Emilie Gutierrez, BSN, RN, CMCN
West Chester,PA
Summary
Nurse leader with over 10 years of experience in clinical programs, patient advocacy, and healthcare economics. Certified in managed care (CMCN). Currently working as Senior Manager Clinical Programs at Payer Matrix, LLC, a company that provides patient advocacy and healthcare solutions for employer-funded health plans. Focuses on development, implementation and managing clinical programs to provide enhanced patient care and to allow for greater cost savings for plan sponsors. Received multiple awards for leadership, professionalism, and dedication to patient care. Passionate about improving patient outcomes and lowering costs through proactive, collaborative, and fundamental managed care.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Sr. Manager of Clinical Programs
Payer Matrix, LLC
03.2023 - Current
- Works alongside CEO, VP Operations, sales, account management and implementation in addition to stakeholders for Self-funded Benefit Plans to provide successful partnership and care coordination with greater positive patient outcomes and lower costs.
- Account manager for over 50 TPAs.
- Lead integration and implementation specialist for new clients and TPA partnerships who elect our medical program.
- Championed process improvement initiatives that led to significant cost savings without compromising on quality standards.
- Successfully developed program to assist patients on medications they cannot afford while partnering with providers to coordinate sustainable therapy options that are affordable for Plan and patient.
- Developed, implemented, and currently managing pilot program aimed at proactive care verses reactive care for those with chronic disease, to provide better patient outcomes and lower healthcare costs.
- Established strong relationships with clients and stakeholders, ensuring long-term partnerships and repeat business.
- Enhanced company reputation by driving successful initiatives that addressed client pain points effectively.
Lead Clinical Care Coordinator
Payer Matrix, LLC
04.2022 - 03.2023
- Led Clinical Care Coordinator team.
- Managed patient care load and worked with Director of Medical Programs to facilitate communication with stakeholders for each client group to provide consistent and streamlined care.
- Researched effective and available programs to provide better patient outcomes and lower client and patient out of pocket costs.
- Developed training process for medically infused drug.
- Spearheaded and implemented new projects to expand scope of engagement.
- Recruited, hired and trained all staff, providing direct supervision, ongoing staff development and continuing education to employees.
Clinical Care Coordinator
Payer Matrix, LLC
10.2021 - 04.2022
- Managed 80-110 patients and coordinated their care with their providers and benefit plans; specifically, those who did not have coverage for Specialty Brand medications
- Built strong relationships with patients and families for optimized care satisfaction.
- Enabled timely service reimbursements by liaising with insurance companies.
- Liaised with other healthcare professionals to develop comprehensive patient care plans and provide highest quality of care.
Health Center Manager
Cerner Corporation – Anuva Health
04.2020 - 10.2021
- Managed three health centers during height of COVID.
- Oversight of all staff members, payroll, quality, and compliance.
- Developed successful COVID Vaccine Clinic for 2,000+ employees.
- Developed and led two Flu Vaccine Clinics for 2,000+ employees.
- Worked alongside Department of Health during height of COVID to ensure compliance and up to date information was provided to staff and patients.
Emergency Room Nurse
Pottstown Hospital
06.2018 - 04.2020
- Lead nurse for complicated and acute cases.
- Trained and precepted new and student nurses.
- Collaborated comfortably and effectively with providers, ED staff and ancillary staffing departments.
- Lead IV nurse and provided education on proper technique.
- EPIC superuser and trainer.
- Daisy Award Honoree.
Nurse Manager Peri-Anesthesia and Infusion Services
Mercy Hospital, Northwest Arkansas
04.2015 - 05.2018
- Managed 70 employees in Infusion Center, Preadmission Testing, Preop Phase 1 and 2, PACU and surgical inpatient unit under direction of Regional Director of Surgical Services and CNO.
- Responsible for day-to-day, payroll, budget, and productivity.
- Developed, proposed and implemented successful inpatient surgical unit soon after taking on position.
- Responsible for day-to-day payroll, budget, and productivity
- Developed and implemented process to track productivity live across six departments in Peri-Op. This led to finding errors in EMR. Once productivity of each department was corrected, it led to increase in revenue by 100k per month. Success of this reporting tool led to its adoption system wide.
- Followed CMS guidelines and core measures.
- Developed cross training program which allowed for redistribution of staff to areas that were understaffed providing increased patient satisfaction and maintenance of productivity.
- Implemented Smart-Square staffing site and designed it to record productivity and staffing ratios.
- Developed program to report and follow outcomes for SCIP measures which led to decrease in surgical site infections.
- Promoted professional development opportunities to encourage nurses to pursue continuous training.
- Conducted performance evaluations and provided constructive feedback to support professional growth of nursing staff members.
House Supervisor
Mercy Hospital, Northwest Arkansas
05.2013 - 04.2015
- Managed staff and hospital need for 250 bed hospital working closely close with CNO and directors to manage patient flow in and out of hospital.
- Led Rapid Response and Cold Blue teams.
- Managed nursing staff schedules to ensure optimal coverage during peak hours and reduced overtime costs.
- Mentored new nurses, providing guidance on hospital policies and procedures, fostering professional growth and development.
- Coordinated staffing needs during emergency situations, ensuring adequate resources were available for patient care.
- Streamlined communication between departments for improved patient flow and satisfaction.
Telemetry/ICU Floor Nurse and Relief Charge Nurse
Mercy Hospital, Northwest Arkansas
08.2011 - 05.2013
- Worked alongside team to take care of 32 telemetry patients.
- Provided exceptional care to high-acute patients needing complex care such as ventilator management, titrating infusions and hemodynamic stability.
- Collaborated with leadership to devise initiatives for improving nursing satisfaction, retention and morale.
- Actively sought opportunities for continuing education relevant to my role as floor nurse in order maintain up-to-date knowledge about emerging trends within profession.
- Participated in quality improvement initiatives aimed at enhancing clinical practice standards across nursing department.
- Voted to lead Shared Governance Steering Committee and Evidence Based Practice Chair.
Education
Bachelor of Science in Nursing -
Western Governors University – Sigma Alpha Pi
01.2020
Associate Degree in Nursing -
Delaware County Community College
05.2011
Skills
- Fiscal Management
- Hiring and Training
- Organizational Development
- Corporate Communications
- Partnership Development
- Troubleshooting and problem resolution
- Cross-Functional Collaboration
- Strategic and Operations Planning
- Professional and Courteous
- Administration and Reporting
- Process Improvement
- Project Planning and Prioritization
- Social Perceptiveness
- Critical Thinking
Certification
- Unencumbered Pennsylvania Nursing License - RN704969
- Certified Managed Care Nurse (CMCN) – 23-7849
Personal Information
Title: BSN, RN, CMCN
Timeline
Sr. Manager of Clinical Programs
Payer Matrix, LLC
03.2023 - Current
Lead Clinical Care Coordinator
Payer Matrix, LLC
04.2022 - 03.2023
Clinical Care Coordinator
Payer Matrix, LLC
10.2021 - 04.2022
Health Center Manager
Cerner Corporation – Anuva Health
04.2020 - 10.2021
Emergency Room Nurse
Pottstown Hospital
06.2018 - 04.2020
Nurse Manager Peri-Anesthesia and Infusion Services
Mercy Hospital, Northwest Arkansas
04.2015 - 05.2018
House Supervisor
Mercy Hospital, Northwest Arkansas
05.2013 - 04.2015
Telemetry/ICU Floor Nurse and Relief Charge Nurse
Mercy Hospital, Northwest Arkansas
08.2011 - 05.2013
Bachelor of Science in Nursing -
Western Governors University – Sigma Alpha Pi
Associate Degree in Nursing -
Delaware County Community College