Nadia Gurarie
Gilbert
Summary
Clinical services leader with proven ability to drive quality patient care and optimize operational efficiency. Strong focus on team collaboration, ensuring seamless integration of clinical practices and staff development. Skilled in strategic planning, regulatory compliance, and patient-centered care, adaptable to shifting priorities and demands. Recognized for leadership in fostering results-driven environment and enhancing service delivery.
Overview
2015
2015
years of professional experience
1
1
Certification
Work History
DIRECTOR OF CLINICAL SERVICES
Traditions Health
2023 - 2025
- Responsible for managing day-to-day operations of the branch. Insuring operational efficiencies, quality of patient care, regulatory compliance. Supporting business development and patient growth.
- Decreased staff turnover by 40% in 8 months by motivating and providing on-going training. Creating high performing team.
- Improved financial performance of the Branch by decreasing CAP by 50% in 6 months.
- Decreased cost of DME, Supplies and stat medications by 20% in 2 months.
- Ongoing review and update of Regulatory Compliance, local, federal and agency policies and procedures.
- Partnering with sales team to access and bring in new business.
- Led clinical operations, ensuring compliance with healthcare regulations and quality standards.
- Developed and implemented strategic initiatives to enhance patient care delivery and service efficiency.
DIRECTOR OF UTILIZATION MANAGEMENT AND SOCIAL SERVICES
Palmdale Regional Medical Center
2020 - 2023
- Directly oversee and monitor case managers, social workers, and support staff. Provide analysis and reports of significant utilization trends, patterns, and impacts to resources. Partnering with the Hospitalist group to decrease LOS and readmission rate. Effective management and mitigation to avoid and reduce risk management issues.
- Implemented avoidable day report to track and trend reasons for LOS.
- Hardwired utilization review and case management process for increased efficiency.
- Decreased average LOS by .5 days in 3 months.
- Decreased monthly denials by 10% in 6 months.
- Developed and implemented policies aligning with healthcare regulations and best practices.
- Led strategic initiatives to enhance operational efficiency and patient care quality.
DIRECTOR OF CLINICAL SERVICES
Kaiser Permanente
2017 - 2020
- Supervise care management teams made up of 57 employees, including RNs, LVNs, PTs, and support staff. Use strategic planning to meet healthcare center’s goals. Partner with local facilities to optimize complex patient placement. Lead utilization programs for behavioral health, in-patient, home health, hospice and long-term care. Improve workplace safety, communicate with multiple departments, and plan activities for nursing services, therapy, social work, and hospice care.
- Developed and monitored initiative for successful transition of patients through the continuum of care between In-patient to home health and hospice.
- Maintained full responsibility of the overall functions of the financial areas and cost control for hospital, home health and hospice programs
- Collaborated with the readmission subcommittee to bring readmissions down by 10%.
- Spearheaded a case management process to shorten length of stay by 1 day in just 6 months.
- Oversaw multidisciplinary teams, fostering collaboration to improve clinical outcomes across departments.
- Monitored performance metrics, identifying areas for improvement in clinical services and operational processes.
DIRECTOR OF CASE MANAGEMENT
Antelope Valley Hospital
2016 - 2017
- Prevented readmissions by crafting and running an outpatient case management program. Managed social workers, case workers, and administrative staff of 60 people. Completed a regular department financial analysis and followed budget trends. Found long-term solutions to problems and partnered with AVH Home Care agency to identify gaps and readmissions.
- Increased daily concurrent reviews to lessen commercial insurance denials by 30%.
- Brought staff overtime down by 20% by reallocating resources.
- Shortened Medicare length of stay by .5 days in just 3 months.
- Developed and implemented strategies to improve patient flow and resource allocation.
- Led multidisciplinary teams to enhance patient care coordination and case management efficiency.
MANAGER OF CASE MANAGEMENT
Providence St. Joseph Medical Center
2015 - 2016
- Led staff of 45 made up of case managers, discharge planners, and social workers. Encouraged retrospective, concurrent reviews of care. Coordinated system to ensure appropriate admissions. Teamed up with Providence Home Care agency to provide excellent patient care.
- Decreased Part B Billing write-offs by 10%, and length of stay and readmission rate by .5 days.
DIRECTOR OF MEDI-CONNECT CASE MANAGEMENT
Regal Medical Group
2013 - 2015
- Evaluated various outpatient departments to consistently improve post-discharge services. Collaborated with home health agencies to give a positive patient experience. Developed department structure and oversaw 28 employees. nurses and social worker home visits for complex patients.
- Brought admission rate down 25% and complex case readmission rate down 15%.
- Built and launched medical management programs for 17,000 patients.
CASE MANAGER- Per Diem
Providence St. Joseph Medical Center
01.2008 - 01.2015
- Coordinated comprehensive care plans for diverse patient populations, enhancing service delivery and patient satisfaction.
- Assessed patient needs through in-depth interviews and evaluations, ensuring tailored support services.
- Monitored patient progress regularly, adjusting care plans as necessary to achieve optimal outcomes.
- Educated patients and families on available resources, fostering informed decision-making regarding treatment options.
DIRECTOR OF REGIONAL UTILIZATION MANAGEMENT, NORTH REGION
Healthcare Partners Medical Group
2011 - 2013
- In leadership over regional managers and staff of 80 employees. Provide direct utilization management and care management activities for referral delivery programs.
- Saved over $400K in medical expenses by implementing a continuity of care contract.
- Lessened turn-around time 1 day by reengineering regional structure.
- Collaborated with cross-functional teams to streamline project workflows and improve service delivery.
- Established key performance indicators to measure success and drive continuous improvement initiatives.
Education
Master of Business Administration -
Western Governors University
Salt Lake City, UTBachelor of Science - Health Administration
California State University Northridge
Northridge, CASkills
- Case Management
- Communication and Presentation
- Data Analysis
- Increasing Organizational Efficiency
- Leadership
- Operations
- Research and Program Development
- Risk Management
- Strategic Planning
- Utilization Management
- Clinical leadership
- Patient safety
- Healthcare management
- Quality improvement
Certification
- California Registered Nurse License
- Compact Registered Nurse License
Timeline
CASE MANAGER- Per Diem
Providence St. Joseph Medical Center
01.2008 - 01.2015
Bachelor of Science - Health Administration
California State University Northridge
DIRECTOR OF CLINICAL SERVICES
Traditions Health
2023 - 2025
DIRECTOR OF UTILIZATION MANAGEMENT AND SOCIAL SERVICES
Palmdale Regional Medical Center
2020 - 2023
DIRECTOR OF CLINICAL SERVICES
Kaiser Permanente
2017 - 2020
DIRECTOR OF CASE MANAGEMENT
Antelope Valley Hospital
2016 - 2017
MANAGER OF CASE MANAGEMENT
Providence St. Joseph Medical Center
2015 - 2016
DIRECTOR OF MEDI-CONNECT CASE MANAGEMENT
Regal Medical Group
2013 - 2015
DIRECTOR OF REGIONAL UTILIZATION MANAGEMENT, NORTH REGION
Healthcare Partners Medical Group
2011 - 2013
Master of Business Administration -
Western Governors University
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