HEATHER INGRAM RN, MSN
Parrish,FL
Summary
Highly analytical healthcare management executive seeking a leadership role within an integrated delivery system. Twenty years of home health care leadership with a proficiency in financial management, value based patient care and positive quality outcomes. Driven to strengthen teams and motivate employees to outperform expectations. Solid clinical utilization review and case management experience within a Medicare/Medicaid/VA, commerical and managed care plans, and Worker's compensation environment. Strong background in quality assurance, claims analysis and management principles and practices. Adept at analyzing data and performance metrics to create clinical excellence.
Overview
24
24
years of professional experience
Work History
Regional Vice President of Operations
LHC Group
02.2017 - Current
- Led team of 16 Executive Directors in operational development of service network, home health, hospice, and HCBS, including implementation quality requirements and operating standards.
- Daily active patient census 2700+ overseeing 16 agencies within Southwest Florida from Pasco county south to Monroe county.
- Produced in collaboration operational methodologies for creation of dashboards, driver diagrams and KPI reports to evaluate performance, adjust strategies and maintain agile, sustainable operations.
- Designed readiness programs for Value Based Purchasing and Pre-Claim Review for clinical management of staff.
- Lead value based contracting and payor relations strategy, through participation in business development efforts and evaluation of payor density within service area, and expansion of payor contracts to new product lines based on expanding licensure and performance.
- Lead payor partnerships by serving as the main point contact for coordination of escalation for any payor inquiries, issues, and responsibility for owning resolutions.
- Responsible for managing the facilitation of quarterly joint operating committee to review payor performance (P&L, operations, customer satisfaction, etc.).
- Developed and implemented strategies to optimize payor contracts and improve the reimbursement process, including identifying opportunities for new payor agreements and renegotiating existing contracts to enhance terms.
- Responsible for the initiation, development, negotiation, and monitoring of payor and health plan contracts, inclusive of monitoring payor specific requirements, while maintaining and continually developing contractual relationships.
- Established and administered annual budget with effective controls to prevent overage, minimize burn rate and support sustainability objectives.
- Participated as executive in Committee for Continum of Care Development. and Care Experience Committee
- Worked collaboratively with training and development and created clinical best practices, readmission task force, and length of stay initiatives to ensure sustainable transition to home setting.
- Improved inter-operability across departments service lines to further improve care navigation and continuity of care preventing cross functional silos
- Reduced budgetary expenditures by effectively negotiating contracts for more advantageous terms.
- Delivered business strategy and developed systems and procedures to improve operational quality and team efficiency
- Achieved high staff morale and retention through effective communication, prompt problem resolution, proactive supervisory practices and facilitating proactive work environment.
- Applied strong leadership talents to encourage creative thinking, problem solving, and empowerment as part of organization's management group to improve morale and teamwork
- Continually improved knowledge, skills and performance based on feedback and self-identified professional developmental needs.
- Manages relationships and operations with external partners/vendors that provide services as part of the UM program.
- Oversee and direct utilization management department personnel and metrics to ensure compliance with business unit objectives.
- Meet and exceeded regulatory and compliance standards and accreditation requirements by maintaining a continuous quality improvement program that aids in external and internal audits.
- Developed a team by managing the overall activities of the department including employee coaching, development, and review.
- Developed and managed staffing models and operational processes to ensure analysis, data, reports, initiatives, and projects are completed accurately and efficiently to meet organizational and client needs.
- Responsible for assuring the documentation, monitoring, and development of training material and training of departmental staff in utilization management guidelines and processes.
Director of Operations
Gulf City Home Care
12.2008 - 01.2017
- Sarasota to Ft. Myers -Oversaw day-to-day production activities in accordance with business objectives.
- Defined, implemented and revised operational policies and guidelines.
- Lead value based contracting and payor relations strategy, through participation in business development efforts and evaluation of payor density within service area, and expansion of payor contracts to new product lines based on expanding licensure and performance.
- Lead payor partnerships by serving as the main point contact for coordination of escalation for any payor inquiries, issues, and responsibility for owning resolutions.
- Responsible for managing the facilitation of quarterly joint operating committee to review payor performance (P&L, operations, customer satisfaction, etc.).
- Developed and implemented strategies to optimize payor contracts and improve the reimbursement process, including identifying opportunities for new payor agreements and renegotiating existing contracts to enhance terms.
- Responsible for the initiation, development, negotiation, and monitoring of payor and health plan contracts, inclusive of monitoring payor specific requirements, while maintaining and continually developing contractual relationships.
- Maintains up-to-date competitive information, including network participation, network reimbursement, provider incentive arrangements, medical and utilization management practices,
- Foster deep relationships/partnerships with key network/payor and critical third-party decision makers.
- Responsible for Utilization Review - assessing medical necessity, quality of care, appropriateness of decision-making, place of service, and length of treatment for overall efficiency in delivery of health care.
- Monitored budget and utilized operational resources.
- Responsible for case management ensuring achievement of specific goals that support health and behavior change. Ensure appropriate interventions to optimize health and well-being. Collaborate with interdisciplinary team to optimize patient outcomes.
- Set team and individual KPIs and provided regular, actionable feedback.
- Maintain oversight of Quality Assurance/Performance Improvement program for appropriate outcomes, process measures, and hospital readmission rates.
- Monitored office workflow and administrative processes to keep operations running smoothly.
- Responsible for initiating and expanding new contracts with Medicare MA plans and re-negotiating existing contracts with insurance providers
- Modernized and improved operational procedures to increase productivity and profitability while tightly controlling costs.
- Accountable for the overall integration, management, and implementation of the Medicare Risk Adjustment Program.
- Oversee and complete all aspects of Risk Adjustment projects and initiatives.
- Oversee day-to-day risk adjustment related operational activities:
- Led CNA training program and conducted classes for prospective CNAs. Oversaw training of 10-15 students annually. Organized and develop training manuals, classes and competencies, testing and evaluation procedures, and educational materials for clinicians
- Effectively supervised 87 direct care staff, 22 office employees, and additional 29 employees under contract.
Director of Nursing
Omni Home Care Sarasota
03.2007 - 11.2008
- Operational oversight of day to day office management of nursing services and patient care. Participated in ACHA & JCO surveys all were deficiency free
- Responsible for supervising and managing 5 Part B Clinics, Private Duty, and Physician Housecalls, mobile MD service, which included physicians, nurse practitioners, two medical technicians,, and one LPN in office.
Director of Nursing
Family Home Health
08.2004 - 03.2007
- Confidently managed overall operation of nursing services and patient care, including financial management, quality assurance, patient care, safety/risk management, teammate satisfaction, quality index scores and facility maintenance.
Staff RN/Relief Charge
Blake Medical Center Women's Center
12.2003 - 06.2004
- ER/Burn Unit -Wound Center
Staff RN/Relief Charge
Manatee Memorial Hospital
07.2002 - 05.2003
- ER/CVICU/Cardiac-Tele/Behavioral Health
Staff LPN and RN
Sarasota Memorial Hospital
03.2000 - 05.2003
- CVICU/Cardiac/Med-Surg/Behavioral Health
Education
Master of Science - Nursing Education
Walden University
Minneapolis, MN2017
Bachelor of Science - Nursing
University of South Florida
Tampa, FL2003
Associate of Science - Nursing
Manatee Community College
Bradenton, FL2002
LPN - LPN
Manatee Technical Institute
Bradenton, FL2000
Skills
- Strategic Planning
- Performance Optimization
- Joint Ventures and preferred partnerships
- Operations Management
- Relationship Building
- Profitability Improvement
- Effective leader
- Data management
Timeline
Regional Vice President of Operations
LHC Group
02.2017 - Current
Director of Operations
Gulf City Home Care
12.2008 - 01.2017
Director of Nursing
Omni Home Care Sarasota
03.2007 - 11.2008
Director of Nursing
Family Home Health
08.2004 - 03.2007
Staff RN/Relief Charge
Blake Medical Center Women's Center
12.2003 - 06.2004
Staff RN/Relief Charge
Manatee Memorial Hospital
07.2002 - 05.2003
Staff LPN and RN
Sarasota Memorial Hospital
03.2000 - 05.2003
Master of Science - Nursing Education
Walden University
Bachelor of Science - Nursing
University of South Florida
Associate of Science - Nursing
Manatee Community College
LPN - LPN
Manatee Technical Institute
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