Jennifer Von Hatten
Aviston,IL
Summary
Results-driven healthcare professional with 18 years of experience in managed care and over 25 years in healthcare. Instrumental in the development and execution of digital concierge programs. Proficient in strategic program development, special initiatives, and operational projects. Demonstrated expertise in data analysis, guidance provision, and fostering team collaboration to drive organizational success.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Business Change Manager
Elevance Health
11.2023 - Current
- Expertise in creating and executing various healthcare and operational strategies and programs, ensuring alignment with organizational goals and regulatory requirements related to Cost of Care Pillars and initiatives such as long length of stay over DRG outliers to gather & analyze the data, deliver to Management team & Medical Directors, and deploy a process to improve the number of cases that go to outlier
- Executed interventions to meet regional targets for IP Pillars (NICU, Readmission, Per Diem, SLOS), including creating key metrics reports and supporting CoC efforts during meetings and reporting
- Led workgroups to manage volume in UM work queues, researching reports, analyzing data, and developing strategies to reduce workload volumes; collaborated with team members to deploy educational initiatives
- Gaining knowledge and collaborating with the launch of Project Raven.
- Develop and implement strategic plans, training documents, job aids, and presentations to support organizational initiatives related to Cost of Care, Cost of Care initiatives, turnaround time (TAT) compliance, team data, Intelliauth (ICA), Digital Concierge Care program, NCQA accreditation, CRQC QIC to name a few
- Managed Utilization Management cases end-to-end, from IP stay approval to Medical Director reviews in ACMP, utilizing MCG, BlueWeb, and Medical Policy & Clinical Guidelines for Commercial Local plans
- Assisted with monitoring TAT compliance, CM & UM metrics, and medical trends, contributing to improved team performance and compliance with key metrics
- Strengthened Carelon partnerships by increasing knowledge of Carelon processes, participating in multi-disciplinary huddles, supporting Carelon migrations, and creating strategic priority documents
- Optimized processes to meet administrative budget targets, supported facility/provider terminations, and monitored daily inpatient elective case reports; assisted with NCQA accreditation and Adobe Pro tasks
- Optimized resources to gain more knowledge with Microsoft tools such as Excel, Powerpoint, and Visio through training and collaboration with associates to then delivered data and results to management team along with senior leadership
- Create and managed leadership huddles and all associate meeting agendas and minutes.
Nurse Care Manager Lead
Anthem, Inc.
09.2015 - 11.2023
- Subject matter expert for the digital programs along with key supporter in the subsequent deployment of the Diabetes Essential (DE), Type 2 Diabetes (T2D) & Heart Failure (CHF) programs that required a very quick turnaround time.
- Manage and oversee the Digital workflows, QRGs, training documents, & schedule along with campaigns and process improvements while collaborating with a variety of teams/departments. Result and outcome driven for expansion and growth of programs and improving the lives of our members. Collaborating with Carelon and leadership in regard to the Tableau Dashboard pertaining to the Digital programs’ data with fostering engagements. Achieved the 2024 CSBD member engagement goal of 20,000 in June.
- Management and analysis of reports in regard to Case Management metrics and data, quality, projects along with the Digital programs.
- Conduct, review and evaluate quality audits for Case Managers, coaching to achieve benchmark & collaborate with PIE team, manager, nurses, etc concerning quality reviews along with delivering opportunities for improvement in data.
- Collaborated with the IN team to support and participated in a client review/audit as well as assisted with preparation for NCQA state audit by conducting audit reviews on cases, presented cases at audit meeting, reviewed results for enhancing growth opportunities
- Subject matter expert with Healthy Returns System (HRS). Subject matter expert & super user for Healthy Innovation Platform (HIP).
- Collaborated in the technical requirements development for the new HIP along with maintaining knowledge of all Case Management program requirements to develop and deployed QRGs & job aides to train associates on HIP
- Served as a key asset in the development of NICU HIP collaborating with essential departments, conducting UAT testing, analysis & training.
- Oversee referrals to outside vendors & providers such as Cleveland Clinic Specialty, Aspire, AWARE, Dispatch Health, Meridian, Ground Game Health, etc.
- Cleveland Clinic has a goal of 500 referrals a year and we achieved that goal in July 2024.
- Strong ability to develop, grow and sustain relationships with multiple business areas such as the sales team, workforce management team, HRS team, reporting team, Digital, Anthem Israel, Sidekick, telephony team along with organizational & senior leadership.
- Developed documents in a variety of areas, QRGs, & tools for performance and metric tracking along with new pilots/programs.
- Fostering & planning for new opportunities to improve processes and procedures to ensuring compliance with regulatory and organizational standards.
Education
Master of Arts in Human Resource Development & Management and Leadership -
Webster University
St. Louis, MO08.2010
Bachelor of Science in Nursing -
Southern Illinois University at Edwardsville
Edwardsville, IL12.2001
Skills
- Change Management
- Six Sigma Green Belt
- Strategic and Operational Projects, Programs, and Planning
- Interdisciplinary and Cross-Functional Collaboration
- Process Improvements and Performance Tracking
- Quality Audits, NCQA Accreditation, Laws, Rules & Regulations
- Decision-Making and Problem-Solving
- Organization, Time Management and Multitasking
- Data and Trend Analysis
- Cost of Care and Inpatient Pillars
- Utilization Management, Case Management, Managed Care
- Analytical and Critical Thinking
- Teamwork and Collaboration
- Reliable and trustworthy
- Customer Service and Professionalism
- MS Office
- Healthy Returns System
- Healthy Innovation Platform
Certification
- Case Management Certification, St. Louis, MO, 2011
- Lean Six Sigma – Green Belt, University of Dayton Center for Leadership, Dayton, OH, 12/2022
Organizations
- HYPE/MERGE Business Resource Group-Committee Chair and Site Lead from 2016 to 2019
- WIN and WAVE
- National and Gateway MS Society
- International Organization of Multiple Sclerosis Nurses
Timeline
Business Change Manager
Elevance Health
11.2023 - Current
Nurse Care Manager Lead
Anthem, Inc.
09.2015 - 11.2023
Master of Arts in Human Resource Development & Management and Leadership -
Webster University
Bachelor of Science in Nursing -
Southern Illinois University at Edwardsville