Joanne O'Regan

Family Medical Leave

Duxbury, MA 02332

adgeqe@r.postjobfree.com

781-***-**** cell; 781-***-**** home

From 2018 until December 2019, provided care for my elderly parent with multiple complex health issues, including cognitive impairment(Alzheimer's Disease); Provided direct care and 24 hour daily supervision in family home setting. Managed acute situations at home (i.e., administering intravenous antibiotics) to prevent hospitalizations. Engaged in community activities and support when able. Collaborated with multiple health care providers, various specialists and vendors to establish appropriate plan of care, including hospice care at home.

#readytowork

Authorized to work in the US for any employer

Work Experience

Clinical Manager / Manager of Quality Assessment/ Performance Improvement

(QAPI)

Northeast Rehabilitation Hospital Network

June 2016 to April 2018

Home Care Leader functioning as consultant to Executive Director to develop and implement strategies to improve home health agency performance in financial, clinical quality, patient outcomes, staff satisfaction, and growth initiatives.

Assumed role of Clinical Manager, then Manager of Quality Assessment /Performance Improvement

(QAPI) and Emergency Management Coordinator.

• As Clinical Manager, oversaw certified clinical services provided by all licensed clinicians providing intensive rehabilitation and nursing care to help beneficiaries achieve patient-centered goals. Developed policies, competency evaluations, orientation program; improved operational processes including intake, admissions, clinical documentation turn-around for billing.

• Performance Improvement Program focused on improving patients' medication self-management, decreasing patient falls, improving patient satisfaction, and decreasing patient infections; lead various interdisciplinary committees that reviewed and analyzed clinical data, identified root causes of poor outcomes, and developed plans for improvement, including educational programs to educate clinicians and patients/ caregivers. Member of hospital system's Quality Management/ Performance Improvement, Patient Safety, Compliance, Risk Management and Grievance Committees. Contributed home care department's data for inclusion in system-wide reporting.

• Quality and compliance oversight included ensuring that all medical records were reviewed concurrently in-house (before final claims submission) for billing integrity, patient eligibility, medical necessity, contract compliance (CMS) and appropriate coding. Documentation errors were corrected prior to final submission, and included individual clinician training. Responsible for compliance issues related to CMS' regulations, Joint Commission surveys, and Medicare's new Conditions of Participation

(CoPs). Handled all Additional Development Requests (ADRs) from our Medicare Recovery Audit Contractor (RAC), including appeals based on medical necessity, level of care, DRG validation and technical denials.

• Responsible for development, implementation and oversight of Emergency Management Program, including completing hazard vulnerability analysis/risk assessment; strategic plan for various scenarios

(i.e., active shooter, flu pandemic, hazardous contamination); staff education including desktop exercises, community-sponsored drills and review of After-Action Reports for drills and actual unplanned emergency responses (loss of power, winter weather).

• Participated in hospital system's planning committees to effectively integrate the home care program with the hospital system's emergency management program.

Clinical Auditor

New England Quality Care Alliance, Inc

January 2016 to March 2016

(contract position)

• Interim contract position to support NEQCA's Quality Program.

• Retrieved and analyzed individual medical record data for Medicare-identified quality measures.

• Electronically submitted patient quality data to Medicare for NEQCA's first year (2015) of participation in their Medicare ACO.

Project Manager

Commonwealth Care Alliance - Boston, MA

January 2014 to October 2015

(contract position)

• Responsible for the development, implementation, oversight and evaluation of the clinical assessment program, (using Minimum Data Set - MDS), for Commonwealth Care Alliance's (CCA) community-level members, enrolled in CMS's Pilot for dually-eligible (Medicare/ Medicaid) adults, using the Accountable Care Organization (ACO) model. (CCA is a nonprofit HMO). Oversight responsibility to ensure that all patients were completely assessed and appropriately identified in the correct class for accurate reimbursement.

• Responsible for hiring, training, and supervising a team of nurses conducting MDS Assessments and developing initial care plans with the members statewide.

• Developed and continuously improved various workflow processes for scheduling nurses, clinical data management and reporting, quality assurance and accurate coding.

• Lead staff in the development of patient-centered, customer service focused representation of Community Care Alliance to its members.

Vice President of Business Development

Steward Home Care

June 2011 to February 2013

Steward Home Care is a division of Steward Healthcare (SHC), one of the first Accountable Care Organizations (Pioneer ACO) approved by CMS (Medicare and Medicaid). SHC consisted of 11 hospitals, over 3,000 physician practices and an Accountable Care Organization, serving over 110 communities, in eastern Massachusetts and New Hampshire. Stewart Home Care had a daily census of 1600 patients, with a budget of $26M.

• Improved customer service skills of staff at all levels of the organization and created environment of

"service excellence" to enhance the organization's reputation among patients, families, physicians and referral sources.

• Responsible for the operational performance of Steward Home Care by driving growth and productivity initiatives, improvements in patient experience and outcomes, and technology enhancements.

• Collaborated with Steward Healthcare's clinical leadership in the development of programs and a post-acute provider network to enhance the quality and financial success of the Accountable Care Organization, while improving communication, coordination, and patient outcomes through the system's continuum of care.

Vice President of Operations and Business Development

Emergency Management Associates, Inc

November 2005 to January 2011

• Developed business plan, secured bank financing, facilitated incorporation.

• Selected/ implemented accounting system, payroll, vendor contracts, and computer system software/hardware.

• Responsible for initial start-up, day-to-day operations and marketing for small, privately held consulting firm.

Quality Review Nurse/ HEDIS auditor

Outcomes Health Information Solutions

January 2009 to June 2009

• Employed as independent contractor/consultant working remotely in Massachusetts.

• Retrieved and analyzed patient medical record data for the National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data Information Set (HEDIS) measures for various health plan clients throughout Massachusetts, utilizing Outcomes Health's proprietary Web-based tools.

Vice President

Partners Home Care - Boston, MA

January 1999 to December 2003

Worked closely with the Chief Medical Officer and other leaders of Partners' Post-Acute Division, to develop collaborative relationships and build clinically integrated disease management programs within the Partners-owned hospitals, Neighborhood Health Centers, and various community-based programs. Analyzed Partners system clinical data and regional public health data trends to identify and address community health /population health issues; enhanced the size and scope of home care's clinical specialty teams to meet the needs of the communities served and the requests of various services and programs within the system; (CHF program, anti-coagulation program, high risk maternity program, among others).

Developed and managed public health programs for twelve local boards of health serving the South Shore area. Provided public health nursing to prevent, reduce and control incidence of communicable diseases and occupational illnesses; monitored trends to inform community health education programming; Oversaw health promotion screening services. Editor of forty quarterly newsletters each year, directed to a variety of audiences, including physicians, referral sources, internal employees, donors, patients/ families and residents of the communities served.

Supervised staff in Community Relations and Fundraising Departments, which included the director of community relations, the annual fund manager, special events coordinators, grant writers, development associates, community relations specialists, graphic designers and contracted consultants.

Oversight responsibility for Admissions Department (marketing, sales, referral relationships, customer relations) and Director of Admissions, Manager of Managed Care Operations, and Clinical Data Analysts.

Vice President, Admissions and Development

For newly consolidated organization, Affiliated Community VNA, Inc

May 1997 to January 1999

Led various planning committees of eight visiting nurse agencies, including Bay Colony Visiting Nurse Association, (see below) including board members, Advisory Committee Members, senior staff and consultants over the course of two years during the exploratory and strategic planning phases prior to a merger, which resulted in the creation of a new consolidated organization, Affiliated Community VNA, Inc.

• Led patient-centered clinical program development to meet the needs of customers and referral sources, including: CHF Program, a preferred provider for several Managed Care Organizations and physician practices; the Neuro/Parkinson's Disease Program, developed with Boston Medical Center's Parkinson's Clinic; The Diabetes Program which included early morning group classes.

• Negotiated and secured contracts with twelve local Boards of Health covering the South Shore area, to provide public health programs, including immunization clinics, communicable disease follow- up, well-child clinics, education programs, and support groups. (Included community hypertension screenings, diabetic management classes, flu clinics, community health fairs, health education speakers' series, etc.).

• Worked closely with board of directors, finance committee, consultants and ACVNA leaders in strategic planning with the ultimate goal to join an integrated service delivery network; initiated negotiations with Partners Health Care System to acquire Affiliated Community VNA, and with Spaulding Rehab Hospital's home care department, Newell VNA and Salem VNA, resulted in the creation of Partners Home Care.

Executive Director

Bay Colony Visiting Nurse Association, Inc. formerly known as Pembroke Public Health Nursing Association.

January 1991 to May 1997

• Provided leadership and overall direction for all activities of the organization, including policy development and program planning, development of clinical specialty teams, and disease management programs, based on analysis of data trends of population health issues.

• Led Board of Directors in strategic planning, community relations and fundraising activities.

• Developed budget and managed all financial aspects of organization, including cost report preparation, Medicare audits, billing and payroll systems.

• Oversight of various staff committees and task forces to develop policies, procedures and programs compliant with the guidelines of the Joint Commission on Accreditation of Healthcare Organizations.

(Accredited with Commendation).

• Responsible for providing public health programs and services through contracts with the Boards of Health of local towns.

Education

Masters in Healthcare Management

Lesley University - Cambridge, MA

September 1996 to May 1999

B.S. in Nursing

Salem State University

Skills

• Development, implementation and oversight of delivery of patient services in certified home health, private duty home care, certified hospice and adult day health.

• RN, community health, public health, health promotion; certificate of completion of Boston VNA internship program.

• Home Health, Post-acute care, integrated health systems, ACOs, ICOs financial management including budget preparation, strategic planning, contract negotiation, fundraising management including community relations, donor relations, special event planning; business development; program development.

• Quality Management, Performance Improvement, Medical Record auditor, certification (expired) in healthcare risk management, past certification in gerontological nursing, community health nursing.

• Outlook

• Managed Care

• NCQA Standards

• Healthcare Management

• MDS

• Emergency Management

• HEDIS

• Program Management

• Process Improvement

• Employee Orientation

• EMR Systems

• Alzheimer's Care

• Utilization Management

• Case Management

• Dementia Care

• Management

• Quality Assurance

• Medication Administration

Awards

National League of Nursing, Centennial Leadership Award January 1995

Recognized as one of eight VNA executive directors in MA who collaboratively planned and implemented a merger of eight non-profit certified home health agencies to create a fiscally sound organization providing a comprehensive array of clinically superior services and programs, to residents of the South Shore of Massachusetts.

Partners in Excellence Award

January 2001

Recognized for contributions to the planning and in-house development of Partner's "4-NEXT" program, a software product that tracked the coordination of patient care across the full continuum. It enhanced the communication and collaboration of services provided by Partners and a network of post-acute providers.

Partners in Excellence Award

January 2000

Recognized for leadership and contribution, as a member of the Merger Committee, for the acquisition of the Affiliated Community VNA by the Partners Healthcare System, to create Partners Home Care, now called Partners Healthcare at Home.

Indeed Skills Assessments:

Electronic Medical Records: Best Practices — Highly Proficient February 2020

Knowledge of EHR data, associated privacy regulations, and best practices for EHR use. Full results: Highly Proficient

Verbal Communication — Expert

February 2020

Speaking clearly, correctly, and concisely.

Full results: Expert

Written Communication — Highly Proficient

July 2020

Best practices for writing, including grammar, style, clarity, and brevity. Full results: Highly Proficient

Indeed Assessments provide skills tests that are not indicative of a license or certification, or continued development in any professional field.

Contact this candidate