Susanna Petrie, MSN, RN, CHLS, CFN
Waynesboro,VA
Summary
Talented Manager with expert team leadership, planning, and organizational skills built during successful career. Successfully equips employees to independently handle daily functions and meet customer needs. Diligent trainer and mentor with exceptional management abilities and results-driven approach.
Overview
26
26
years of professional experience
Work History
Manager of Care Management (Medicaid)
Yamhill Coordinated Care Organization
04.2023 - Current
- Manages a team of registered nurses (RNs) and community health workers (CHWs)
- Lead a project to bring care management (CM) back in house after it was outsourced several years ago
- Design and implement program descriptions, workflows, job descriptions, and reporting structures for CM using Helios, a web-based platform that supports care coordination and population health management
- Collaborate with the state of Oregon to restructure CM regulations for coordinated care organizations (CCOs), which are networks of providers that offer integrated physical, behavioral, and oral health care to Medicaid members
- Work with the information technology (IT) department to create various reports for in-house, the state, and the Centers for Medicare and Medicaid Services (CMS), using data from Helios and other sources
- Served as the interim Manager of Utilization Management (UM) for 5 months and performed all UM duties, such as reviewing prior authorizations, claims, and appeals, and ensuring compliance with state and federal guidelines
- Reviewed and developed intake and discharge planning strategies to encourage client engagement and retention.
- Provided leadership, guidance and support to staff members.
- Collaborated with multidisciplinary teams to facilitate client care and reduce case management barriers.
- Streamlined, standardized and implemented case management processes and techniques to maximize revenue cycle.
- Created care plans that addressed clinical and financial challenges, family requirements and facilitated patient quality of life.
- Referred clients to appropriate team members, community agencies and organizations to meet treatment needs.
- Monitored program performance and outcomes for successful delivery of services.
- Became certified in Health Literacy, which is the ability to obtain, process, and understand basic health information and services, and train all staff in applying health literacy principles to their communication and documentation
Manager of Care Management (Medicare)
WellMed Medical Management
10.2021 - 04.2023
- Managed a team of registered nurses (RNs) for the West Texas division of WellMed
- Managed UM team performing the inpatient authorizations using MCG, a clinical decision support tool, for members transitioning to the next site of care (NSOC), such as skilled nursing facility (SNF), acute rehabilitation unit (ARU), and long-term acute care (LTAC)
- Managed CM team of LPNs providing complex CM to Medicare members including chronic disease management and transition of care
- Empower staff to enhance patient-focused care and positively impact patient outcomes, as reflected in higher patient satisfaction and quality improvement efforts
- Established performance goals for employees and provided feedback on methods for reaching those milestones.
- Supervise the delivery of nursing services and nursing personnel, ensuring that they receive training and supervision as needed to meet performance expectations and are evaluated fairly and in a timely manner
- Oversee and participate in the hiring process of all assigned
- Defined clear targets and objectives and communicated to other team members.
Program Manager Transition of Care
Sea Mar Community Health Clinic
08.2017 - 10.2021
- Created and implemented the Transitions of Care program for Sea Mar FQHC in Western WA
- Led the project design, capability identification, and scope and scale planning
- Wrote all the policies, hired and trained the nurses, and established relationships with the hospitals in Western Washington
- Collaborated with Sea Mar and Multicare to customize technology and tools for the care model
- Managed the nurses in 9 counties who case-managed the patients for 30 days post discharge, doing medication reconciliation, follow-up appointments, and home visits
- Performed root cause analysis for all re-admissions and tracked readmission risk for participating patients
- Reduced the readmission rate from 13% to 9%
- Participated in the annual Latino Legislation Day, doing presentations to the legislators in Olympia
RN Case Manager
Consistent Care Services
05.2016 - 08.2017
- Administered the Yakima program that aimed to reduce the number of high utilizers in the emergency department (ED) by providing them with comprehensive and holistic care
- Managed two patient advocates in Yakima who worked closely with the high utilizers to assess their needs and connect them with appropriate resources
- Contracted with local hospitals and insurance groups to ensure the sustainability and effectiveness of the program
- Coordinated medical care, housing, drug treatment, and social needs for super users who often faced multiple and complex challenges that prevented them from accessing regular primary care
RN Case Manager
SouthCentral Foundation
04.2014 - 05.2016
- Company Overview: part of an integrated care team at Indian Health services
- Managed a panel of 1400 patients
- Documented patient records in EHR
- Handled specialty referrals, telephone triage, and medication management
- Processed contract health referrals
- Provided patient education and STD treatment
- Part of an integrated care team at Indian Health services
Staff RN
Critical Access Hospital
10.2013 - 04.2014
- Company Overview: Worked in the ED as a staff RN, on the medical floor and in long-term care
- This short-term assignment was out in the bush in Alaska
- Worked in the ED as a staff RN, on the medical floor and in long-term care
LVN to RN Case Manager
Progressive Home Care
11.2004 - 10.2013
- Provided post-surgical care for patients with various conditions (orthopedic, cardiac, abdominal, and gyn)
- Performed foley catheter care, CHF and COPD education and management, DM education and management, and extensive wound care including wound vac and ostomy management
- Coordinated with local PCPs and specialists for appointments and referrals
- Collaborated with other disciplines (PT/OT/ST) for optimal patient outcomes
LVN
Sutter Auburn Faith Hospital
07.1998 - 11.2012
- Managed up to 5 patients per shift
- Performed shift assessments and monitored vital signs
- Administered medications and IV fluids
- Provided wound care, catheter care, and post-surgical care
- Handled admissions and discharges
Education
Master’s - MSN - Case Management
American Sentinel University
Master’s - MSN - Leadership in Healthcare Administration
Grand Canyon University
Bachelor’s - BSN
University of Phoenix
Associate - ADN/LVN
Sierra College
Skills
- Extraordinary Case Management
- Excellent Communication
- Advanced Critical thinking
- Compassionate caregiver
- High Organized
- Passionate lifelong learner
- Attention to detail
- Ethical care provider
Licensure and Certification
- Oregon RN license, 202001483RN
- Virginia RN license 0001331139 Compact
- Certified Case Manager, CCM 4221961
- Certified Healthcare Quality Specialist (in progress)
- Faith Community Nurse Certified
- Certified Health Literacy Specialist
Timeline
Manager of Care Management (Medicaid)
Yamhill Coordinated Care Organization
04.2023 - Current
Manager of Care Management (Medicare)
WellMed Medical Management
10.2021 - 04.2023
Program Manager Transition of Care
Sea Mar Community Health Clinic
08.2017 - 10.2021
RN Case Manager
Consistent Care Services
05.2016 - 08.2017
RN Case Manager
SouthCentral Foundation
04.2014 - 05.2016
Staff RN
Critical Access Hospital
10.2013 - 04.2014
LVN to RN Case Manager
Progressive Home Care
11.2004 - 10.2013
LVN
Sutter Auburn Faith Hospital
07.1998 - 11.2012
Master’s - MSN - Leadership in Healthcare Administration
Grand Canyon University
Bachelor’s - BSN
University of Phoenix
Associate - ADN/LVN
Sierra College
Master’s - MSN - Case Management
American Sentinel University
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