Nicole DeCoudres, PA-C
Chicago,IL
Summary
Strong leader and problem-solver dedicated to streamlining operations to decrease costs and promote organizational efficiency. Uses independent decision-making skills and data analysis to positively impact customer success.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Sr Director, Client Business Management
Guidehealth/ Arcadia/ Sage Technologies
01.2022 - Current
- Directed design and execution of business transformation initiatives to drive performance, profit optimization and growth opportunities.
- Spearheaded new and existing customer negotiations from start to finish
- Oversaw new customer implementation
- Optimized project timelines by effectively delegating tasks and prioritizing workload among team members.
- Maintained positive customer relations by addressing problems head-on and implementing successful corrective actions.
- Leveraged data and analytics to make informed decisions and drive business improvements.
Sr Client Business Manager
Guidehealth/ Arcadia/ Sage Technologies
01.2019 - 12.2021
- Built relationships with customers and community to establish long-term business growth.
- Engaged in product training and demonstrations for our provider & member portal.
- Compiled and analyzed claims/authorization/refund/reinsurance data to determine approaches to improve customer performance.
- Mentored junior team members, providing guidance on best practices and professional development opportunities.
- Performed provider/facility contracting to fulfill customer's network adequacy while ensuring fair and reasonable provider reimbursement.
- Project managed client transitions (merger, new site, dissolution).
- Educated providers regarding managed care contracts and resolved issues.
Clinical Quality Lead
Guidehealth/ Arcadia/ Sage Technologies
12.2015 - 03.2019
- HEDIS/Medicare subject matter expert
- Data mined via EMR/fax/in-office collection
- Presented monthly quality performance to providers and Medical Directors and reported any trends/opportunities.
- GPRO/CMS web interface reporting for MSSP ACOs
- Member and provider outreach
- Identification of quality gaps through claims data analysis
- Collaboration with customer IT teams for EMR data extracts
- Imported extracts into data warehouse
- Trained/audited internal team members
Physician Assistant
Talcott Primary Care
09.2012 - 11.2015
- Solo midlevel practitioner in a five-physician PCP office with a large Medicare ACO population
- Ordered and interpreted diagnostic testing to confirm diagnosis and implement accurate treatment plans.
- Increased quality performance by creating EMR templates with CPT II and HCPCs to close gaps in care through claims.
- Conducted nursing home rounds, annual wellness visits (Medicare), and comprehensive diabetes visits
- Reported practice-level ACO (GPRO) data
Education
Masters - Medical Science, Physician Assistant Studies
Midwestern University
08-2012
Bachelor of Science - Health Science
Benedictine University
12-2009
Skills
- Collaborative leadership
- Team management
- Reporting expertise
- Process improvement
- Project management
- Negotiation
- Problem-solving
- Medicare Equivalency Reporting
- Data Analysis via Microsoft Access, Pivot Tables, Power BI
- Contract management
Accomplishments
Winner of Arcadia's 2021 Arc Award. This is the company's highest impact award. It is given to the employee who has delivered a combination of cultural and business results that clearly stand apart from all others without which the company would not be where it is.
Certification
Licensed Physician Assistant 085004485 - Illinois. NPI 1861745952
References
- Brian Croegaert, Guidehealth/Arcadia/Sage, Sr VP Value Based Care, 815-670-1858
- Tom Dierickx, Guidehealth/Arcadia/Sage, Sr Director, Data Services, 779-771-3601
Applications
Arcadia Analytics, Availity, Blue Access for Providers, Confluence, JIRA, Healthpac eldorado claims processing system, Microsoft Access/Excel/Office/Powerpoint, MXO Tech, Optum/Encoder Pro, Power BI
EMR Applications: EPIC, Athena, Nextgen, Cerner, Meditech, Allscripts
Timeline
Sr Director, Client Business Management
Guidehealth/ Arcadia/ Sage Technologies
01.2022 - Current
Sr Client Business Manager
Guidehealth/ Arcadia/ Sage Technologies
01.2019 - 12.2021
Clinical Quality Lead
Guidehealth/ Arcadia/ Sage Technologies
12.2015 - 03.2019
Physician Assistant
Talcott Primary Care
09.2012 - 11.2015
Licensed Physician Assistant 085004485 - Illinois. NPI 1861745952
Masters - Medical Science, Physician Assistant Studies
Midwestern University
Bachelor of Science - Health Science
Benedictine University
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