Amber Wirts, CMPE

*** **** ****

Milton NH *****

Email: adsv4v@r.postjobfree.com

615-***-****

PROFESSIONAL EXPERIENCE:

HCA II – December 13, 2021 to present

Director Physician Services Northeast Market

Oversight of operations, budget, and general management of the Northeast market

Responsible for 126 providers, 3 directors, 250 teammates

Develop, implement, and monitor practice budgets including analyzing financial impact of changes and forecasts, and expenditures. Annual budget of 84,000,000 EBITA of 48,000,000

Supervisory responsibility for physicians and practice staff as well as meet regularly with constituents including but not limited to operations leadership, physicians, and hospital administration to review practice strategy, market and division goals, financial performance, and practice key indicators

Partner with division leadership to align goals and targets weekly as well as monthly reporting of business line outcomes

Oversee physician recruiting and contracting in collaboration with other PSG colleagues including negotiated contract for new and existing providers

Strategic and tactical operational responsibility for the business and clinical functions through administrative and clinical staff including providers, front desk, medical records, nursing, and ancillary services to ensure maximum utilization of resources and the efficient delivery of services of his or her assigned practices

Responsible for Human Resources items

Identify practice/business development opportunities to increase market share

Direct and manage strategic projects for areas such as patient flow, patient satisfaction, practice volume, billing and collections, service utilization, coding, physician, and staff training

DaVita Nephrology Practice Solutions: October 23, 2018 to Nov 19, 2021

Director Practice Operations Southeast Region

Oversee all practice administrative, business and clinical leadership functions and ensure the team is meeting all relevant practice metric goals

Responsible for holding regular meetings with physicians, non-physician practitioners and practice team to ensure clear communication on goals and initiatives

Hold monthly operations strategy meeting to review provider reporting and metrics, financial status and set goals for the following months to close any gaps that maybe projected

Physician recruitment and onboarding

Help direct reports overcome any organizational obstacles encountered during projects

Know, understand, implement, follow, and communicate to teammates all DaVita and NPS employment policies and procedures, awards, and other opportunities and foster a positive work environment

Hire, develop, and retain teammates so they can excel in their assigned roles in a team environment

Facilitate teammate development (PDRs, coaching, mentoring, DaVita training, NPS training, outside training); collaborate with direct reports to create professional development goals

Ensure the practice is delivering the highest levels of Service Excellence to physicians, patients and internal and external stakeholders, at all times

Manage 138 providers, 188 direct and indirect teammates

Manage monthly budget of 10,000,000

Utilize report writing and data mining/retrieval from the Electronic Medical Record and Practice Management systems to provide baselines for analysis and to develop action plans for improvement

Ensure compliance with all appropriate regulatory agencies, corporate compliance, system protocols and office procedures; and communicate policy changes to appropriate staff

Review established business Policies and Procedures and conduct spot audits to ensure compliance

Serve as a role model for the core value of integrity; demonstrate solid judgement; and outreach to the legal and compliance team related to any appropriate questions or issues

Collaborate with the NPS Marketing Team in the creation of marketing collateral.

KMC: November 30, 2015 to September 01, 2018

Director of Clinical Operations

Plans, implements and monitors development of new physician practices, and ancillary services and practice sites by preparing proforma and overseeing construction, relocation, credentialing, contracting, marketing, orientation and financial reviews. Successfully opened three new practices this year including, Plastic Surgery clinic, Med Spa and a cosmetic physician-based practice. Also implemented an in-house dispensary at two locations and implemented Remicaid Infusion treatments.

Forecasts, communicates, monitors and evaluates financial performance and operational achievement of multiple clinics sites through discussions and written documentation with physicians and executive team. Determines capital needs through collaboration with staff.

Assures quality of patient services and patient satisfaction by effective recruitment, training, mentoring and retention of engaged staff.

Manages daily operations at nine clinics and coordinates the work activities and schedules.

Evaluates performance and recommends merit increases, promotions, and disciplinary actions of all staff

Ensures that office space, supplies, equipment, and assistance are provided and maintained appropriately for medical staff and patient care.

Ensures that all business functions are operative and that all processes are effectively and efficiently in place. Reviews processes and makes recommendations for improvement. Creates goals for clinic operations and ensures that these goals are in line with organization goals.

Operates within the context of an established budget. Makes recommendations for annual budget and maximizes opportunities to meet and exceed budget guidelines.

Improved utilization of EMR by training and opening up functions that were not being used.

Contracting in various roles – January 03, 2014 to August 18, 2015

Business Operations Analyst – Pharmacy

Improve the operational systems, processes and policies in support of organizations mission -- information flow and management, business process and organizational planning.

Implementation of Sales Force CRM within the pharmacies operations team.

Responsible for Compliance and Persistency program– Ensure all contractual reporting criteria is included in the quarterly reports that are dispersed to participating vendors, oversee vendor audits, contract review, quality control, compliance adherence, and operational development for all Compliancy and Persistency pharmacy programs.

Assess, conduct studies, prepares detailed reports and provides process improvement recommendations surrounding attrition.

Analyze and evaluate content and performance of queries, reports and other data-based processes suggesting improvements which may include changes in the structure or indexing of data.

Interim Director of Operations

Implement sales plan to inspire growth within the market place.

Rolled out a branding plan with a marketing firm to improve visibility within the communities

Secured contract with local hospital to provide exclusive surgical services to all patients

Build and maintain business relationships with partners within the community

Manage and increase the effectiveness and efficiency of Support Services (HR, IT and Finance), through improvements to each function as well as coordination and communication between support and business functions.

Play a significant role in long-term planning, including an initiative geared toward operational excellence.

Oversee overall financial management, planning, systems and controls.

Development practice budgets

Invoicing to funding sources, including calculation of completed units of service.

Payroll management, including tabulation of accrued employee benefits.

Disbursement of checks for agency expenses.

Regular meetings with Physician around fiscal planning.

Supervise and coach office staff on a weekly basis.

Lead Meaningful Use Analyst – Acute Care

Subject Matter Expert on Stage 1, 2 and 3 Medicare and Medicaid EMR incentive programs – implementing criteria to meet meaningful use and PQRS standards within the EMR structure

Responsible for Meaningful Use Education for all Acute Care

Work directly with Executive Team and facilitate meetings to ensure Meaningful Use projections are on target and meet the standards published by ONC and CMS

Research requirements for state agencies on registry support (Immunizations, Syndromic Surveillance, Specialty, Cancer)

Research and analyses existing and upcoming meaningful use guidelines and report on how they will affect the business and best way to approach and implement needed changes

Excellent communication skills and the ability to interface at all levels of the organization within and outside of the company. Superb relationship building and interpersonal skills

Excellent analytic, problem-solving, organizational skills, demonstrate self-confidence, honesty and integrity at all times

Maintain a manner of leadership and flexibility that diffuses pressure and promotes a team atmosphere

Develop and articulate written business definitions and documents

E+ cancer care LLC - Leader– October 2006 to January 03, 2014

Operations Leader

Help the business assess and implement technology solutions in a cost-effective way by determining the requirements of the project, and communicating them clearly too all stakeholders, facilitators and partners.

Create, coordinates and maintains documentation and communications of the requirements to all stakeholders

Established and implemented best practices throughout the clinics, allowing for the most effective operational function of each clinic across the organization

Prepares technical reports by collecting, analyzing, and summarizing information and trends

Oversee revenue generation, with responsibility in assisting with physician governance and leadership, business development, strategic alignment, community outreach, and business operations.

Assists and coaches practice site managers in management of resources and work processes

Managed Care Associate Leader Aug 2010 to May 25, 2013

Coordination of initial provider enrollment and re-credentialing for all centers, physicians and other clinicians.

Collaborate with the attorneys to ensure that appropriate documentation is submitted for government payers timely.

Assist the due diligence team in licensure and certification requirements for upcoming acquisitions.

Serves as liaison and point of contact to billing and center staff for questions regarding managed care contracts, fee schedules, and CMS issues. Point of contact for internal staff with billing and claims issues/questions.

Works directly with Business Data Analyst and other staff to ensure that managed care contracts are paying according to negotiated terms through regular reports.

Manage daily operations of physician and facility enrollment/credentialing department for 23 facilities associated with e+cancercare.

Created, implemented, and maintain goals, objectives, polices/procedures and systems for all areas in the provider enrollment department.

Maintain working knowledge of CMS regulatory and enrollment policies, communicate changes to department leads.

Oversee ACR accreditations for all locations, insuring timely recertification protocols are in order and completed within the required time frame.

Monitor licensing protocol for all cancer facilities and imaging centers –RAM, X-Ray, CLIA, COLA.

Monitor and Maintain OSHA and HIPPA compliance for all sites within the organization.

Special Projects Leader May 2009 to Aug 2010

Lead EMR team in all training efforts of physician and staff.

Performed facility audits to ensure each location is compliant with federal and state regulations, as well as, company standards.

Effectively lead and facilitated all audit related meetings and communications with CBO team members, health center staff and leaders, Business Partners, and Executive Leadership as required.

Recommend process changes and/or improvements within Department or system changes to reduce losses or improve efficiency. Analyze the staffing model regularly to distribute the work load accordingly.

Resolve problems in all areas of billing and centers to ensure compliance with state and federal regulations as well as company standards.

Marketing strategies to increase referral base and educate referring physicians and staff on PET/CT advantages in patient care.

Operations Leader Oct. 2006 to Aug.2010

Restructured daily operations; successfully transferred daily responsibilities from field locations to a centralized location reducing staff by half and resulted in a saving s of over $200,000 in gross salaries per year.

Responsible for work assignments and daily operations for 22 locations in eight states.

Brought appeals/denial approval rate from 51% to a constant 89% increasing revenue by 38% on claims that would have otherwise been written off.

Monthly and yearly forecasting of patient volume by comparing previous months and years to anticipate growth trends.

Review net revenue reports as required by standard operating procedures, including but not limited to: balancing reports, volume reports, trending reports, issue logs, and audit results.

Prepare yearly budget proposals based on trend within the markets and potential increases or decreases in revenue.

Orthopedic Associates of Aspen and Glenwood Springs

Clinic Manager - March 06-Oct 06

Managed the daily work assignments and departmental personnel for the entire practice, including 22 direct staff reports and eight physicians.

Worked with medical staff and nurses to ensure quality patient care and services were provided.

Resolved issues with patients to ensure we provided exceptional customer care to each patient.

Ensure the effective development and implementation of benefit programs, wage scales, job descriptions, personnel policies and payroll practices.

Set improvement plans for staff members that required adjustments in their professionalism or other areas.

Evaluate performance and recommend merit increases, promotions, and disciplinary actions, dismissal of employees who have unsatisfactory performance.

Helped fiscal management and other administrative staff to develop and implement cost effective policies and procedures for all operational areas including bookkeeping, billing, insurance, fee schedules, credit/collections, purchasing, data processing and space planning.

Tulsa Bone and Joint

Lead Medical Assistant: Nov. 2002-Mar 2004

Oversee all Medical Assistants for all physicians in practice insuring proper coverage each day.

Acquired insurance, workman’s comp, and Medicare authorization and guidelines for each patient’s upcoming surgery and follow-up care (Pre Certs, Pre D.)

Communicated with case nurse mangers and work comp adjusters on the status of their patients.

Scheduled pre op testing, EKG, X-Rays, CBC, Chem. 14, and Cardio clearance when needed.

Applied ICD-9 and CPT coding of all daily and surgical patient charges.

Medical work up of all patients seen by physician, medication refills to pharmacy, removal of casts, sutures, staples, changed bandages.

TLC Laser Eye Center, Tulsa, Oklahoma

Patient Consultant, Financial Admin, Tech, Continuing Education Coordinator: May 1999- Sept 2002

Travel Coordinator for ICL, complex cases, and all other TLC patients who travel to Canada for surgery.

Submit pre-determination letters to insurance companies and assist patients with their needs for insurance claims.

Performed Topography, recheck refractions, pupil sizes, dominate eye and other important test done on surgery day.

Coordinate information from TLC Clinical Affairs department and the FDA out to five locations for complete protocol complacence from each site for three FDA studies.

SKILLS:

Proficient knowledge of Microsoft 2003 thru 2007 (Word, Access, Excel, Power Point, ), iMacro, Sales Force, Quick Books, Med-X, Pharos, Merge RIS, On Base, Outlook, Centricity/Aria, Provider Trust, Multiple other software. ICD-9 and CPT coding skills, conflict resolution

EDUCATION:

Monett High School, Monett, MO. 1993

Crowder College, Healthcare Administration, 1998

Metro University, Healthcare Administration, 2001

Ashworth College – currently enrolled MHA program

ACCOMPLISHMENTS:

Crowder College Dean’s List

A member of Phi Theta Kappa – National Honors

Who’s Who Among American College Students

Business Merit Award

National Dean’s List

All American Scholars

CMPE

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