Erin Weissenburger, MSN

• Daily Operational Oversight of a team of 35 case managers
• Providing guidance and support to ensure efficient workflow and productivity
• Fostered a culture of continuous improvement by encouraging staff to share innovative ideas and providing resources for professional development.
• Oversaw the daily operations of the hospital-wide Utilization Management (UM) program
• Collaborates with relevant departments to optimize utilization processes and ensure compliance with established protocols
• Analyzes and identifies trends related to denials to address and rectify issues promptly
• Implements strategies to minimize denials and improve the overall efficiency of the case management process
• Ensures that all patients are discharged in a timely, efficient, and safe manner
• Collaborates with healthcare professionals to coordinate post-discharge care and support services
• Regularly assesses and evaluates the effectiveness of processes and make improvements, as necessary
• Provides leadership and mentorship to case management staff
• Facilitates training programs to enhance the skills and knowledge of the team
• Fosters effective communication and collaboration with other departments within the hospital
• Collaborate closely with medical staff, administrators, and external partners to achieve optimal patient outcomes
• Implements strategies for continuous improvement based on performance metrics, such as avoidable day tracking and reporting
• Ensures that resources are allocated efficiently to meet departmental goals.

• Responsible for leading, supervising and mentoring a team of 16 case managers, providing guidance and support to ensure the achievement of team goals and objectives
• Additional responsibilities include revenue cycle reporting, oversight of utilization mangers, and clinical appeals
• Responsible for thirty direct reports including annual performance evaluations, payroll, new employee orientation, interviewing and onboarding of inexperienced staff.
• Trained new team members by relaying information on company procedures and safety requirements.
• Promoted a positive work environment by fostering teamwork, open communication, and employee recognition initiatives.
• Managed schedules, accepted time off requests and found coverage for short shifts.
• Conducted regular progress reviews with individual team members to identify areas for improvement and provide guidance on career development opportunities.

• Maximized the collection of revenue for patient cases through oversight of the appeals and denials process
• Review denials for opportunity for reconsideration with third party payers
• In addition, also responsible for thorough review of the medical record to compose comprehensive appeal letters to defend appeals
• Collaborates closely with the Director of Case Management and Social Work, Physician Advisors, Case Management Team Leads, and Utilization Review nurses.
• Acted as a departmental resource on appeals matters.
• Created, composed and maintained appeal response templates.
• Developed strong working relationships with internal and external stakeholders, fostering a collaborative environment for efficient resolution of appeals.

• Responsible for the coordination of a multidisciplinary plan of care ensuring the delivery of quality patient care that facilitates discharge and expected outcomes, utilizing appropriate and cost effective strategies
• Performs and communicates clinical reviews and data to insurance payers
• Collaborates with health care team to streamline patient care
• Identify system barriers to cost effective quality care
• Familiar with Medicare and managed care payers as well as Interqual criteria.
• Served as a liaison between patients and various support services such as financial assistance programs, community resources, and mental health counseling to ensure holistic care was provided.
• Collaborated with healthcare leaders and physicians to support and offer resources in performance of duties to maintain high-quality and efficient patient care.

Hospital of the University of Pennsylvania, Philadelphia / Wissahickon Hospice, Bala Cynwyd, PA.

• Assisted physicians with diagnostic procedures, ensuring accurate results and seamless coordination of care among healthcare providers.