Leslie McClaugherty

Clinical Director Managed Care Medicare @Resurgens Orthopaedics

Atlanta, GA, US
MOBILE NUMBERS
+14•••••••45

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WORK HISTORY

Jan 2016 — Present

Clinical Director Managed Care Medicare @Resurgens Orthopaedics

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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

1977 — 1981

University of Florida

Bachelor's of Science, Registered Nursing, Nursing Administration, Nursing Research and Clinical Nursing

N/A

Legal Nurse Consultant Professional Training

Certificate, Legal Nurse Consulting

SKILLS

Content Managed WebsitesInsurance Claim ReviewLeadershipPersonal InjurySocial MediaProject ManagementMillimanMedical Legal ConsultingProfessional LiabilityJiraNursing EducationStrategic PlanningElectronic Medical Record (Emr)Software Project ManagementOmnitureRequirements GatheringRegression TestingUser Acceptance TestingMedicare/CmsSdlcOperating RoomBusiness Process ImprovementWeb TestingSoftware Quality AssuranceClinical ConsultingGoogle AnalyticsScrumClinical DevelopmentAgile Project ManagementTest PlanningAgile TestingWeb ApplicationsRequirements AnalysisAlternate Payment ModelsUser ExperienceDisease ManagementDigital MediaStar RatingsMobile ApplicationsManagement

ABOUT LESLIE MCCLAUGHERTY

RN,BSN, Legal Nurse Consultant/Case Management Seasoned registered nurse with…

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