Gail Abeyta
Pueblo,CO
Summary
Results-driven Nurse Leader with 30 years of experience in patient care management and team coordination. Developed efficient care delivery models and ensured regulatory compliance, leading to enhanced operational efficiency and patient satisfaction.
Overview
31
31
years of professional experience
1
1
Certification
Work History
Director of Care Management
Commonspirit St Francis and Interquest
Colorado Springs, Colorado
06.2024 - Current
- Managed operations of care management, social work, and utilization management, ensuring alignment with regulatory compliance standards.
- Developed care management strategies to enhance patient outcomes and satisfaction.
- Led committees on length of stay, utilization management, throughput, and readmissions to improve patient care and resource management.
- Standardized processes across Penrose, St Francis, and St Francis Interquest Hospitals to enhance operational consistency.
Director of Care Management
UCHealth Parkview and Pueblo West
Pueblo, CO
07.2017 - 06.2024
- Managed the operations of Care Management, Social Work, Utilization Management, and Clinical Documentation Integrity Services.
- Led initiatives to improve health outcomes by addressing social determinants of health (SDoH) through collaboration with internal and external stakeholders
- Developed Health Equity Steering Committee to address disparities in patient care.
- Monitored and reported on departmental and organizational outcome measures to ensure compliance and drive improvements
- Assisted in maintaining hospital revenue integrity by ensuring accurate billing processes.
- Supported change management through EHR conversion and implementation of electronic systems for predictive analysis, external referral management, and clinical pathways
- Align departmental policies with regulatory requirements
- Assisted in the development of new service lines to expand patient care offerings.
- Contributed as a member of the Hospital Ethics Committee.
Director of Care Management
Centura Health
Pueblo, CO
06.2008 - 06.2017
- Developed care management strategies to enhance patient outcomes and satisfaction.
- Developed post acute transitional care coordination, improving patient access to necessary services and enhancing population health management.
- Managed operations of case management, utilization management, clinical documentation integrity, palliative care, and transition in care services.
- Implemented quality improvement programs that streamlined care processes and workflows, enhancing overall care delivery.
- Oversaw compliance with regulatory standards and organizational policies, ensuring high-quality care management and minimizing risk.
Clinical Documentation Specialist; Care Management
Centura Health
Pueblo, CO
05.2005 - 06.2008
- Developed and implemented Clinical Documentation Integrity Program to enhance accuracy and compliance in documentation practices
- Enhanced Case Mix Index through targeted improvements in EHR documentation quality
- Partnered with interdisciplinary teams to identify and address gaps in clinical documentation processes, fostering continuous improvement
RN - Critical Care
Centura Health
Pueblo, CO
06.1995 - 05.2005
- Achieved critical care and trauma certifications.
RN- Hospice
Sangre de Cristo Hospice
09.1996 - 05.1997
Education
MSN -
Western Governors University
BSN -
Colorado State University-Pueblo
Skills
- Social Determinants of Health
- Motivational Interviewing
- Ethics
Certification
- Colorado Registered Nurse Licensure
- CSU Executive Leadership
- ACMA Case Management Administrator Certificate
Timeline
Director of Care Management
Commonspirit St Francis and Interquest
06.2024 - Current
Director of Care Management
UCHealth Parkview and Pueblo West
07.2017 - 06.2024
Director of Care Management
Centura Health
06.2008 - 06.2017
Clinical Documentation Specialist; Care Management
Centura Health
05.2005 - 06.2008
RN- Hospice
Sangre de Cristo Hospice
09.1996 - 05.1997
RN - Critical Care
Centura Health
06.1995 - 05.2005
MSN -
Western Governors University
BSN -
Colorado State University-Pueblo