Elizabeth Handline

• Designed and led UM and CM programs to improve performance, ensure compliance, and reduce costs across care settings.
• Directed population health and value-based care strategies aligned with regulatory and client objectives.
• Streamlined workflows through automation and operational redesign to drive efficiency.
• Oversaw staffing models, departmental structure, and vendor compliance for optimal performance.
• Served in interim leadership roles, managing teams and client deliverables at the executive level.
• Used utilization, cost, and quality data to inform strategic recommendations and process improvements.
• Developed policies, KPIs, and reporting tools to support accountability and audit readiness.
• Delivered expert consulting services and executive presentations to national healthcare payers and providers.

• Directed development efforts for nursing staff, social work team, task handling personnel.
• Reviewed employee performance and provided ongoing feedback and coaching to drive performance improvement.
• Achieved 100% effective support for the implementation of in-home providers, ensuring alignment with company financial, operational, and quality goals.
• Directed cross-departmental communications to oversee an ED Utilization Study, achieving a 9% reduction in readmissions.
• Provided leadership, insight and mentoring to newly hired employees to supply knowledge of various company programs.
• Ensured compliance with regulatory requirements and industry standards.
• Analyzed business performance data and forecasted business results for upper management.

• Organized and executed comprehensive health needs support for Medicare members, achieving an increase in engagement rates through effective assessment, planning, and care coordination.
• Provided education to patients and their families on disease management, medications and other treatments.
• Coordinated with healthcare team to establish, enact and evaluate patient care plans.
• Analyzed data from various sources including claims information, laboratory results and medication histories to identify potential risks or gaps in care.
• Conceptualized and implemented the 'Massage at Work' program, resulting in a notable increase in employee productivity, and contributing to the company's recognition as a First Coast Healthiest Company for two consecutive years.

• Assessed appeal claims using utilization management, with emphasis on treatment denials.
• Assessed medical code data and records to validate insurance claim denials.
• Provided critical analytical support to utilization management, effectively preventing unnecessary and duplicate payments, as well as secondary appeals, leading to significant cost reductions.
• Ensured consistent delivery of high-quality care during the appeals process, positively impacting member satisfaction.
• Monitored compliance with regulations pertaining to professional nurse practice standards as well as state laws governing nursing practice.

• Provided strategic leadership at Dance Trance Fitness, transforming it into a global enterprise.
• Achieved multiple awards for outstanding community service and innovative business practices.
• Led a diverse global team, ensuring adherence to standards and policies through effective management.
• Developed clear mission, vision and culture for company as foundation for growth, branding and development of employee culture.

• Led the creation and reorganization of the Mayo Clinic's pre-transplant department, resulting in improved patient care, scheduling, and clinical trial efficiency.
• Honored for outstanding leadership and innovative approach, resulting in a pay rise.
• Earned commendation from the Medical Director for leading a major pre-transplant reorganization that enhanced departmental efficiency and patient care quality.
• Developed and executed a comprehensive patient education system, encompassing group sessions and presentations.
• Acted as patient advocate and implemented total patient care through team nursing process.

• Extracurricular Activities: Certified Executive Leadership and Success board member
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