10.2013
Bachelors of Science - Nursing
University of the Incarnate Word
San Antonio, TX12.1996
Skills
- Performance improvement and monitoring
- Budget management
- Leadership skills
- Compliance knowledge of CMS regulations for CM
- Staff Recruitment & Training
- Revenue Cycle
- Physician Relations
- Process Enhancements & Strategy
- Performance Tracking & Reviews
- Resource Management
- Patient Satisfaction Scores
- Operations management
- Quality improvement
- Healthcare regulations
- Patient safety
- Staff development
- Training and education
- Healthcare administration
- Teamwork and collaboration
- Self motivated
- Effective communication
- Critical thinking
- Professionalism
- Relationship building
- Public speaking
- Written communication
Community Service
Volunteer Cantor for church
San Antonio Family Association volunteer
Jail Ministry
Active volunteer with teens at parish
Habitat for Humanity
Certification
- Licensed Registered Nurse in Texas 27 years
- InterQual Resource Certification
Languages
Spanish
Limited Working
Timeline
Healthcare Director
HURON CONSULTING GROUP
05.2018 - Current
Regional Director Case Management, Market
BAPTIST HEALTH SYSTEM
11.2015 - 05.2018
Director of Case Management-Northeast Methodist Hospital
METHODIST HEALTHCARE SYSTEM
12.2012 - 11.2015
Director of Cardiovascular Transitional Service Unit
METROPOLITAN METHODIST HOSPITAL
09.2010 - 12.2012
Director of Cardiovascular Unit
NORTHEAST BAPTIST HOSPITAL
02.2007 - 04.2009
Bachelors of Science - Nursing
University of the Incarnate Word
- Licensed Registered Nurse in Texas 27 years
- InterQual Resource Certification
Master's - Health Administration
Webster's University
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