Tammy Sullivan

• Created a regional team of 10 nurses and 1 UM Specialist to become West Shore UM.
• Mentored each team member individually to specific role.
• Developed UM Standardized Operating Procedures (SOPs) for all UM functions to increase efficiency by decreasing variation.
• Cultivated collaborative relationships with West Shore Case Management colleagues to enhance throughput/LOS work.
• Collaborated with Revenue Cycle Leaders to seamlessly integrate UM with Patient Access, Denials/Appeals, and Billing Departments to minimize revenue leakage and waste.
• Escalated Payer Policy concerns affecting PSH collection of due revenue.
• Established self as UM and EMR SME for PSH system.

• Managed Corporate Case Management Dept overseeing Case Management RN's, Social Work, and Utilization Management.
• Managed daily operational activities, ensuring alignment with financial goals and social engagement strategies.
• Led case management system metrics by identifying trends and implement strategies for reducing denial and readmission rates.
• Established collaborative partnerships with internal and external preferred providers and community agencies to enhance service delivery.
• Chaired system Case Management Professional Development Council, UM Committee, and Case Management Long Stay meetings

• Conducted needs assessments and coordinated care for patients at Reading Health System and Penn State St. Joseph Medical Center.
• Developed relationships within health systems to enhance business opportunities and promote collaboration.
• Provided education to patients, families, providers to hospice care and its value.

Acted as Community Liaison/ Educator for home hospice instructing community physicians and facilities regarding hospice services for a not for profit agency.

Administered comprehensive patient assessments to determine care needs and develop individualized care plans.

Collaborated with interdisciplinary teams to enhance patient outcomes and improve service delivery.

Educated patients and families on health management, medication administration, and preventive measures.

Enhanced patient outcomes by efficiently connecting high-risk emergency department patients to community resources, facilitating smoother transitions of care.

Increased patient access to healthcare and insurance through targeted assistance.

Optimized resource utilization by accurately reviewing patient cases for observation or inpatient status.

Improved hospice and palliative care services through collaborative interdisciplinary approaches, ensuring patient-centered care.

Strengthened team capabilities by mentoring nursing staff and new case managers.

Streamlined operations with the introduction of an electronic medical records-based case management model within the health system.