Summary
Overview
Work History
Education
Skills
Licenses, Memberships and Certifications
Timeline
OperationsManager
Susan Shultis MSN, RN

Susan Shultis MSN, RN

New Freedom,PA

Summary

Board-certified Registered Nurse with extensive experience in behavioral health, acute medical care, and quality assurance. Skilled in quality audits, compliance with NCQA and CMS standards, and fostering collaboration to improve patient outcomes. Proficient in process improvement and adapting to new systems to support organizational goals. Dedicated to maintaining the highest standards of care and advancing healthcare delivery.

Overview

18
18
years of professional experience

Work History

Specialty Services Registered Nurse

The Retreat at Sheppard Pratt
03.2022 - Current
  • Ensured compliance with Joint Commission standards and Office of Health Care Quality (OHCQ) regulations in private psychiatric care setting
  • Delivered comprehensive behavioral health care to patients with complex psychiatric and co-occurring conditions, including treatment-resistant depression, anxiety, and personality disorders
  • Board-certified in Psychiatric Mental Health and Holistic Nursing, integrating biopsychosocial care models
  • Conducted internal quality audits to uphold accreditation readiness, regulatory compliance, and patient safety
  • Collaborated with interdisciplinary teams to design and implement behavioral health interventions tailored to individual patient needs
  • Provided education and support to patients and families on treatment options, self-management strategies, and medication adherence

Integrative Care Nurse II

Greater Baltimore Medical Center
03.2020 - Current
  • Led quality improvement initiatives focused on Lean methodologies to enhance patient safety, documentation accuracy, and workflow efficiency.
  • Monitored and ensured compliance with infection prevention protocols and safety standards across units.
  • Collaborated with interdisciplinary teams to optimize documentation processes, ensuring alignment with CMS, NCQA, and state regulatory requirements.
  • Provided staff education and mentoring to enhance understanding and implementation of quality and safety protocols.
  • Conducted audits and reviews to ensure continuous improvement in patient care outcomes and adherence to organizational policies.

Director Organizational Leadership & Development

Mid-Atlantic Billing & Recovery
03.2013 - 05.2018
  • Directed strategic initiatives to enhance operational efficiency, resource optimization, and improve patient satisfaction metrics.
  • Led comprehensive medical billing operations, including revenue cycle management, claims processing, and denial resolution for multi-specialty practices.
  • Developed and implemented billing policies and procedures to ensure compliance with CMS, HIPAA, and other regulatory standards.
  • Partnered with executive leadership to optimize billing workflows, achieve clean claim submission rates, and enhance collections performance.
  • Provided expert consultation on medical billing best practices to support acquisitions, mergers, and new practice startups.

Director of Operations

KMH Healthcare Corporation
03.2007 - 03.2013
  • Directed operations and managed comprehensive medical billing and coding functions for Independent Diagnostic Imaging Facilities (IDTF), ensuring timely claims submission and payment reconciliation.
  • Ensured compliance with ACR, MQSA, CMS, and other regulatory standards, leading successful accreditation and inspection outcomes.
  • Oversaw payor contracting, credentialing, and reimbursement strategies to optimize revenue cycle performance.
  • Collaborated with multidisciplinary teams to implement workflow improvements and enhance operational efficiency.
  • Trained and mentored staff on billing software, coding updates, and regulatory changes to ensure accuracy and compliance.

Education

Master of Science - Nursing; Quality Safety & Risk Management

Drexel University
Philadelphia, PA
12.2024

Bachelor of Arts - Organizational Leadership

Pennsylvania State University
University Park, PA
12.2016

Skills

  • Expertise in NCQA, CMS, and state-mandated quality measures
  • Managed care operations: utilization review, care management, behavioral health, clinical appeals
  • Quality audits and quality assurance practices
  • Effective communication and constructive feedback
  • Facilitating interdepartmental collaboration
  • Proficiency with multiple software applications and adaptability to new systems

Licenses, Memberships and Certifications

Licenses - Registered Nurse (RN) | State of Maryland R247555 | State of Pennsylvania RN 729130

Board Certification - Holistic Nurse, HN-BC | ANCC | Member of American Holistic Nurses Association

Board Certification - Psychiatric Nurse, PHM-BC | ANCC | Member of American Psychiatric Association

Timeline

Specialty Services Registered Nurse

The Retreat at Sheppard Pratt
03.2022 - Current

Integrative Care Nurse II

Greater Baltimore Medical Center
03.2020 - Current

Director Organizational Leadership & Development

Mid-Atlantic Billing & Recovery
03.2013 - 05.2018

Director of Operations

KMH Healthcare Corporation
03.2007 - 03.2013

Master of Science - Nursing; Quality Safety & Risk Management

Drexel University

Bachelor of Arts - Organizational Leadership

Pennsylvania State University

Similar Profiles

CREATE PROFILE
Susan Shultis MSN, RN