Judy Fears

Case Manager for locate and engage program that quickly assess conditions that have most impact on members health, provide education and resources to address members gaps and barriers to care, as well as work with long term complex members for ongoing support.
· Received three Impact Award Bonuses for productivity, diligent and concise documentation and presentation work in 2004.
· Educates members about contracted physicians, facilities and healthcare providers.
· Developed favorable working partnerships and collaborative relationships with members, physicians, and healthcare service providers.
· Partners with social work as appropriate.
· Identifies and refers cases or issues to QI, Subrogation, Underwriting, or other departments as appropriate.

• RN Nurse Navigator for busy Oncology clinic consisting of patient population of 1800 cancer patients and 500 active treatment patients.
• Provide support and resources to oncology patients throughout the healthcare process, from cancer detection to chemotherapy/radiation therapy and beyond.
• Active in process improvement projects including improvements to patient materials and Epic EMR improvements for orders and documentation.
• Public speaking for Breast Cancer Awareness Month at local events.
• Genetics testing coordinator for ordering and sending off Oncotype DX and germline genetics testing. Companies consulted with include Natera, Invitae and Myriad.

• Managed cross product work and initiatives for team of 12 Product Owners for managed care clinical and business documentation system, NexGen TruCare Cloud with focus on clinical appeals, reviews, denials and authorizations.
• Worked key business areas to maximize value and gains for IT investment. Attended SCRUM as needed.
• Identified feature enhancements, managed backlog and roadmap leading to the delivery of cross-department customer success.
• Supported innovation by leading collaboration among Cloud design architects, UX designers, key stakeholders, and IT leadership.

• Implemented new project management processes including team training, budgetary design, process improvement and procurement for new project management software.
• Audit duties including running meetings with government leaders and organizing a new SharePoint.
• Oversight of contracts and project concerns involving multiple government entities.

• Oversaw team of Clinical Systems Analysts creating a more robust TruCare clinical documentation application supporting 20+ million Medicaid/Medicare members and $40+B in sales. Developed and chartered TruCare Council.
• Managed system support and participated in SCRUM with change management, testing, and successfully implementing multiple upgrades and system changes.
• Executed multiple high-profile projects within clinical systems, aligning business with customer’s needs. Areas include claims, authorizations, quality, and payment. Launched pilot of highly valuable offline application for remote workers.
• Chartered and served as project owner and leader for TruCare Council, ensuring information, tools, and structure of the TruCare application were appropriate, effective, and user-friendly.

• Led Epic EMR Systems Builds and Deployments: Delivered business, operational, and project leadership for Epic electronic medical record systems across multiple implementations, ensuring seamless integration and operational efficiency.
• Applied Advanced Project Management Expertise: Utilized Daptiv application, SDLC methodologies, change management processes, and Ernst & Young requirements to drive structured project execution and compliance.
• Supported Epic Implementations and Go-Lives: Contributed to Epic go-live command center operations, issue resolution, and post-implementation support to minimize disruptions and optimize system performance.
• Enhanced Security and Quality Initiatives: Collaborated on security builds, Meaningful Use compliance, and quality improvement projects, including chart audits and clinical documentation enhancement efforts.
• Achieved Epic Certifications: Earned certifications in Inpatient Orders and Beacon Oncology modules, enabling specialized configuration and optimization of oncology workflows.
• Fostered Cross-Functional Collaboration: Partnered with physicians, coordinators, clinical informatics professional, and Epic training specialists to validate strategies, promote project alignment, and deliver successful outcomes.

• Worked closely with IT to implement3 clinical applications within a 3-year timeframe including a large-scale phone system, Avaya. Created materials for Learning and Development and utilized ImpactPro predictive modeling as well as Verint phone system data reporting.
• Received promotion to Senior RN as part of a pilot program, resulting in the successful launch of a product saving $16M for WellPoint care management clients in 2-years.
• Worked Medicare/Medicaid disease management programs caring for the top 5 core diseases: COPD, Asthma, Heart Failure, Diabetes and Kidney Failure supporting an unprecedented 1,300 healthcare professionals in a virtual work environment.
• As consultant worked utilization management initiatives monitoring and reducing hospital readmissions.
• Performed level 1 utilization review including precertification according to guidelines.
• Performed chart audits and worked utilization management pool performing intake and authorization submissions.
• Workflows familiar in Medcompass/AssureCare, Milliman Care Guidelines (MCG) and Ingenix ImpactPro.