Leslie McClaugherty
- Role
- Clinical Director Managed Care Medicare at Resurgens Orthopaedics
- Location
- Atlanta, GA, US
- LinkedIn followers
- 500 followers
About Leslie McClaugherty
RN,BSN, Legal Nurse Consultant/Case Management Seasoned registered nurse with…
Experience
Clinical Director Managed Care Medicare
Jan 2016 — Present
The Medicare [CMS] bundled payment program is designed to help coordinate care between providers, hospitals, physicians and practitioners, and provide a higher quality of care and lower costs for Medicare beneficiaries. By developing relationships with hospitals, post acute care facilities and physicians we are working to standardize operating protocols, improve care coordination and patient outcomes. Through providing coordinated quality care for Medicare beneficiaries,we are reducing the cost of care and lengths of stay in the post acute setting. In addition to relationship building among all disciplines, I analyze Medicare Milliman data for our physicians, hospitals and sub-acute facilities to identify trends and areas for focused improvement which translates into cost savings. Through strategic planning, data analysis and actively managing patients in sub-acute facilities we have been able to reduce the cost of care by hundreds of thousands of dollars without compromising patient outcomes. Resurgens Orthopaedics based in Atlanta is Georgia\'s largest orthopaedic practice. EMRs: Allscripts, Cerner, Epic, Athena Committee Member: Resurgens\' Annual Ortho Nursing Conference Piedmont Hospital Systems - Total Joint Taskforce Piedmont Hospital Systems - Hip Fracture Taskforce
Education
University of Florida
Bachelor's of Science, Registered Nursing, Nursing Administration, Nursing Research and Clinical Nursing
1977 — 1981
Legal Nurse Consultant Professional Training
Certificate, Legal Nurse Consulting
Skills
- Content Managed Websites
- Insurance Claim Review
- Leadership
- Personal Injury
- Social Media
- Project Management
- Milliman
- Medical Legal Consulting
- Professional Liability
- Jira
- Nursing Education
- Strategic Planning
- Electronic Medical Record (Emr)
- Software Project Management
- Omniture
- Requirements Gathering
- Regression Testing
- User Acceptance Testing
- Medicare/Cms
- Sdlc
- Operating Room
- Business Process Improvement
- Web Testing
- Software Quality Assurance
- Clinical Consulting
- Google Analytics
- Scrum
- Clinical Development
- Agile Project Management
- Test Planning
- Agile Testing
- Web Applications
- Requirements Analysis
- Alternate Payment Models
- User Experience
- Disease Management
- Digital Media
- Star Ratings
- Mobile Applications
- Management
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