Donna Rackley
Health Services Director Case Management @Wellmark Blue Cross and Blue Shield
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WORK HISTORY
Health Services Director Case Management @Wellmark Blue Cross and Blue Shield
Des Moines, IA, US
Plans, directs, and manages the day-to-day operations of Case Management products and services • Leads a team of clinicians with focus on advancing engagement, improving health outcomes, reducing medical cost and health disparities while improving patient safety and gap in care closure.• Collaborates with informatics/analytics, market leaders, medical directors, product, quality, vendors, providers, and other key partners to understand results and defined areas of clinical opportunity• Advancing the performance of service utilization, patterns, clinical outcomes, high dollar claim trend patterns, quality outcomes and financial results
EDUCATION
Kentucky Baptist Hospital School of Nursing
Nursing
Chamberlain University
Bachelor’s Degree, Nursing
ABOUT DONNA RACKLEY
Healthcare professional with experience delivering innovative operations, quality, and process improvements for managed care and healthcare companies. Enabled successful business strategies founded on data, metrics and business process capability execution. Built high-performing teams, setting goals and measuring performance through targeted metrics. Led cross-functional teams, focusing on superior customer service. Possess broad business and healthcare administration skill supplemented through Certified Case Manager(CCM), Certified Healthcare Quality Professional (CPHQ) and Clinical Expertise (RN). Extensive knowledge base encompassing CMS, NCQA, URAC, HIPAA, Compliance and Department of Insurance standards. Recognized as an analytical leader and trusted coach who drives bottom-line success.
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