Reagan Gargasz

Regulatory compliance oversight including contract interpretation, proposal development, and new business implementation ensuring program and strategic operational design maintaining compliance to regulatory standards.

• Comprehensive operational management including support in the development of programs, clinical operations, execution strategies, productivity expectations, oversight, policy and procedure, training, and audit readiness.

• Program development and management of comprehensive oversight for complex medical management of Medicaid and Dual-Eligible populations; including contract interpretation and clarification, quality metric identification, report development, technology and systems subject matter expertise, root cause analysis, and development of remediation action plans.

• Program development and medical management for newly established home health care agency providing comprehensive services to Medicare, Medicaid, and Privately insured members
• Financial management, strategic planning, affordability, and profitability including annual facility business plan to assure achievement of designated gross profit margin expectations.

• Consultative specialist contracted to evaluate census, financial, or performance challenged health care facilities to determine root cause of failure and establish rapid remediation plans for immediate implementation
• Evaluation of financial responsibility, affordability and profitability, staff utilization, and productivity to facilitate improve financial status and promote financial recovery.

• Complex medical management and case management for Medicare, Medicaid, and Privately insured members
• Discharge planning, utilization management, discharge planning, clinical care management, service determinations and authorizations, scheduling, and service coordination
• Reducing hospital bed days, readmissions, and critical incidents.

• Clinical staff nurse, specializing in emergency and trauma medicine including Level 1 Trauma Center, Intensive Care, Level 2 & 3 Emergency Room, and Surgical Intensive Care experience
• Complex medical management of critically ill patients ranging from newborn to geriatric, autonomously functioning in an acute care clinical setting.