Revenue Cycle Project Manager
Resume:
Darlene Mangrum Blade
Fairview, TN 37062
adx3o9@r.postjobfree.com
I have a combined 30 years of experience in technical and operation revenue cycle experience. I have led 50 + implementations of Cerner alone. I have worked in multiple software systems and many solutions within these systems. I have been a Revenue Cycle Project Manager for 8 years with project management oversight for patient access, patient accounting, materials management, supply chain, HIM, accounts payable as well as including end user cloud base training in many solutions.
PROFESSIONAL EXPERIENCE
Summit Behavioral Health October 2022-present
Vice President Revenue Cycle Operations
Daily oversite of all revenue cycle central business offices, Utilization Review teams
Prepare monthly finance reports for C-suite and executive leadership meeting
Worked with each department to develop project plan to own revenue and build processes
Develop and implement Audit procedures charge to chart, billing, and compliance audit request
Review, Modify and Train on the charge reconciliation process
Monitor weekly revenue reports for discrepancies and route to appropriate departments
Review monthly operational stats with C-suite
Partner with IT for technology improvements and automating billing and posting processes
Project manager all Revenue Cycle initiatives for the department
Establish standard processes, job descriptions and KPI’s across Revenue Cycle Platform
Developed staffing model of ratio to facility for Revenue Cycle
Developed staffing evaluation process
Built and maintain all projects for Revenue Cycle operational and technical
R1RCM Southern Illinois Region May 2022-October 2022
Regional Director of Revenue/Site Lead
Daily oversite of all revenue cycle solutions for 5 QHC hospitals in So. IL
Coordinate Staffing with Patient Entry for daily resource staffing
Worked with each department to develop project plan to own revenue and build processes
Developed and trained each department on charge triggers for revenue integrity
Review, Modify and Train on the charge reconciliation process
Monitor weekly revenue reports for discrepancies and route to appropriate departments
Review monthly operational stats with C-suite
Providence Health Systems West Coast Region March 2022-November 2022
Senior Project Manager Revenue Cycle
Ministries Patient Access Call Center Upgrade
GoTechNow (part-time contract position)
Develop Project Plan, Charter, Scoping Documents
Ensure all stakeholders are identified and engaged in project
Design meeting cadences for weekly status upgrades
Design Bi-weekly Steering Committee meeting cadences for sponsors and stakeholders
Develop and implement Change Management Processes
Develop and monitor tracking systems for status changes, issue resolution and change management
Develop End User training modules
Track task from inception to closure
Training for End Users as well as administration and supervisors
Humboldt General Hospital Winnemucca, NV July 28, 2020-October 16, 2021
Interim Revenue Cycle Director\Chief Operations Officer for Revenue Departments - Cerner Community Works Post Implementation Optimization
ALKU (formerly Holland Square Group) Consultant
Organized business office resource structure
Developed training module for staff to allow inhouse business office functions
Worked with clinical and IT departments to bring all business office functions in house
Developed transition plan to terminate contract with outside business office third party
Worked with each department to develop project plan to own revenue and build processes
Developed and trained each department on charge triggers for revenue integrity
Review, Modify and Train on the charge reconciliation process
Provide one on one training with all revenue departmental staff on Cerner Community Works System
Create job aides for revenue cycle positions with emphasis on billing
Review with billers how to define and monitor work queues daily
Developed and instituted global project plan for a rework on conversion build for corrections to bring business office functions in house
Developed coding priority queues, hired HIM Director with coding credentials and added additional coding staff based on specialty allow coding to move to in house as well
Developed job descriptions for all positions of the Revenue Cycle Department
Designed justification for QR\QM position approval additional staff to perform processes for approvals
Centralized prior authorization and scheduling
George L. Mee Memorial Hospital King City, California April 6, 2020 – July 2020
Sr. Revenue Cycle Advisor- Cerner Community Works Post Implementation Optimization and Training
ALKU (formerly Holland Square Group) Consultant
Review, Modify and Train on the charge reconciliation process
Provide one on one training with all billing staff on the Cerner system
Create job aides for revenue cycle positions with emphasis on billing
Review with billers how to define and monitor work queues daily
Review historical data for accuracy after converted to Cerner
Organize, assign, and assist with special projects to clean up historical claims from legacy system
Cabell Huntington Hospital/Marshall Health Care Huntington, WV September 2019 – March 30, 2020
Sr. Revenue Cycle Advisor- Cerner Millennium Conversion
ALKU (formerly Holland Square Group) Consultant
Evaluated DCWs, Workflows and future state review for any missed steps in requirements gathering for build for CPA, Registration (Win32, CPM), Scheduling, HIM
Created CDRC Lessons Learned from past implementations as a guide to ensure no missed task
Created training instructions for chart abstraction for legacy claims testing and validation
Designed and built Revenue Cycle Project plan to cover the Cerner Millennium 1 patient/1 chart
Designed individual for ambulatory, acute and physician track platforms for implementation
Managed Revenue Cycle Conversion and Implementation Teams for entire platform
Created and implements all testing activities including script writing, execution, and validation
Performed 100% Charge Focus Testing for all Cerner Charges
Designed and performed with team all legacy script testing with 92% pass rate
Developed all Training, Policy and Procedures and SOP documentation
Developed front end and back-end processes for Cerner Millennium
Designed and developed charge reconciliation process
120 Days of facility revenue cycle optimization and implanted Cerner enhancements
Erie County Medical Center Buffalo, NY July 2019-September 2019
Revenue Cycle Project Manager-Cerner Millennium Conversion
Ettain Group Consultant
Designed and built Revenue Cycle Project plan to cover the Cerner Millennium 1 patient/1 chart
Created and implemented all testing activities including script writing
Developed all Training, Policy and Procedures and SOP documentation
Developed front end and back-end processes for Cerner Millennium
Designed and developed charge reconciliation process
Parallon Project Services Team Nashville, TN May 2019-July 2019
Sr. Project Manager I- Registry Clinical Abstracting
Rezult Group Consultant
Identify Stake holders in project
Develop Roles and Responsibilities for each Clinical Solution
Define needs to move all hospitals clinical registries into identified Parallon Service Centers
Develop Communication Plan
Develop Education/Training Plan
Determine Pilot Facility
Requirements Gathering of all downstream vendors as identified
Develop IRR, Technical Requirement
Develop and Implement User Toolkit
Gather Organization Charts for all Service Centers
Review Timelines with Service Centers and Business Partners
Develop Policies and Procedures, Core Measures and SLA for each hospital
Develop Future State Workflows based on Scope Document
Columbus Regional Health Whiteville, NC February 2019-May 2019
Revenue Cycle Manager
Avaap Staffing Group
Designed and finalized Revenue Cycle Project plan to cover the Cerner Community Works 1 patient/1 chart
Designed individual for ambulatory, acute and physician track platforms for implementation
Managed Revenue Cycle Conversion and Implementation Teams for entire platform
Created and implements all testing activities including script writing, execution, and validation
Performed 100% Charge Focus Testing for all Cerner Charges
Designed and performed with team all legacy script testing
Developed all Training, Policy and Procedures and SOP documentation
Developed front end and back-end processes for Cerner Millennium
Designed and developed charge reconciliation process
Developed and executed change management processes for system changes and software upgrades
Indiana Regional Medical Center Indiana, PA Feb 2018 – April 2019
Project Manager, Cerner Millennium Community Works Implementation
Rezult Group Consultant
Designed and built Revenue Cycle Project plan to cover the Cerner Millennium 1 patient/1 chart
Designed individual for ambulatory, acute and physician track platforms for implementation
Managed Revenue Cycle Conversion and Implementation Teams for entire platform
Created and implements all testing activities including script writing, execution, and validation
Performed 100% Charge Focus Testing for all Cerner Charges
Designed and performed with team all legacy script testing with 92% pass rate
Developed all Training, Policy and Procedures and SOP documentation
Developed front end and back-end processes for Cerner Millennium
Developed and executed change management processes for system changes and software upgrades
Designed and developed charge reconciliation process
120 Days of facility revenue cycle optimization and implanted Cerner enhancements
Community Health Systems Franklin, TN Dec 2012 – Dec 2017
IS Senior Manager, Deployment Services Dec 2016 – Dec 2017
Established protocol and policies for all deployment team for planned Cerner conversions
Developed and implemented standardized project plans for all multi-tiered Cerner conversion including Millennium Community Works and Clinical platforms
Established post go-live acute support and lessons learned for first 30 days
Established pre-planned travels and resource alignment for fiscal savings for the department
Develop tracking/accountability tickler system for all projects
Develop tracking process for unplanned request
Assist Director with CHS Divestitures and Acquisitions
Work with Director and DCIO to screen and recruit fresh staff
Develop Program Project Space for both Divestitures and Acquisitions to capture Resource Allocation, budget accountability and metrics for trending and milestones
IS Senior Manager, Cerner Clinical Services May 2016 - Dec 2016
Managed Daily Operations 3 Lean Projects for multiple Cerner applications
Worked with Cerner Corp and Internal CHS Cerner Team to streamline processes of daily functions
Developed tracking/accountability tickler system for all projects
Interviewed, hired, and managed 10 core team members and 15+ consultants
Developed and implemented cross training and peer review models
Developed Program Project Space for all Cerner applications supported to capture Resource Allocation, budget accountability and metrics for trending and milestones
IS Cerner Revenue Cycle Manager Dec 2012 - May 2016
Managed daily operations and all Cerner Revenue Cycle implementation projects to include integration between Cerner patient accounting and Cerner clinical applications
Worked with Cerner Corp and Internal Rev Cycle IS Deployment Team to streamline processes of daily functions impacting PA workflow and compliance
Developed tracking/accountability tickler system for all projects
Developed tracking process for unplanned request
Deployed new day-end process eliminating nightly downtime
Identified by CHS’ human capital leadership for “Excellence in Hiring”
Received the “President’s Award “
Promoted to Senior Manager January 2016
Managed 8 core team members and 10+ consultants
Developed and implemented cross training and peer review models for PA team
Elements Behavioral Health Long Beach, CA Feb 2011- Sept 2012
Sr. Revenue Cycle Manager
Developed and implemented a central business office for parent company with affiliates in four states
Developed policy and procedures for all functions within the medical billing office, implemented an internal audit department for all facilities
Increased client base by 70% by implementing insurance billing at all facilities
Increased insurance collections consistently by 50% each month for eight consecutive months, record collection for all facilities for a 4-month period
Developed and implemented a utilization review division of billing office for increased coverage and extension for clients in all facilities
Obtained CLIA certificates for all facilities to implement urinalysis drug screen testing for approximately $1,400,000.00 in incremental revenue for five facilities
Manager A/R for five facilities and maintained days in A/R under 60 days for all facilities that were out of network
Trained all facility clinicians and medical teams for appropriate documentation for all levels of service provided
Hired and trained entirely fresh staff
Supervised staff that grew from 2 to 14 in an 18-month period
Evaluated and purchased patient account system Allscripts, responsible for the system set up, implementation and daily technical maintenance of system, addition of all new departments for patient accounting purposes
Healthmark Partners Nashville, TN May 2009-April 2010
Central Business Office Manager
Provided administrative supervision of the Central Business Office, staffing to meet work demands, liaison between surgery centers and corporate staff
Assisted staff with difficult cases with timely communication to centers and HMP executive staff
Supervised daily function of coders, billers, collectors, and cash posters, provide training to CBO personnel, ensure all CBO personnel follow all appropriate policies and procedures as outlined by corporate guidelines
Managed A/R/ of six centers monthly
Assisted team with startup of new centers and/or business units, prepare weekly performance matrix for corporate executive staff
Implemented and trained all CBO facilities on the AdvanteX system
Trained all fresh staff and current staff with system updates in the facilities and corporate CBO
Implemented system integration of new clearing house with multiple patient accounting systems across the facilities, responsible for the weekly technical maintenance and verification of proper system uploads
Gold Skin Care Center Nashville, TN Sept 2007 - Sept 2008
Business Office Manager
Managed daily operations of business office with monthly processing of financials, daily balances of deposits
Supervised and maintained vacation accruals and usage for twelve employees
Developed policies and procedures for and managed the daily operations of the front desk and phone room staff
Maintained credentialing for multiple physicians and physician extenders with hospitals as well as multiple insurance companies,
Developed and maintained claims tracking system for system accuracy
Maintained A/R for two largest carriers in practice, worked denials and monitored trending for slow payment cycles, from payers, decreased aging A/R by 30% in 5 months
Implemented and trained all staff of business office and front desk in conversion to new patient accounting software, trained all new business office and front desk staff
Instrumental in converting medical office, research center and spa to electronic medical records (EMR), responsible for weekly maintenance check of the patient accounting system merge with medical records, facilitated the merge of accounting general ledger to the patient accounting system
Frist Cardiology, PLLC Nashville, TN Aug 2006 - Sept 2007
Office Administrator
Coordinated both clinical and administrative function of a 5-physician cardiology practice
Processed payroll and benefits for twenty employees, maintained monthly facilities and clinical budget, processed monthly reconciliation of budgets, monitored expenditures of practice, and prepared monthly financial statement for physicians and accountant
Supervised and staffed daily for both clerical and clinical staffing
Developed marketing plan for practice resulting in the addition of three satellite clinics and two nuclear divisions, orchestrated marketing plan to increase practice visibility to multi-media areas
Trained staff on clinical and patient accounting software as well as maintaining training for system upgrades
Responsible for all technical system support for patient accounting system and made the determination when to call in outside support
USPI Brentwood, TN Nov 2005 - Aug 2006
Business Office Supervisor
Managed the daily the operations of the business office with monthly processing of financials, daily balancing of deposits, process payroll and benefits for 60+ full time and PRN employees
Maintained vacation accruals and usage for all employees
Liaison employees and center Administrator, backup manager for shared business office manager
Worked parallel with center Administrator to develop sales/marketing plan for surgery
center to surgery practices-implementation of plan increased the center’s surgical cases by 38% in first 6 months
Maintained training for all front desk and business office staff on patient accounting system with system upgrades, Trained all new Business Office Staff
Local area network support for patient accounting and email system
Vanderbilt University Medical Center Nashville, TN June 1991 - Oct 2005
Office Administrator
Served as supervisor in various divisions for over 14 years, daily supervision of at minimum five staff members
Responsible for monthly and annual budget preparation, payroll, and benefits for divisions
Maintained credentialing for multiple physicians and fellows with hospital as well as multiple insurance companies-worked closely with hospital marketing department to roll out all new physicians
Trained new and current VUMC staff in customer service
Trained all current and fresh staff to division on patient accounting systems and system upgrades, Local area network support for division, managed all system error request and made determination when to escalate to VU network division
EDUCATION
David Lipscomb College Nashville, TN 1985-1989
BA, Accounting
Summa cum laude with a GPA of 4.2
First-year starter for Lady Bison’s Basketball team
Competed in campus intermural sports
Served as Vice-President of Student Body Government 1987-1989
Received the Dr. John Lloyd Leadership Ethic Award for excellence in Student Body Satisfaction
Received Outstanding Student Awards for government, leadership, and campus mentoring
Received the Nashville Agape Award for summa cum laude distinction for Mothers for Higher Education
PROFICENT MASTERY SKILLS
Medhost Financials Solutions
Cerner Revenue Cycle Solutions
Cerner Registration and Surgery Solutions
Cerner Surginet Solution
Cerner FirstNet Solution
Cerner Profile Solution
Cerner Urgent Care Solution
Cerner Anesthesia Solution
Allscripts Financial Solutions
Meditech Revenue Solutions
Hyland Onbase
Med Manager
Mysis
Atriva
Vizio
Microsoft Office Solutions
Microsoft Project
Excel
Word
PowerPoint
One Drive
SharePoint
OneNote
Remedy
ServiceNow
SalesForce
Medik
HCS EMR
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