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Case Management Manager

Location:
Booneville, MS
Salary:
Flexible
Posted:
December 14, 2023

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Resume:

Shelia Ethridge Easter, RN, BSN, CCM, ACM

662-***-****

ad1yq5@r.postjobfree.com

SUMMARY

● 36.5 years experience as an RN, 32 years of Case Management Experience to include:

● 3.5 years Corporate Hospital Case Management, 20+ years Director of Case Management

Experience.

● Trusted advisor and catalyst of positive change with history of achieving increases in revenue,

productivity, and customer satisfaction while leading Case Management across 170 facilities

simultaneously (in previous Corporate Case Management position).

● Director of Case Management Highlights: Exceeded Goal: Medicare Length of Stay (LOS)

REDUCED by 2 days within 60 days (Goal was 90 days)

● Instituted Corporate Compliance Program for Case Management to achieve 100% compliance

within first six months of employment.

● Integrated social work and case management into unified Case Management model and

implemented software to improve data management, reporting, and quality control.

● Areas of expertise in discharge planning include ICU, Peds MICU, Post-Partum, Labor & Delivery,

NICU, SICU, PCU Step-Down, Med/Surg, Pediatrics, Admissions, Float, ED, Ortho, Neuro, Psych,

Cardiac, CVICU, Oncology, Palliative Care, Hospice, Home Care, Rehabilitation, Ambulatory,

Transitional Care/Clinic, Skilled Nursing,

LICENSURE & CERTIFICATIONS

● RN License compact August 1986 to December 2024 (MS Compact)

● Certified Case Manager August 2023

● CPR Certification August 2022 to August 2024

● Accredited Case Manager

● BLS Certification

● RN Licenses in other states (would only need to update)

SYSTEMS EXPERIENCE

● EPIC, Allscripts, Cerner, MIDAS, Allscripts/NaviHealth, InterQual, Milliman/MCG,

Meditech, KEPRO, Oasis/SOCs, ROC, Pointcare, Paragon, Sunrise, McKesson, HER, 3M,

Medicision, Tile, Morcare, Decision Point, Xsolis

PROFESSIONAL EXPERIENCE

January 2018 to Present

Baptist Memorial Golden Triangle Hospital (315 patient bed, Level III Trauma Center, Teaching

Facility)

Columbus, MS

RN Case Manager

● Worked with Multi-Disciplinary Team of Physicians and healthcare professionals to hold

daily MDR Rounds.

● Consulted with patients and families to assess condition and needs, provided education

and empathetic support, and propose additional resources.

● Continuously improved quality of care, resource utilization, and cost-effectiveness at

315-bed facility.

● Evaluated and implemented plans of care, audited charts to ensured insurance

compliance, detailed reports, and maintained documentation in Epic EMR.

● Supported team success by providing coaching and mentoring to new nurses and filling

in as Floating Floor Nurse and ER Nurse as needed.

** Moved back to Mississippi in order to become caregiver of parents which is why I did not

take a Director role at that time**

June 2016-July 2017

John D. Archbold Memorial Hospital (264 patient bed, Level II Trauma facility)

Thomasville, GA

Director Case Management (Contract)

● Reduced Length of Stay (LOS) by 2 days for Medicare within 2 months.

● Responsible for all Case Management and Case Management team.

● Priority and focus - meeting all required metrics and additional quality metrics/CM

projects assigned.

● Established a Utilization Review Committee (Selected a physician from each specialty

along with Med-Surg/ER Hospitalists in order to ensure patients were always in the

correct status to decrease observation rate.

● Working knowledge of finance and budgetary process, and government billing

regulations. Conducting Moon Letters, IM Letters, etc.

● Knowledge of Conditions of Participation and Joint Commission standards.

*Took time off then looked for the right contract.

June 2013 to December 2015

Le Bonheur Children’s Hospital (255 patient bed, Level I, Pediatric Trauma Center Facility)

Memphis, TN

Director of Case Management (Contract)

• Motivated and guided teams of up to 24 Case Managers, Social Workers, Appeals

Coordinators, and administrative support staff at facilities.

• Significantly reduced length of stay (LOS) and readmissions through implementation of

Emergency Department (ED) and weekend CM, comprehensive training and

cross-training, and effective change management.

• Collaborated with ER Physicians and Hospitalists at John D. Archbold Memorial

Hospital to understand needs and pioneer ER Case Management processes and best

practices yielding greater financial transparency.

• Accomplished unparalleled reimbursements for facilities by diligently working with 120+

payor groups and contracts to ensure payment.

• Catalyzed business transformation, improved financial monitoring, and augmented

productivity among RNs and Social Workers by introducing new CM model and adjacent

software adopted by entire Methodist system while working at Le Bonheur Children’s

Hospital.

• Working knowledge of finance and budgetary process, and government billing

regulations.

• Knowledge of Conditions of Participation and Joint Commission standards.

August 2012-May 2013

Wuesthoff Medical Center (HMA), Melbourne, FL

Director of Case Management Management (Contract)

• Recruited to lead team of 13 in the execution of all Case Management activities

including Case Management, Utilization Review, Social Work, and Discharge Planning.

• Lowered readmission rate by 2% and improved patient service

• Trusted advisor and catalyst of positive change with history of achieving increases in

revenue, productivity, and customer satisfaction while leading CM across five facilities

simultaneously.

• Working knowledge of finance and budgetary process, and government billing

regulations. Conducting Moon Letters, IM Letters, etc.

• Knowledge of Conditions of Participation and Joint Commission standards.

January 2009 to August 2012

HOSPITAL CORPORATION OF AMERICA (HCA)

Nashville, TN

Director Corporate Case Management

● Reported directly to Corporate Vice President of Hospital Case Management for HCA

Hospital system.

● Regarded as subject matter expert (SME) for HCA Corporate Case Management Program.

● Overseen 17 Case Management Division Directors to ensure all aspects of HCA’s Hospital

Case Management Program rolled out at the Corporate level was timely, effective and in

compliance at Hospital level.

● Responsible for implementation and development of MIDAS+ across 17 divisions and

170 HCA hospitals nationally.

● Revised MIDAS Education applications to include discharge planning and new

acquisitions, allowing organization to train employees nationwide and gather expansive

patient information to inform business critical decisions on individual facility and

corporate levels.

● Extensive knowledge of regulatory environment with ability to institute best practices

and drive consensus among key stakeholders at all levels to continuously enhance

quality and compliance.

● Traveled extensively to 170 hospitals to align implementation milestones with

overarching project timeline and budget and to train, mentor, and support executive

teams and their staff members.

● Responsible for Teaching/Training CEO’s, Corporate Leadership on all aspects of Case

Management Program.

EDUCATION

Bachelor of Science in Nursing, 1989

University Medical Center -

Jackson, MS

Associate of Science in Nursing, August 1986

Itawamba Community College -

Fulton, MS



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