Karen D.

WORK HISTORY

EDUCATION

ABOUT KAREN D.

I am a highly dedicated, highly accomplished healthcare leader, advisor and practitioner with over 15 years’ experience working in both hospitals and 3rd-party healthcare companies, leading teams, optimizing utilization and performance, increasing sales, and making an impact.Currently I am leveraging my medical background as a Senior Director of Payment Integrity with Zelis Inc.Whether it’s working within hospitals or within the companies serving those hospitals, I know the healthcare industry inside and out - how it works, where it doesn’t, how to optimize utilization, where processes need to be improved, how to access decision makers, how to increase sales, performance metrics, the works. And I get things done!Over the course of my healthcare career, I have:• Directed a team of certified coders and nurses, identified and implemented strategic initiatives, developed and implemented sales and client management training, and assisted with cross-sell and up-sell programs that helped Zelis increase its Expert Claims Review (FKA Hospital Bill Review) and Claims Editing products• Overseen and improved the utilization management program for 20+ Shriner’s Hospitals across the US• Overseen and improved the payment appeals program for University of Vermont Medical Center• Directed a team of 20-30 nurses in donor centers and mobile blood drives for the American Red CrossAs a leader, I am analytical, strategic, innovative, and focused on putting the right things in place to get the best results. I not only notice what’s needed - whether its processes, approaches, opportunities, training, etc- but I take the initiative to get it done. As a leader of people, I am collaborative and aim to build working cultures where people love what they do and are supported to do great work. I hold a Masters in Nursing as a Pediatric Nurse Practitioner and am certified in Health Care Quality and Management.