Carol Gregory Email & Phone Number

South Carolina, United States

Indianapolis, Indiana, Us

Develop strategic roadmap for physician engagement including quality indicators, measurement of success against contracts while developing a memorable patient experienceWork with multi-disciplinary teams to develop digital solutions which enhance the member and provider experienceSupport national clients and providers to improve understanding of healthcare operational options to improve the care delivery experienceFunction as the quality and healthcare operations subject matter expertStrategic development for digital integration with healthcare systems for improved data exchange and virtual care options for patients and physicians

Indianapolis, Indiana, Us

Strategy Roadmap – Lead development and delivery of strategic roadmap for provider engagement strategy to optimize clinical best practices, data analytics, and performance improvement methodologies to national team of consultants. Succeeded in deployment of 85 associates within nine months.Multidisciplinary Team – Created top-quality multidisciplinary team of Physicians, Pharmacists, Nurses, and Master Black Belts within 30 days. Facilitated training and development of new provider engagement consultant program.Contract Product Line – Clinical Subject Mater Expert for design and initial sales cycle of value-based contract product line for sophisticated healthcare providers.

Indianapolis, Indiana, Us

• Partners directly with Clinically Integrated Networks, IPAs, and Health Systems to design and implement population level strategies intended to improve the quality of care and reduce the cost of care• Collaborates with internal clinical, technical, and information management partners to identify and deliver a collaborative framework to support a transformation to patient-centered, high quality, cost effective care models• Designs and implements programs to close clinical gaps in care, reduce total cost of care, and enhance clinical documentation by providers• Assess, identify opportunities, and implement customized operational improvements for value base contracts such as Medicare Advantage, I-SNP, CPC/CPC+, Hospital Value-Based Purchasing, and payer specific programs• CDT Footprint is 14 markets, 5.6 million members and 400 provider groupsTraining – Developed mentoring program for Care Consultant teams resulting in a retention rate of 94%.

Hartford, Connecticut, Us

• Leadership of initiatives to create value based contracting strategies, accountable care organizations, population health management services, and patient centered medical home care models for primary care provider organizations and their affiliates • Significant field work with independent physician associations, large group practices, hospital-owned practices, rural health centers, and others to create strategies that increase value to providers and patients alike• Developed employer partnerships with health systems and payers with the overall strategy aimed at reducing total cost of care for employers who are self-insured• Led integrated population health management programs with Baylor, Scott & White, Cleveland Clinic, and Arizona Care Network

Indianapolis, In, Us

• Design and implement an effective compliance and quality program for the organization of 13 Federally Qualified Health Center locations throughout the state of Indiana reporting to the Board of Directors• Leadership for implementation of PCMH accreditation, Meaningful Use implementation and eClinicalWorks EMR implementation for 60 primary care, dental, and mental health providers, and staff• Development, implementation, and support of PCMH Level 3 certification for 5 FQHC offices with medical, dental, and behavioral health after writing and receiving HRSA grant funding• Management of grant opportunities and principle editor for UDS submission to HRSA. Receiving over $5 million dollars in grant funding over the course of employment, including funding for a new site and mobile van • Established Compliance hotline, fraud, and abuse auditing for all locations and centralized it to the corporate office alleviating administrative burden on the practices.• Define operations strategies specific to community needs assessment to engage community partners. Development of Behavioral Health integration strategy, Social Determinants of Health tracing, and leadership for 340B implementation. Improving quality scores by 12% in a fiscal year and demonstrating a 4% increase in revenue.

• Responsible for reporting data for an acute care inpatient facility to the Joint Commission of Accreditation of Healthcare, the Centers for Medicare and Medicaid Services, the Indiana Health and Hospital Association for the facility quarterly.• Compliance Coordinator responsible for structuring and conducting audits based from the Office of Inspector Work Plan for the appropriate billing structure according to the Centers for Medicare and Medicaid.• Administrator for the facility Chargemaster, making recommendations, corrections and overseeing implementation of such for all facility departments.• Work directly with Patient Registration, Health Information Management, Case Management, Utilization Review and the Billing Office to audit and correct billing, coding, and case management concerns on an ongoing basis.• Responsible for a number of information systems necessary for tracking, aggregating, and distributing quality data to various in-house and outside agencies.• Education within the organization for middle and senior management, physicians, and team members of reportable quality initiatives such as ORYX Core Measures, Leapfrog, and Hospital Quality Alliance.• Direct supervision of PI Research Analyst and PI Auditor and Case Management in completion of their duties.

• Monitor and develop the facility charge description master.• Responsible for conducting audits in line with the Office of Inspector General Yellow Book annually. This would include audits specific to Centers for Medicare and Medicaid Services billing compliance as well as commercial payor regulations.• Act as a liaison with external auditors for billing, coding, and compliance audits.• Work as back up for Case Management when required.• Implement and administer computer software as required by corporate for the regulation of charge processes within the facility.• Aggregate and report all monthly findings to the Facility and Ethics Compliance committee.

Master Of Business Administration - Mba, Health/Health Care Administration/Management

Bachelor Of Arts (Ba), Nursing Science

Associate Of Science (As), Registered Nursing/Registered Nurse

Associate'S Degree, Organizational Leadership And Communication