Irene has more than 20 years of healthcare experience in operational consulting management and direct patient care. She specializes in regulatory compliance performance optimization and managing organizational transition.
Prior to joining Huron Irene was a managing director of Navigant Consulting Inc. leading the Risk Mitigation and Compliance practice. Previously she was director for the Southeast Region of Arthur Andersen LLP. During her career Irene has focused on assisting clients with regulatory compliance assessments financial exposure analysis corporate integrity agreements financial operations integration and improving patient throughput. She has assisted clients with creating innovative solutions for delivering and funding patient care that capitalizes on their strengths responds to the future healthcare needs of their communities and ensures compliance with regulatory guidelines. Prior to her years in consulting Irene served in both clinical and administrative capacities within large academic and urban hospitals.
Representative examples of Irene's engagement experience include:
Led the implementation of a corporate integrity agreement for the largest for profit healthcare system in the United States. Required an understanding of company processes and critical controls for the areas of ethics and compliance. Developed work plans to be executed by the company and IRO. Provided insight into the operational implications for testing by the company.
Managed a project for a large for profit healthcare system to identify potential risk relating to allegations by commercial payers of DRG up coding lab unbundling medical necessity and billing for undelivered services. Included full chart reviews for over 30 hospitals.
Managed support for settlement discussions regarding multidistrict litigation including development of an audit work plan full medical and billing record audits for 1500 records and presentation of findings.
Managed evaluation of documentation and coding processes at 30 hospitals in a large healthcare system. Developed profile of best practices for implementation. Evaluated errors and facilitated an extensive quality control process.
Led Joint Commission team through the new tracer methodology for a successful tri-annual survey. Identified processes lacking JCAHO standard intent and implemented corrections for compliance.
Led the implementation of concurrent review programs. Efforts involved integrating several fragmented functions including utilization review case management medical record coding and discharge planning. Engagements typically resulted in substantially improved severity and mortality profiling as well as appropriate reimbursement
Led a performance improvement effort for an integrated delivery system which included a 400 bed acute care hospital 125 bed convalescent center home health agency and multiple physician practices. Objective was to improve cost position through changes in clinical practice and process improvement.
Performed a diagnostic assessment for a 600 bed medical center to identify regional best practices cost reduction opportunities and process improvement.
Completed large physician practice redesign. Process included full assessment and implementation clinical practice restructuring recommendations for outsourcing vendor reassignment management education and compliance program implementation.
Education & Certifications
Master of Science in Health Health Care Administration University of North Florida Jacksonville FL
Bachelor of Science Nursing University of Maryland Baltimore MD
Health Care Compliance Association (HCCA)
American Organization of Nurse Executives
Nashville Healthcare Council
American Health Information Management Association (AHIMA)
Women Business Leaders of the U.S. Health Care Industry Foundation