Raylene Platel MD MPH
Plano,TX
Summary
Experienced physician executive with 16 years of progressive operational and strategic leadership in complex and diverse healthcare settings. Demonstrated outcomes in service line leadership through building and leading strong teams with a focus on care coordination, clinical quality, technology, data analytics, customer service, and collaboration with multiple stakeholders. Healthcare leader with a growth and strategy mindset, P&L experience, strong analytical skills, deep experience in healthcare management, Joint Commission and state regulations, clinical excellence, patient safety, quality improvement, graduate medical education, utilization management, value-based care, revenue cycle management, and risk management. Skilled in physician medical group management, provider recruitment, payor contracting, negotiations, compensation models, practice management, and operations review. Successful in integrating clinical and academic missions. Thriving in leading healthcare teams that exceed expectations and improve clinical and financial operations,I am guided by the core belief in patient-centered care.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Regional Chief Medical Officer
Prime Healthcare-Texas, Alabama, and Georgia
05.2024 - Current
- Lead a team of six facility Chief Medical Officers in the Region.
- Established a CMO Council for strategizing and innovating our processes in clinical opeartions,utilization review, quality care and patient safety best practices
- Improvement of patient outcomes and delivery of care through improved clinical quality processes with a 18% percent reduction in length of stay and 35 % reduction in one day stays.
- Application of continuous process improvement strategies to enhance utilization review and case management.
- Acquired and transitioned the Hospitalist program into the employment group with a 15% increase in revenue from improved documentation and coding.
National Inpatient Care Management-RMD
UHG, United Health Group
03.2024 - 04.2024
- Active collaboration with treating providers including discussion of evidence – based guidelines, opportunities to close clinical quality / service gaps, and care plan changes that can impact health care expenses
- Collaboration with operational and business partners on clinical and quality initiatives at the site and customer level to address customer expectations
- Adept in the use and application of evidence-based medicine (EBM) such as InterQual care guidelines and criteria review
Vice President-Graduate Medical Education
Medical City Healthcare
09.2022 - 11.2023
- Served as the Administrative leader and manager of the seventeen hospital based residency and fellowship programs,Program Directors, Directors of Medical Education (DME, Osteopathic Programs) and facility Designated Institutional Officials (DIO).
- Worked collaboratively with TCU SOM and UNTHSC SOM leadership to maintain and establish medical student rotations.
- Served as the Designated Institutional Official (DIO) for the Graduate Medical Education Consortium.
- In partnership with physician medical group and facility CEO provided direction of GME/Continuity Clinics.
- Provided subject matter expertise on GME to Division and facility leadership.
- Managed the implementation and ongoing use of the MedHub residency management tool for the Division.
- Actively met with hospital leadership to understand challenges and create solutions.
Physician Advisor
R1RCM
06.2022 - 04.2023
- Concurrent review of clinical cases to ensure a compliant level of care, which increased compliance and reduces the risk of exposure to denials
- Reviewed and responded to the hospital UR department in a timely manner; usually within 1-2 hours of the submission to the queue
- Actively engaged with attending physicians to discuss appropriate status as supported by documentation
- Make phone contact with the utilization review team and/or case managers at client hospitals regarding submitted case determinations
- Provided written analysis of the case and performed case reviews across multiple specialties
Chief Medical Officer
HCA Healthcare
02.2016 - 09.2022
- led clinical performance expectations that support the goals of consistent clinical performance and practice standards across the facility to ensure superior clinical outcomes and unparalleled patient experience
- Worked with Chief Executive Offers, medical staff, and Boards of Directors to improve the functionality and effectiveness of the hospital medical staff organization
- Partnered with medical staffs and hospital management teams, facilitating teamwork and shared goals. Represents medical staff viewpoints to management and relays management viewpoints to medical staff by establishing and maintaining mutually beneficial relationships between Corporate leadership and community and/or employed physicians.
- Provided clinical support and consultation regarding cost-effective clinical resource management in the facilities by sharing reports and recommendations regarding how to reduce the variable cost per case while maintaining and enhancing clinical effectiveness
- Led a data-driven environment of quality and cost improvement, and developed systems to review utilization of resources and objectively measure outcomes of care in the inpatient and outpatient settings
- Served as a direct liaison between HCA-affiliated physicians and facility/corporate clinical services functions
- Established and maintained an ongoing program to orient and develop management expertise for Hospital Chiefs of Staff, Medical Executive Committees, and other medical staff leaders by providing oversight and leadership for all medical education programs
- Led educational sessions and provides ongoing in-service programs to facility medical staff regarding clinical resource management, appropriate documents standards, utilization and quality issues, and quality improvement activities, in collaboration with the Chief of Staff or other clinical leadership in the facility
- Assembled regional physician advisory panels to provide ongoing feedback to senior management, and serves as a liaison between committees and facility/corporate leadership, as well as to affiliated physicians
- Educated physicians on HCA clinical technologies
- Collaborated with HPG and Supply Chain on formulary and supply opportunities
- Developed, implemented, and monitored disruptive physician and impaired physician policies, and develops monitoring and intervention programs in the region
- Provided recommendations in the development and/or revision of hospital policies and procedures pertinent to the medical staff and medical staff affairs
- Served as a consultant to hospital Medical Staff Services regarding physician credentialing, utilization, and quality profiling. Serves as a member of hospital’s peer review committees as requested
- Evaluated clinical appropriateness of new medical technologies and programs, and makes recommendations concerning the relevance of such technologies and programs to HCA hospitals
- Served as a resource and consultant to the Vice President Physician Services Group and/or Vice President Business Development in physician recruitment, clinical program development, and overall hospital strategy
- Provided medical consultation on contracting, pricing, and analysis of managed care issues. Offered clinical support for appeals and denials process, discharge planning, case management, and utilization review/management
- Promoted consistent, positive patient interactions that advance the agenda of unparalleled patient service and resulted in 80th percentile HCAHPS Physician scores.
- Facilitated measurable improvement in physician engagement at 90 th percentile in the organization.
Medical Director Physician Assistant Program
Wayne State University School of Medicine
05.2012 - 12.2016
Physician- Hospitalist,Primary Care and Post Acute
Academic Internal Medicine Specialists
07.2008 - 02.2016
Education
Some College (No Degree) - Physician Leader
HCA Physician Leadership Academy
Nashville11-2019
MD- Internal Medicine Residency -
Detroit Medical Center-Wayne State University
Detroit, Michigan06.2008
MPH-Epidemiology -
University of North Texas, HSC
Fortworth, Texas05.2005
MBBS -
NTR University of Health Sciences
05.2001
Skills
- Wayne State University School of Medicine-Clinical Assistant Professor
- Michigan State University Osteopathic School of Medicine- Clinical Assistant Professor
Certification
· Hospital Board member 2016-2022
· Chair of Perinatal Committee 2021-2022
· Chair of Quality and Patient Safety Council 2016-2022
· Chair of Utilization Management 2016-2022
· Chair of Clinical Informatics 2016-2022
· Co Chair of Credentials Committee 2016-2022
· Co Chair of Peer review Committee 2016-2022
· Designated Institutional Official 2022-23
Certifications
- Board certified in Internal Medicine, 08/2008-ongoing
- The American Board of Artificial Intelligence in Medicine
- Active medical license- Texas, Michigan and Florida
Recognitions
- Elected to the Board of Directors-American College of Physicians -Texas Chapter 11/2024-
- Citrus County Chronicle Healthcare Innovations Award 2018 &2019
Volunteer Experience
- McKinney Inclusion Council member
- Young men’s service league Membership committee
- McKinney Roots Farm
Timeline
Regional Chief Medical Officer
Prime Healthcare-Texas, Alabama, and Georgia
05.2024 - Current
National Inpatient Care Management-RMD
UHG, United Health Group
03.2024 - 04.2024
Vice President-Graduate Medical Education
Medical City Healthcare
09.2022 - 11.2023
Physician Advisor
R1RCM
06.2022 - 04.2023
Chief Medical Officer
HCA Healthcare
02.2016 - 09.2022
Medical Director Physician Assistant Program
Wayne State University School of Medicine
05.2012 - 12.2016
Physician- Hospitalist,Primary Care and Post Acute
Academic Internal Medicine Specialists
07.2008 - 02.2016
MBBS -
NTR University of Health Sciences
· Hospital Board member 2016-2022
· Chair of Perinatal Committee 2021-2022
· Chair of Quality and Patient Safety Council 2016-2022
· Chair of Utilization Management 2016-2022
· Chair of Clinical Informatics 2016-2022
· Co Chair of Credentials Committee 2016-2022
· Co Chair of Peer review Committee 2016-2022
· Designated Institutional Official 2022-23
Certifications
- Board certified in Internal Medicine, 08/2008-ongoing
- The American Board of Artificial Intelligence in Medicine
- Active medical license- Texas, Michigan and Florida
Some College (No Degree) - Physician Leader
HCA Physician Leadership Academy
MD- Internal Medicine Residency -
Detroit Medical Center-Wayne State University
MPH-Epidemiology -
University of North Texas, HSC
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