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Retired Healthcare ExecutiveAccomplished executive with extensive experience in health care leadership, program and system development and improving / expanding healthcare programs. Experience in strategic program development and implementation, policy and contract interpretation, regulatory compliance and clinical documentation systems developed in collaboration with key stakeholders. Collaborative and energetic change agent, leading teams in development of medical cost reducing, customer focused policies and processes. Unique combination of experience and knowledge from the ground up in health service operations, quality and regulatory compliance. Proven track record in successful planning and direction of activities that improve clinical and quality outcomes. Strategic program development / implementation. Natural ability to sort through clutter and chaos to find most effective path for maximum benefit. National Speaker on Managed Care Topics. Interested in consulting opportunitiesAreas of Expertise
Health Care Executive
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Health Care Executive And ConsultantHealth Care ExecutiveIndianapolis, In, Us
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Health Care Executive/ConsultantHealth Care Executive 2013 - Present
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Vice President Medical ManagementMhs Indiana Mar 2019 - Jun 2020Indianapolis, IndianaRetired
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Vice President Healthcare Management ServicesWellpoint Anthem Dec 2013 - Dec 2018Responsible for the development, implementation and oversight of integrated Healthcare services to serve Anthem Commercial and Government Business members and providers. -
Vice President Healthcare Management ServicesWellpoint Anthem Dec 2013 - Dec 2018Responsible for the development, implementation and oversight of integrated Healthcare services to serve Anthem Indiana Medicaid members and providers.
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Vice President Of Clinical OperationsCaresource Management Group 2010 - 2013Provided strategic development, implementation and oversight of clinical operations and processes of health service programs leading to improved outcomes and reduced cost of care. • Responsible for executive leadership, direction and support of clinical operations for Medicaid members in Ohio, Kentucky and Florida and for dually eligible members in Ohio, ensuring successful financial, regulatory and clinical outcomes for organization and stakeholders. • Worked collaboratively ensuring alignment of clinical programs and operational processes to meet strategic goals of all internal and external stakeholders. • Direct oversight of utilization management, 24 hour nurse advice line, disease management, case management and quality monitoring functions for over 900k Medicaid managed care members and 1,500 Medicare / Medicaid dually eligible members. • Led Health Service team to successful NCQA / URAC accreditation and Federal and State audits through compliant policy and development and implementation. -
Director Medical ManagementCaresource Management Group 2006 - 2010Directed all Medical Management services for more than 600k Medicaid managed care members enrolled in CareSource Ohio and Community Choice Michigan. • Ensured operational and clinical alignment with provider processes and systems, restructured department to implement specialty review units, which included claims analysts, medical reviewers, configuration specialists and auditors, ensuring accurate and timely processes for utilization review and claims payment. • Responsible for interpretation of federal and state regulations governing delivery of health care for Medicaid and Medicare patients. • Responsible for completion of RFPs for Covered Families and Children, Aged, Blind and Disabled and dual eligible Medicaid members. • Led team in configuration and implementation of Facets system to adjudicate benefit package for Medicaid and Medicare managed care members, including application of clinical edits. • Developed policies, procedures and processes fully compliant with state and federal regulations leading to successful URAC and Ohio Medicaid audits.
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Manager Medical ManagementCaresource Management Group 2004 - 2006Managed RN’s and non-professional staff providing medical management services to over 600k Medicaid eligible managed care members. • Researched, developed and implemented policies and processes in accordance with CFR, URAC and state regulations. • Actively participated in contract and provider negotiations. • Successfully led CSMG Medical Management in achieving full accreditation for URAC.
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Manager Case Management/Discharge PlanningHumana Military Healthcare Services 2001 - 2004Responsible for direct management of RNs and Social Workers providing case management, discharge planning and concurrent review services to 800k Region 5 Tricare beneficiaries. • Collaborated with Military Care Systems to develop programs and process to maximize base resources and retain patients in Military Treatment Facilities. • Researched, developed and implemented policies and processes for identification and medical management of Tricare patients within Tricare / DOD policy using available data to implement and analyze intervention. • Served as HMHS Medical Affairs liaison and educator for Region 5 Mental Health subcontractor.
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Manager Care Management/Pediatric Case Management NurseAnthem 1997 - 2001Directed RN’s and non-professional employees in an aggressive managed care setting. • Led Case Management, Utilization Management and Quality Improvement responsibilities for Anthem Blue Cross / Blue Shield Dayton region with a membership of 323,050. • Interacted collaboratively with patients, providers and physicians to coordinate health care needs in both inpatient and outpatient settings. Advocated for parents of acutely and chronically ill children, providing guidance regarding benefits, options for care, community resources and other health management needs. • Developed Synagis immunization program. -
Clinical NurseDayton Children'S Medical Center/ Fidelity Home Care 1997 - 2001Prior experience includes Director of Private Duty Services at Children’s Home Care of Dayton, Relief Charge, Transport and Staff Nurse (ICU and NICU), Pediatric Nursing Supervisor for Fidelity Home Care. Noted accomplishments include:• Researched feasibility of and developed private duty nursing company for Children’s Medical Center. • Developed and wrote budget and business plan for 80+ nurses in care of chronically ill, medically fragile high tech children. • Developed and implemented pediatric home care program for Fidelity. Developed policies and procedures and nursing protocol for home care of children and chronically ill, high tech children.
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Frequently Asked Questions about Cheryl Slagle
What company does Cheryl Slagle work for?
Cheryl Slagle works for Health Care Executive
What is Cheryl Slagle's role at the current company?
Cheryl Slagle's current role is Health Care Executive and Consultant.
What is Cheryl Slagle's email address?
Cheryl Slagle's email address is ch****@****rce.com
What is Cheryl Slagle's direct phone number?
Cheryl Slagle's direct phone number is +141039*****
What skills is Cheryl Slagle known for?
Cheryl Slagle has skills like Medicaid, Managed Care, Medicare, Disease Management, Healthcare, Healthcare Management, Utilization Management, Case Management, Inpatient, Hipaa, Nursing, Healthcare Information Technology.
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