Laura Bagley
Clanton,AL
Summary
Experienced RN with over 10 years of functional case management leadership experience. Enacts strong and collaborative approach across care continuum and manages workflow to support dynamic teams. Spearheads operational effectiveness and efficiencies to develop quality improvement activities and achieve financial goals.
Overview
29
29
years of professional experience
1
1
Certification
Work History
Manager of Case Management
Maury Regional Health
07.2018 - 09.2023
- Improved case management efficiency by streamlining processes and implementing time-saving technologies.
- Led a team of case managers to achieve higher success rates in client outcomes through regular training and performance evaluations.
- Developed comprehensive case management plans for clients, resulting in improved service delivery and satisfaction.
- Collaborated with cross-functional teams to resolve complex cases, ensuring timely resolution and positive outcomes for clients.
- Established strong relationships with external partners, enhancing collaboration and improving access to resources for clients.
- Implemented data-driven strategies to identify areas for improvement in case management processes, leading to increased productivity and better client outcomes.
- Facilitated interdepartmental meetings focused on interdisciplinary care planning, promoting collaboration between various service providers involved in each client''s care plan.
- Developed and maintained comprehensive policies and procedures for the case management department, ensuring consistency in practice across all team members.
- Structured standardized case management processes to comply with regulatory agency statutes and standards.
- Managed and monitored program activities and evaluated quality for improvement recommendations.
- Streamlined, standardized and implemented case management processes and techniques to maximize revenue cycle.
- Served as corporate resource for compliance and audits to facilitate legal process and appeals.
- Developed and implemented training programs for staff.
- Developed and implemented a Behavioral Health Clinical Liaison program facilitating mental health placement and referral to community services.
- Managed Ortho Navigation program resulting in top revenue producing program.
- Managed Social Workers developing a strong social determinants of health referral program to community resources.
- Coordination with UR to address initial denials, MCG trained, front line appeals for post acute care.
SR Manager Medicare Regulation/Physician Advisor
HCA Corporate
09.2016 - 06.2018
- Oversee daily operations and implementation of physician advisor functions across 180 hospitals.
- Developed physician advisor referral education and policy around the two midnight rule at the corporate level.
- Liaison with external physician advisor vendors to promote excellent clinical outcomes and data analysis.
- Data analysis and reporting r/t Medicare statistics.
- Appeals and calls related to BFCC QIO and RAC reviews.
- Developed education and workflow processes around medical necessity education for Medicare stays.
- Led cross-functional teams to achieve project milestones and deliver high-quality results.
- Spearheaded change management efforts for seamless adoption of new systems or processes among employees.
- Implemented and developed operational standards, policies and procedures.
Manager Case Management, UR, and Home Health
Aurora Medical Center
03.2011 - 08.2016
- Achieved departmental goals by developing and executing strategic plans and performance metrics.
- Facilitated successful cross-functional collaborations for the completion of key projects, fostering strong working relationships among team members. Implemented interdisciplinary rounding decreasing LOS from 4.2 to 2.7 days.
- Cultivated partnerships with external stakeholders to maximize business opportunities and extend network reach within the industry sector.
- Streamlined workflows by identifying bottlenecks in existing systems and proactively addressing these challenges through appropriate solutions implementation. Utilizing daily UR ad Inter-Qual review of Obs and IP and frontline denial processes increased denial recoupment by 900,000 in one year.
- Built high-performing teams through effective recruitment, onboarding, and talent development initiatives. As Patient Experience Committee lead responsible for leading team to top quartile in patient experience scores.
LOD Case Manager/ER RN
US Navy
04.1994 - 03.2011
- Authorized care and case management of surgical and follow up care of wounded veterans returning from Iraq and Afghanistan.
- Worked with Army to develop internet based authorization software for all branches of service.
- ER Manager, Charge and staff nurse across several different bases, duty stations including oversees. Responsible for direct patient care, training and mentoring of junior staff.
- Staff RN in Family Practice, Pediatric and Internal Medicine clinics.
Education
Bachelor of Science - Nursing
Middle Tennessee State University
Murfreesboro, TNBachelor of Science - Biology
Cumberland University
Lebanon, TNSkills
- Staff Development
- Policy implementation
- Quality assurance
- Written and Verbal Communication
- Process improvement
- Team leadership
- Conflict resolution
- Cross-functional collaboration
- InterQual Admissions Criteria
- Performance management
- Readmission Reduction
- Care Coordination
- Utilization Management
Certification
RN Compact Lic
CMAC (Certified Case Manager Administrator)
BLS
Timeline
Manager of Case Management
Maury Regional Health
07.2018 - 09.2023
SR Manager Medicare Regulation/Physician Advisor
HCA Corporate
09.2016 - 06.2018
Manager Case Management, UR, and Home Health
Aurora Medical Center
03.2011 - 08.2016
LOD Case Manager/ER RN
US Navy
04.1994 - 03.2011
Bachelor of Science - Nursing
Middle Tennessee State University
Bachelor of Science - Biology
Cumberland University
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