Manager Project

Sandi Rudegeair

Phone: 717-***-**** (mobile)

E-Mail: pwdj9r@r.postjobfree.com

EXECUTIVE SUMMARY

Senior healthcare executive with progressive experience in both not-for-profit and proprietary multi-entity systems. Skilled in hospital operations, information systems, and strategic planning with an in-depth knowledge of hospital billing and reimbursement processes. Significant accomplishments in turn-arounds, revenue enhancement and expense reduction, board/committee relations, new program design, implementation and development of client vendor relationships.

PROFESSIONAL EXPERIENCE

Steward Health – Boston, MA

Corporate Director of Revenue Management August 2011 – eliminated/outsourced

- Facilitate revenue operations for multiple hospitals utilizing multiple software tools (Craneware/Insight, MedAssets, Navigant, etc)

- Liaison between company and Deloitte for outsourcing operations with Deloitte (AR>90 days

to India)

- Contract management and process flow leadership

- Conduct monthly revenue cycle meetings at all facilities to increase revenue (instructional meetings at department level)

- Research root cause (late bills, DNFB) and implement change for improvement

- Special Project management

- Correspondence backlog clean-up project

- Implementation of centralized Revenue Integrity Team (Med Assets software)

- Negotiation with SEIU regarding operational needs of sites within system

- RAC responsibility (Craneware)

- Interim HIM Director as needed system wide

- Centralizing Release of Information utilizing one company system wide.

- Appeals and Denials (AllScripts and Insight)

- Member of Provider Outreach and Education (compliance – NHIC – CMS)

HealthPort Technologies (formerly known as Smart Document Solutions)– Port St Joe, FL

District Manager of Operations July 2010 – August 2011

- Leadership of the daily operation for Release of Information multiple states and healthcare facilities (Panhandle area of Florida, AL, and GA)

- Establish and maintain quality vendor and client relationships

- Recruitment and training of staff (all levels, in hospitals, clinics, and physician offices)

- Project Manager for new Site Start-Up, Needs Assessment Analysis, and Employee Relations Southeast Region

- Site training of HIPAA practices

- Leading quality improvement activities for area

- Successful conversion of paper records to electronic as needed (such as HPF)

Weirton Medical Center – Weirton, WV (acute care facility 238 beds)

Director of Health Information Management, Case Management, Social Workers and Privacy Officer – April 2009 – July 2010

- Successful implementation of Clinical Documentation Improvement Program (increased case mix index %, increased revenue $933, 000. in first 6 months)

- Facilitate revenue cycle committee meetings with statistical reports and in-depth analysis of billing and reimbursement process needing improvement

- Development of RAC coordinator role

- Restructure of Case Management Department from Utilization Review, decreasing Observation days and average length of stay ( 8 RNs)

- Effective review and documentation leading to decrease in denial rates

- Successful SEIU negotiations regarding productivity measures and discipline initiatives

- Decreased billing days from 10 to 4, decreasing non billed to <3 million dollars

- Restructure department to accommodate electronic medical record (3M) successful implementation

- Hospital and community wide HIPAA (and Privacy Practice) monitoring with updates and training

- Physician education of Interqual Criteria to insure appropriate inpatient placement and length of stay

- Support Performance Improvement activity hospital wide

- Successful conversion of paper medical record to SoftMed Electronic Record

- Successful process development and implementation of vendor relationships for outsourced

projects

Consultant – August 2008 – April 2009 St Pete Beach/Clearwater

Transcription South, Inc HIPAA policy updates, Policy and Procedure updates, Special Business Development – new business measures and process development to enhance vendor/client relationships

Florida Keys Medical Center – Key West, FL (acute care 110 beds)

Director of Health Information Management and Case Management, Privacy Officer July 2008 – November 2008

- Leadership of Health Information Management and Case Management daily operations ( 4 RNs and 10 other professional staff)

- Facilitate areas of opportunity to improve hospital billing and reimbursement processes within Revenue Cycle Committee departments

- Successful implementation of Emergency Department Case Management (proper inpatient placement and length of stay, criteria based)

- Met and maintained national standards top ten DRG length of stay days while containing costs related to services

Lovelace Medical Center and Lovelace Rehabilitation Hospital – Albuquerque, NM (acute care facility 210 beds, 5 campuses including rehab)

Director of Health Information Management and Film Library, Privacy Officer July 2007 – 2008

- Direct leadership of all areas in health information management daily operations

- Interim Case Management leadership (required reporting CHF, COPD, Surgical

Procedures)

- Facilitator for Revenue Cycle Team activities to improve internal processes of hospital billing systems and reimbursement

- Vendor development of outsourcing (India) coding work (met and trained teams from India and further developed process of work flow to and from with quality improvement measures in place

- Successful implementation of MS-DRG, RAC, and POA requirements

- Effective project planning for electronic medical record implementation

- Improved morale of staff with development of right fit structure for staff

- Compliance/HIPAA training

- Active participant various hospital wide committees

- Reduced staff expenses by $200,000., by restructuring and process improvements

- Implemented voice recognition for radiology department

- Completed cost-effective project with off-site record storage vendor

- Provided data driven information for hospital wide quality improvement activities

- Implementation of electronic medical record conversion to allow for off-site coding

Mentored by COO (reference)

Smart Document Solutions – Operations Director – July 2004 – 2007

Axolotl – Operations Director – 2003 – 2004

Transcription South – Operations Director - 1997 – 2003

Florida Hospital – Manager, Quality Improvement – 1996 – 1997

Evangelical Hospital – Director, HIM, Case Management 1995 – 1996

Bayfront Medical Center – Manager, Quality Improvement – 1994 -1995

Tampa General Hospital – Manager, Quality Data – 1993 – 1994

OTHER PROFESSIONAL ACCOMPLISHMENTS

- Task Force member Employer's Purchasing Alliance in Tampa, Florida,

successfully implementing database of all information from hospitals in the state regarding, length of stay, outcomes, costs, and severity of illness based on disease related groups to be released to the public (1999) to help them make wise healthcare choices.

- Facilitator for Atlas Data collection in Florida and Pennsylvania.

- Successfully led donation campaign at local church.

- Facilitated User Group for Healthcare Abstractors in Ardent Health System

EDUCATION:

BS/MBA Healthcare Administration (2003)) – Almeda University

Enrolled Excelsior College (Bachelor program Liberal Arts – Public Relations) expected graduation February 2013

Excellent references upon request.

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