Holly Conger
Savannah
Summary
Motivated and detail-oriented Speech-Language Pathologist with almost 20 years of experience in healthcare operations, utilization management, and direct patient care, seeking to leverage my expertise in care coordination, case management, patient care, medical necessity review and interdisciplinary collaboration in a non-clinical healthcare role. Eager to contribute to healthcare innovations and operations by utilizing strong analytical skills, a deep understanding of patient needs, and commitment to improving health/patient outcomes. Open to roles in utilization management/medical necessity review, healthcare administration, patient advocacy, care coordination, device medical sales, quality improvement, healthcare consulting, or care transition coordination/liaison.
Overview
19
19
years of professional experience
1
1
Certification
Work History
Speech-Language Pathologist
Memorial University Medical Center
06.2006 - Current
- FT 2006-2018; PRN 2018-current
- Evaluate, develop and implement individualized treatment plans tailored to each patient's specific cognitive-communication and dysphagia needs.
- Collaborate with interdisciplinary teams to enhance patient care, achieve maximum outcomes and good quality of care and optimize rehabilitation strategies for each patient
- Participated in numerous departmental and hospital wide committees to enhance patient and team satisfaction (team member satisfaction committee)
- Participated on fundraiser committee for Uncorked event: assisted in organizing event, planned a fundraiser to raise money for the trauma department and ER
- On CARF committee for Brain Injury Certification in inpatient rehab
- Provide dietary in-services to nutrition team on importance of placing appropriate diet consistencies on patient’s trays to ensure accuracy for diet orders and improve patient safety
- Adjust treatment plans based on progress/lack of progress and data analysis and provided education to patients, their families and treating staff
- Continuously communicate with team regarding changes in patient status for cognitive-communication and swallowing recommendations
- Student placement coordinator for speech therapy department and supervisor to speech therapy students to meet their school requirements for graduation
- EPIC super user for our hospital software documentation (EMR)
- Perform outpatient Modified Barium Swallow Studies (MBSS) in radiology department
- Participated in several chart audits within the therapy department
- Determine G Codes for progress notes and evaluation documentation
- Served as a mentor for new Speech-Language Pathologists, providing guidance on best practices while fostering an environment conducive to learning and growth.
Clinical Review Coordinator/Home Health Care Coordinator, Home and Community Division
Optum/UHC
04.2022 - 04.2025
- Responsible for the management of authorization requests for home health services in accordance with CMS and nationally recognized standards
- Evaluated the medical necessity of requests for services by analyzing clinical data for Medicare Advantage members and delivering actionable insights that optimize care decisions and reduce unnecessary services.
- Collaborated with Medical Directors and/or health plan care management staff to determine the most appropriate course of action for a member based on clinical factors
- Exceeded and maintained productivity standards above 90% consistently.
- Demonstrated operational efficiency by optimizing workflow processes, reducing TAT to under 3 hours
- Maintained QAR scores of 100% for 7 consecutive months by utilizing and applying education with great attention to detail and application of work processes/workflows
- Coordinated review processes to ensure compliance with regulatory standards and internal policies.
- Utilized and applied CMS Chapter 7 guidelines/criteria for home health
- Reviewed OASIS documentation/clinical notes and utilized InterQual, CMS Chapter 7 criteria- NCD/LCD, for appropriate authorizations.
- Followed up on providers/agencies as necessary for clarification of clinical documentation of patient’s status
- Collaborated with intake team, home health team, appeals/denials teams, and Medical Directors to ensure efficient processing of home health authorization requests in accordance with mandated TAT and quality metrics
- Investigated, processed, resolved and responded to inquiries and complaints from providers
- Prepared cases for Medical Director's review and notified the health care provider/agencies of denials reviewed by Medical Director
- Participated in regular review of departmental reports on key quality metrics and identified opportunities for systematic improvement
- Maintained knowledge of nationally recognized utilization management, CMS Chapter 7 home health regulations, NCQA and URAC standards of practice
- Ensured reporting/notification requirements were met as related to privacy and regulatory compliance (HIPPA)
- Facilitated communication between stakeholders to resolve issues and clarify review requirements.
Speech-Language Pathologist
Encompass Home Health
06.2018 - 08.2021
- Conducted comprehensive assessments to diagnose speech, language, and swallowing disorders for personalized treatment planning.
- Leveraged patient feedback to continuously improve therapy approaches and techniques.
- Advocated for patients' needs within the healthcare system, facilitating access to resources and support services.
- Established strong relationships with patients and families, fostering trust and collaboration towards shared treatment goals.
- Continuously communicated with team regarding changes in patient status for cognitive-communication and swallowing recommendations
- Team coordinator/leader for annual Alzheimer’s Association Walk
- Previous lead clinician for community involvement for all disciplines (BP clinics, kick-offs, wellness presentations)
- Participated in chart audits to ensure SOC/OASIS are in line with Medicare compliance
- Organized quarterly team building events
- Previously assisted sales team to retrieve face to face physician signatures for POC and attend weekly meetings with ALF/ILF facilities to improve patient care outcomes and obtain new referrals
Speech-Language Pathologist PRN
Encompass Health Rehabilitation Hospital of Savannah
04.2015 - 08.2017
- Treated patients with a variety of diagnosis including TBI, SAH, ICH, CVA, encephalopathy, cancer patients, laryngectomies, and Gillian Barre
- Worked in coordination with team members and other disciplines (MD, neurologists, OT’s, PT’s, nurses, case managers, interpreters, and dieticians) to achieve maximum outcomes and good quality of care for each patient
- Facilitated increased independence in cognitive, communication, swallowing, and physical functioning for cognitive impaired adults
- Continuously communicated with team regarding changes in patient status for cognitive-communication and swallowing recommendations
Education
M.A. - Education, Speech-Language Pathology
Valdosta State University
Valdosta, GA05-2006
B.A. - Science in Education, Communication Disorders (SLP)
Valdosta State University
Valdosta, GA05-2002
Skills
- Adaptable flexible time management conflict resolution ethical judgement negotiation skills organization skills data analysis process improvements team work critical thinking process improvements problem solving documentation review operational strategy CMS regulations/guidelines National and Local Determination (NCD/LCD) External/Internal Stakeholder Engagement Case Management Multi-tasking Independent decision making skills Excellent written/oral communication skills detailed oriented
Certification
- Medicare and Retirement Certification (UHC 2024)
- American Speech-Language and Hearing Association (ASHA) CCC-SLP
- Vital Stim Certified
- Certified Brain Injury Specialist (CBIS)
Technical Profeciencies
- Microsoft Office Applications | Electronic Medical Records (EMR/EHR) | Analytics | Quality Assurance | Metrics/KPI's | InterQual | Oasis | Trouble Shooting | Share Point | Microsoft Teams/Zoom | Pure Cloud | Sales Force | various office equipment includig efax and telephone system | OneNote | Webex | Google Meet
Timeline
Clinical Review Coordinator/Home Health Care Coordinator, Home and Community Division
Optum/UHC
04.2022 - 04.2025
Speech-Language Pathologist
Encompass Home Health
06.2018 - 08.2021
Speech-Language Pathologist PRN
Encompass Health Rehabilitation Hospital of Savannah
04.2015 - 08.2017
Speech-Language Pathologist
Memorial University Medical Center
06.2006 - Current
M.A. - Education, Speech-Language Pathology
Valdosta State University
B.A. - Science in Education, Communication Disorders (SLP)
Valdosta State University
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