Leslie A. Ricci
Pittsburgh,PA
Summary
Motivated, personable health care professional with a successful 35 plus year career. Experience includes staff nursing, managed care utilization, care management, behavioral health, revenue cycle, quality/process improvement, patient safety, work redesign, strategic planning, project management, leadership skills and sales. Well accustomed to optimizing workflow and understanding the business needs of an organization to provide the right solution (business strategy, technology, process, and people). Skilled in building customer relationships and understanding customer needs. Strong communication and interpersonal skills for providing superior customer service. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
33
33
years of professional experience
Work History
Sr. Sales Executive
MCG Health
04.2021 - Current
- Sold and negotiated into national strategic accounts
- Finished at 120% to quota 2022 and attended President's Club
- Responsible for direct sales into current client base and new business
- Establish, develop, and maintain positive business and client relationships
- Responsible for strategizing and territory reviews to position value and ROI
- Demonstrated products and features to customers, answered questions and overcame objections.
- Created prospect rapport by approaching leads and cultivating strong business relationships through sales.
- Recognized and resolved compound problems that effected upper-level management and business initiatives.
- Facilitated relationships with target accounts through implementation of proven networking methods.
Sales Director
Deerwalk Part of Cedar Gate Technology
03.2020 - 04.2021
- Responsible for direct sales into current client base and new business
- Strategized with product and development on solution road map and future state
- Presented and demonstrated clinical workflow solution to prospects and current clients
- Responsible for RFP's providing meaningful and constructive responses
- Developed key partnerships with industry-leading organizations to strengthen professional network and expand future business opportunities.
Sr. Account Executive
MCG Health
04.2016 - 03.2020
- Responsible for premium and strategic payer accounts nationally/internationally
- Conduct yearly use case assessment and planning meetings
- Identify accounts needing optimization and MCG support resources
- Retain customer base (100%) and identify upsell opportunities
- Participated in process improvement activities both client specific and MCG internal
- 100% retention and loyalty of current client base
- Met goal for upsell referrals and conversion for $80M book of business
- Employed proactive and collaborative approaches to strengthen relationships and manage customer needs.
- Established customer relationships, interfacing with representatives and collaborating to achieve mutually beneficial results.
Sales Director
Emmi Solutions LLC
06.2015 - 03.2016
- Responsible for direct sales into the current client base for new software
- Developed key partnerships with industry-leading organizations to strengthen professional network and expand future business opportunities.
- Identified gaps in current product based on market and customer base needs
- Worked with Marketing to develop a marketing plan and strategy for EmmiTransition
- Consulted on Transition of Care for Territory Managers during sales process
Account Executive
CoCENTRIX
01.2014 - 06.2015
- Maintain existing customer and revenue base
- Responsible for increasing sales of product and optimization services
- Aligned networking opportunities across the customer base
- Liaison between the customer base and CoCENTRIX Services, Product/Development
- Maintained 100% of existing client base
- 75% conversion rate from legacy to new platform
Regional Sales Executive
Allscripts
03.2014 - 12.2014
- Focus on selling Patient Flow solution
- Net new and existing – East Region
- 1M Quota – less than five months at this position
- Created a business solution consisting of services and software that uniquely addresses the client's needs
- Performed sales demo; negotiated deals
- Responded and coordinated efforts around client issues and managed escalations
Sr. Clinical Transformation Consultant
Allscripts
06.2011 - 03.2014
- Coordinated and facilitated transformation engagements to provide a structured project including data analysis, process mapping, recommendation and validation for future state workflow and application configuration using Lean Six Sigma model for process improvement and ADKAR model for change management
- Provided client recommendations for improvement on current state aligning workflow, technology, business goals and people for greater efficiency and optimization of solution set
- Responsible for internal coordination of services and sales relating to transformation including pre-sale activity with client
- Successfully implemented enterprise care management process and solution at large health systems
- Improved workflow automation to reduce wasted time and resources.
- Guided staff in clinical best practices and evidence-based methods.
- Collected and analyzed key data to make accurate assessments.
Sr. Relationship Manager
Allscripts
01.2010 - 01.2011
- Account Management of large health system hospitals
- Assessment of client's needs for optimization of current application
- Responsible for sale of add on solution/services
- Aligned networking between clients for best practices and solution management
- Planned and attended meetings with clients to cultivate and grow partnerships and opportunities.
Director, UPMC Center for Quality Improvement
University Of Pittsburgh Medical Center
01.2004 - 03.2008
- Worked closely with organizational leadership and board of directors to guide operational strategy.
- Developed and implemented strategic plan for the spread of patient focused projects across the health system
- Trained in work redesign using TPS methodology
- Planned and executed annual Quality & Patient Safety Symposium for the organization, region and international audience
Manager - Interventional Radiology
University Of Pittsburgh Physicians
03.2006 - 01.2008
- Interventional Radiology, UPP
- Managed six Physician Assistant staff within Interventional Radiology & coordinated four physician schedules
- Responsible for outpatient clinic operations
- Scheduled, obtain authorization for patients in clinic receiving Interventional Radiology services
- Educated patients on procedure details, provided instructions, and answered questions to minimize anxiety and improve cooperation.
Director of Payer Call Center
University Of Pittsburgh Medical Center
01.2002 - 01.2006
- Oversaw daily operations for a centralized payer call center including nurses and non-clinicians to support payer call activity across health system for medical necessity. Driving revenue and working with corporate and hospital CFO's
- Involved in evaluating software and decision making towards final vendor selection
- Developed and executed training infrastructure with materials to support health system case management departments for new hires and existing staff.
- Managed reporting and analysis of health system-wide clinical retrospective denials. Reported less than 1% of medical necessity denials system wide
Manager Pre-Certification
UPMC Presbyterian Shadyside
11.1999 - 01.2002
- Managed 22 plus staff in Pre-Arrival process for all admissions including pre-certification. verification and pre-registration
- Implemented Denial Management process for outpatient and inpatient denials with successful turn over rate
- Worked closely with revenue cycle department both acute and physician practices
- Directed a new registration system at UPMC Shadyside Pre-Arrival Center
Utilization Management Coordinator
UPMC Health Plan
03.1998 - 11.1999
- Performed prior authorization review of services requiring notification.
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
- Obtained authorizations from multiple insurance carriers for out of network requests
- Submitted cases for criteria failures and helped facilitate resolutions and approvals.
- Managed Appeals and Grievances through determination
- Worked with in network UPMC UM departments performing pre-assessment surveys for NCQA regulatory standards
Utilization Manager
Intracorp
10.1992 - 03.1998
- Resource Coordinator for the system facilities and health plan affiliated facilities
- Consultant for system case management departments focusing on utilization patterns, resource consumption
- Conducted pre-assessment surveys of newly contracted facilities and annual assessment of existing network facilities of their Utilization Management departments using NCQA guidelines, Utilization Management, HMO, Nurse Advisory Health Line
- Utilization Review Specialist for PPO, EPPO and POS Products
- Team Lead/Mentor for new hires
- Team Lead on Tertiary Appeal process
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
Staff nurse
Allegheny General Hospitals SICU
04.1992 - 04.1993
- In SICU for cardiothoracic patients
Staff nurse
Leslie A Ricci, St Clair Hospital IMC and CCU
05.1990 - 04.1992
- In telemetry unit and CCU
Education
MBA - Healthcare Professionals
Chatham University
Pittsburgh, PA05.2007
Bachelor of Science - Nursing
Carlow University
Pittsburgh, PA12.1998
Associate of Science - Nursing
Community College of Allegheny County
Pittsburgh, PA06.1990
Associate of Science - Medical Assistant
Gannon University
Erie, PA05.1983
Affiliations
Nurse of the Commonwealth of PennsylvaniaMEMBERSHIPS: American Case Management Association (ACMA) - June 2002 to present Founder and Past President of ACMA Western PA Chapter Case Management Society of America (CMSA) – June 2020 to present
Timeline
Sr. Sales Executive
MCG Health
04.2021 - Current
Sales Director
Deerwalk Part of Cedar Gate Technology
03.2020 - 04.2021
Sr. Account Executive
MCG Health
04.2016 - 03.2020
Sales Director
Emmi Solutions LLC
06.2015 - 03.2016
Regional Sales Executive
Allscripts
03.2014 - 12.2014
Account Executive
CoCENTRIX
01.2014 - 06.2015
Sr. Clinical Transformation Consultant
Allscripts
06.2011 - 03.2014
Sr. Relationship Manager
Allscripts
01.2010 - 01.2011
Manager - Interventional Radiology
University Of Pittsburgh Physicians
03.2006 - 01.2008
Director, UPMC Center for Quality Improvement
University Of Pittsburgh Medical Center
01.2004 - 03.2008
Director of Payer Call Center
University Of Pittsburgh Medical Center
01.2002 - 01.2006
Manager Pre-Certification
UPMC Presbyterian Shadyside
11.1999 - 01.2002
Utilization Management Coordinator
UPMC Health Plan
03.1998 - 11.1999
Utilization Manager
Intracorp
10.1992 - 03.1998
Staff nurse
Allegheny General Hospitals SICU
04.1992 - 04.1993
Staff nurse
Leslie A Ricci, St Clair Hospital IMC and CCU
05.1990 - 04.1992
MBA - Healthcare Professionals
Chatham University
Bachelor of Science - Nursing
Carlow University
Associate of Science - Nursing
Community College of Allegheny County
Associate of Science - Medical Assistant
Gannon University
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