S. Diane McEntire

3668 MacIntosh Lane, Cottonwood Heights UT 84121 (801) 209-2498 sdmcentire39@yahoo.com 

	AREAS OF EXPERTISE
Revenue Cycle Operations	A/R Management	Interim Management
Epic Practice Management	Project Management	Union/Labor Relations
Coding, Charge Capture & Billing Operations	Software Implementation Optum ClaimsManager	Cost-reduction Strategies
	PROFESSIONAL EXPERIENCE

SDM Consulting, S-Corp                                 2013 – Present 

Owner, Independent HealthCare Consultant  

Client Engagement

Valley Medical Center University Medicine Renton, WA February 2015 - Current 

 

Epic PB Resolute PM 

Cadence/Prelude PM 

Community Connect Implementation  

 

Served as the Project Manager responsible for the successful Implementation Epic Community Connect Cadence and Resolute PB. 

§ Developed and managed project plans, resources, budget, appointment conversion strategy from legacy system and mentor PB Contract trainer. 

§ Coordinated workflow and application design and validation sessions with patient access, revenues cycle and Epic Analysis IT staff. 

 

 

AdvantageCare Physicians (ACP)  NYC June 2014 – October 2014 

 

EPIC PB Resolute PM 

Cadence/Prelude PM 

 

Served as the Project Manager responsible for the successful Implementation Epic Community Connect Cadence and Resolute PB. 

§ Developed and managed project plans, resources, budget, appointment conversion strategy from legacy system and mentor PB Contract trainer. 

 

§ Coordinated workflow and application design and validation sessions with patient access, revenues cycle and Epic Analysis IT staff. 

 

LifeBridge/Practice Dynamics, Inc Reisterstown, Maryland June 2014 – June 2015 

 

Optum ClaimsManager Support Analysis 

 

Primary contact for coding team, created new user defined coding rules and modified existing coding rules to meet the business needs for payor contracts. 

University of Washington Physician’s Seattle, WA February 2013 – May 2014 

 

Interim Director of Coding and Charge Capture 

Managed the day to day operations of the coding and charge capture department, working close with the leadership team to streamline the charge capture process, implemented charge reconciliation controls, provide education to coding staff on proper coding standards.   

 

§ Project Lead Optum ClaimsManager system upgrade 

§ Implemented missing charges reporting 

§ Vendor selection for outsource coding 

§ ICD-10 Project lead 

 

Partners HealthCare Boston, MA October 2014 – Present 

 

Optum ClaimsManager Support Analysis 

 

Primary contact for coding team, created new user defined coding rules and modified existing coding rules to meet the business needs for payor contracts. 

 

Vitalize Consulting Solutions             April 2012 – February 2013 

Resource Manager 

Responsible for overall management of 50 plus Epic HealthCare consultants throughout the United States. 

§ Manage relationship between the client and consultant to ensure the correct skill sets for the client’s needs where being met. 

§ Monthly meetings with client to review status of project to ensure we are on task and keeping within the client budget. 

§ Weekly meetings with consultants to review projects to ensure they are meeting project deliverables outlined in the scope of work. 

§ Manage and mentor a team of consultants to help build upon their skills and industry knowledge. §  Work close with sales team to match consultant skills to upcoming client engagements. 

Culbert HealthCare Solutions, Boston, MA               November2007–April 2012  

Senior HealthCare Consultant

Achieve client’s operational objectives by developing core recommendations for strategic plans and assessments, driving consensus among client stakeholders, and positioning the client for a successful outcome. 

 

Client Management: 

§ Provide leadership and management of large projects from start to finish to ensure client satisfaction meeting the project goals and objectives including keeping the appropriate sales and practice directors informed. 

§ Maintain communication with client executives to ensure strong relationship and satisfaction with current consultant work efforts and potential for extensions and new projects. §  Identify new staffing needs of existing engagements. 

Employee Management: 

§ Manage and mentor a team of consultants ensure they were staying current with their skills, and industry knowledge. 

§ Meet weekly with junior consultants to review scope of work to ensure they were meeting project deliverables as promised, with quality and within project timelines.  

§ Conduct bimonthly team conference calls to foster team spirit and update team on company and team happenings and any industry news. 

 

Client Engagement:

 

UWP- University Washington Physicians, Seattle, WA 

Interim Director of Coding and Charge Capture 

 

Managed the day to day operations of the coding and charge capture department, working close with the leadership team to streamline the charge capture process, implemented charge reconciliation controls, provide education to coding staff on proper coding standards.   

§ Optimized Epic Charge Review Work Que’s and Resolute functionality to stabilize revenue cycle operations.   

§ Worked collaboratively with EpicCare team to ensure proper setup and use of SmartTools and OrderSets to ensure charge capture and clinical documentation adheres to compliance standards. 

§ Implemented coder productivity standards and biannual coding QA audits. 

 

Client Engagement:

Novant Health, North Carolina Team Lead Epic Resolute Go Live Support 

Manage day to day go live support in command center.

Client Engagement:

Johns Hopkins Medicine, Baltimore, MD 

Project Manager, Epic Revenue Cycle Planning 

Educated client on nuances to Epic’s patient access and revenue cycle tools, as well as prepared leadership on Model system implications in a large, compiles academic delivery network. 

§ Assessed registration, scheduling and billing staff training program from legacy system (GE/IDX).  Developed future training program including curriculum requirements to support the conversion to Epic Cadence, Prelude/ADT and Resolute PB. 

§ Mapped current state workflows related to charge capture, payment posting, denial management and A/R management to identify decision points in Epic workflows, billing office structure and Resolute build. 

 

Client Engagement:

Cedars Sinai Medical Center – Cedars Sinai Medical Group, Los Angeles, CA Project Manager, Epic Revenue Cycle Assessment 

 

Evaluate charge capture workflows as well as EpicCare and Charge Router setup identify root cause of missing charges and increased charge lag. 

§ Assessed Epic EAP Master File to determine appropriateness of orderable and chargeable setup. Recommended modifications to assist in coding and charge capture. Worked closely with EpicCare team to develop improved EAP build. 

§ Documented revenue cycle workflows in GE/IDX environment to layout future state in an integrated Epic model. 

 

Client Engagement:

The Vancouver Clinic, Vancouver, WA 

Epic Project Manager 

 

Served as the Project Manager responsible for the successful “Big Bang” Implementation EpicCare Ambulatory, Cadence, Prelude and Resolute PB. 

§ Developed and managed project plans, resources, budget, data conversion strategy, training program and the application, interface and training teams. 

§ Coordinated workflow and application design and validation sessions with clinical, patient access, revenues cycle and IT staff. 

 

 

Client Engagement:

Mount Sinai Medical Center, New York, NY 

Revenue Cycle Consultant 

 

Managed the rollout of departments charge interface from EpicCare Ambulatory to GE/IDX billing system.   §  Responsible for building translation table from Epic master files to file charges appropriately into GE/IDX. 

§ Lead testing and go-live support  

§ Served as the IT representative on the project team responsible for implementing the Optum ContractManager application. 

§ Worked collaboratively with the Faculty Practice Plan to develop the project plan and implementation methodology. 

 

Client Engagement:

Children’s Healthcare Associates, Children’s Hospital of Philadelphia, Philadelphia, PA  Interim Director Coding & Compliance 

 

Managed staff of 15 FTEs responsible for abstract coding, charge entry and compliance 

§ Redesigned coding and compliance workflows and integrated compliance and abstraction group into one team. 

§ Analyzed client performance and implemented procedures to improve charge capture and decrease lag days. 

§ Assisted with the implementation of a compliance auditing system for tracking current provider audits and scheduling future audit process. 

§ Developed policy and procedures for tracking compliance concerns 

§ Assisted with analysis of rejections trends for various payers and made recommendations for appropriate revenue recoveries based on correct coding. 

§ Deveolped new employee orientation policies and procedures. 

 

Client Engagement:

 

Kings Daughters 

 

Revenue Cycle Analysis 

 

 

Partners HealthCare, Massachusetts General Physicians         April 2005 – November 2007  

Director Central Billing Office, Charger Professional Services

Managed revenue cycle operations for a multi-specialty group practice comprised of 90 providers in 17 practice locations. Directed staff of 40 FTEs responsible for coding, charge entry, accounts receivable and collections. 

Selected contributions:

§ Primary contact for all internal and external communication for issue resolution and management related to the revenue cycle.

§ Delivered a variety of finical presentations to the Physician Group and Hospital Administration

§ Facilitated implementation of EMR from compliance and coding perspective for the provider group

§ Implemented a comprehensive point of service billing process across multiple departments to ensure more accurate charge capture

§ Implemented A/R denial reports based on HIPAA denial messages §  Automated cash posting receipts and reconciliation process

 

 

Ingenix (now Optum)                      1993 – 2003 

Director of Client Services, Implementation, Training and Support

Worked close with internal Product managers and external software vendors to ensure ClaimsManager product meeting the needs of our client base.  

Selected contributions:

§ Primary contact for all internal and external communication for issue resolution and management related to ClaimsManager

§ Provided market trends to product management for further development changes 

§ Product lead for Ingenix ClaimsManager and the TES development team

§ Participated in Client on site demo’s with sales

§ Participated in Vender user group meetings

§ Facilitated implementation of EMR from compliance and coding perspective for the provider group

§ Implemented a comprehensive point of service billing process across multiple departments to ensure more accurate charge capture

§ Implemented A/R denial reports based on HIPAA denial messages §  Automated cash posting receipts and reconciliation process

 

EDUCATION, TRAINING, AND AFFILIATIONS 

Epic

Charge Capture certification                  In Process

American Academy of Professional Coders (AAPC)

American Health Information Management Association (AHIMA)

Healthcare Financial Management Association (HFMA)

Medical Group Management Association (MGMA)