Jeff Herald Email and Phone Number

GHS Clinical Decision Support is a team of Quality specialists that enhances health-related decisions and actions with pertinent, organized clinical knowledge and patient outcomes shared in order to optimize care quality, patient safety and efficient healthcare delivery. The CDS toolkit includes a variety of systems, software tools, and proven decision support methodology including Lean Six Sigma, FOCUS- PDSA cycles, Project Management principles, and evidence based guidelines for clinical application.

Led successful implementations of MedAssets Decision Support software, utilizing expertise in hospital data, reporting, and financial modeling. Offered process improvement solutions and tailored products to fit the unique business needs of more than 50 healthcare systems across the US. Leveraged extensive knowledge of hospital budgeting process to develop strategies for managing multi-entity budget efforts.• Devised innovative solutions to overcome significant technical obstacles related to the beta release of one budgeting product. Ensured that some of our largest clients were able to complete their budgets in a timely manner despite various technical issues. Successfully managed relationships with key stakeholders to ensure their continued use of MedAssets technology.• Leveraged expertise in automation and scheduling tools to trim hundreds of hours of month-end processing time from hospital budgets. Developed methods for automating workflows related to monthly data tasks, reporting, costing, and contracting calculations. • Selected to lead a task force focused on increasing collaboration across the newly-formed Advisory Solutions business unit. Managed an engagement team across all departments that made actionable recommendations to senior leadership, resulting in the development of a strategic plan to improved shared service delivery. • Empowered decision makers by developing a wide variety of ad hoc reports, utilizing an array of source systems and reporting engines.• Participated in numerous source system conversions to ensure ICD10 compliance. Extracted, manipulated, reloaded and reconciled several years of DSS data so clients could seamlessly transition to a new system while maintaining the integrity of their cost accounting tools.• Developed best practices and delivered product demonstrations related to the Task Runner Utility automation product. Served as the internal and external subject matter expert on the tool.

• Reviewed physician claims for MedSolutions, a medical management company specializing in radiology • Adjudicated and investigated claims for several insurance companies, including UHC, Cigna, BCBS and Great West • Created and maintained pre-authorization files for high cost procedures, applied capitation and fee-for-service payments to claims using Plexis Claims Manager software, communicated with patients, ensured customer satisfaction, and assisted in training of new hires

• Completed business internship program with MBS, nation’s largest privately-owned revenue management firm • Performed all tasks attendant to revenue cycle management, including account representation, customer service, proper claim reconciliation, data analysis, and problem case resolution• Utilized McKesson’s Horizon software to access patient records, investigate radiological claims, resolve insurance discrepancies, and use the information to initiate the billing process• Ensured that MBS clients received correct contract fulfillment for services rendered • Compiled ad hoc financial reports in support of regional Group Director