Gretchen Reynard Email & Phone Number

Boston, Massachusetts, United States

• Managed comprehensive oversight and administration for the organization’s Program of All Inclusive Care for the Elderly (PACE), spanning multiple Massachusetts locations, reporting directly to the President and CEO.• Managed a team of 200+ clinical and non-clinical staff, focusing on high-performance and goal attainment.• Oversaw P&L and managed a $60M budget, driving financial growth through financial trend analysis and forecasting.• Supervised critical operations including utilization, care management, health plans, clinics, provider networks, 24-hour care, rehabilitation, adult day centers, homecare, and quality assurance processes.• Initiated a Utilization Management department in 2020, focused on enhancing hospital and nursing facility outcomes, achieving reductions in hospital stays by 15%, readmissions by 8%, and long-term care census by 57%.• Directed the development of a Medical Expense Management system, leveraging EMR and claims data to track cost of care trends and implement revenue optimization strategies, with a focus on HCC coding.• Developed and implemented a Key Metrics Dashboard in 2023 to monitor performance and inform strategic decisions.• Fostered and maintained relationships with key business, community, state, and federal partners.• Managed the submission and approval of two Service Area Expansion applications to CMS in 2021 and 2022.• Coordinated federal and state quality improvement programs, leading initiatives to elevate KPIs.

• Directed nursing operations for all programs within the Transitional Care Service Line, including Atrius' Home-Based Nurse Practitioner Program, Long-Term Care Nurse Practitioner Rounding Program, and partnerships with VNA Care Network • Executed initiatives to enhance clinical, financial, and quality outcomes across Transitional Care programs• Provided direct patient care for a small panel of long-term and sub-acute patients within a nursing facility, ensuring high-quality care and effective patient management• Oversaw a team of 100 staff members, driving excellence in daily operations and strategic planning.• Atrius Health, Ovation Award Winner, Aug 2018• Directed daily operations of the Care Management Department, covering Utilization Management and Social Services across 35 locations in Massachusetts for a prominent multi-specialty provider practice.• Led the enhancement and strategic overhaul of Atrius Health's care management model, focusing on staffing efficiencies, performance metrics, policy frameworks, and standardized procedures.• Analyzed data trends in average length of stay, readmissions, and emergency room utilization to refine and adjust care management strategies effectively.• Ensured strict compliance with all care management protocols under the Tufts Medicare Advantage contract, maintaining high standards of regulatory adherence.• Spearheaded the Medicaid ACO partnership, seamlessly integrating case management processes with Tufts Health Plan to optimize patient care coordination.

Watertown, Ma

• Led the clinical development and successful launch of the Senior Care Options product for dual-eligible individuals over 65 in 2013, including comprehensive responses to the State’s RFA and submissions to CMS’s Model of Care Special Needs Plan (SNP).• Led a team of 75 employees and contractors, driving performance and ensuring alignment with company objectives.• Managed the establishment and ongoing review of care and staffing models, performance metrics, policies, procedures, and workflows for the product.• Oversaw clinical performance, including acute inpatient and post-acute utilization, along with medical expense management, maintaining compliance across 27 ASAPs in Massachusetts.• Directed the Post-Acute Transitions Team, significantly improving post-acute care durations and transitions, while fostering effective collaborations with facility, community, and clinical rounding teams.

Waltham, Ma

Jamaica Plain, Ma

Masters Of Science In Nursing, Family Nurse Practitioner

Bachelor'S Degree, Registered Nursing/Registered Nurse

Bachelor'S Degree, English Language And Literature/Letters