| Collectively, our Medical Management staff has over 175 years of experience. By investing in clinical human resources, BMS continues to position ourselves to offer a full array of medical management options to suit all client needs. |
| Director of Medical Management |
| |
Leslie Roberts, RN, BSN, CCM joined BMS in 1996 as a Nurse Case Manager and brings with her 25 years of experience working in the fields of utilization review, quality assurance, discharge planning and has worked in case management for the last 12 years. Her past experience includes: Quality Assurance Reviewer at University Community Hospital in Tampa, FL, Utilization Review Coordinator at Hilton Head Hospital, SC, and Charter Hospital of Charleston, SC, Director of Utilization Management and Discharge Planning at East Cooper Hospital in Mt. Pleasant, SC, Nurse Case Manager at an independent case management company and Nurse Case Manager with Benefit Management Services. |
| Population Health Manager |
| |
JoAnn Halleran, RN, MSN, CCM brings with her over fifteen years of medical experience and has provided case management for patients in a wide variety of areas including catastrophic illness, chronic medical conditions, high-risk obstetrics, infertility and pediatrics. She is a Parent/Child Clinical Nurse Specialist and has extensive knowledge in obstetrics. |
| Clinical Data Analyst |
| |
Susan Crisco, RN, CCM, BSN, MBA is responsible for the department's data management. This includes: database design and set-up, reporting, training and decision support analysis.Susan has over 19 years of medical experience and has worked in a variety of medical and IT related roles and settings. She has been a case manager, trainer, project consultant, database developer, outlook forms developer, assistant department head and clinical staff nurse. She is a certified case manager. She is also a veteran. She served in the US Navy from 1989 to 1995 as a Navy Nurse Corp Officer with assignments overseas and in the United States. |
| Quality Assurance Analyst |
| |
Jennifer Proko, RN, CHCQM, FAIHQ - Quality Assurance Analyst - previously worked at a PPO for 14 years involved in Utilization Review, Case Management and Quality and Compliance Management. Some of her titles and responsibilities: Manager of Quality Improvement, HIPPA Privacy Coordinator, URAC coordinator, policy and staff development, product design, marketing, developed orientation program for new employees, worked on the Disease Management program development team and published a company newsletter. Jennifer has 17 years of psychiatric experience as a Staff Nurse, Head Nurse, Nursing Supervisor and Staff Development Instructor. |
| Clinical Staff |
| |
Carolyn Recard, RN, BS, CCM is a Nurse Case Manager. Carolyn has over twenty-five years experience in the health care provider industry, including telephonic medical case management, worker’s compensation and occupational health. Her clinical background is in medical-surgical and urgent care. |
| |
Holly Haston, RN is a Nurse Coach with 24 years of medical experience. She has worked as a Case Manager and Director of Case Management for 10 years, a Utilization Review Coordinator for 2 years, a Clinical Field Representative for an inpatient rehabilitation facility and Director of Community Relations at a home care agency. Holly’s clinical background includes experience in medical surgical nursing, neurological ICU and oncology. |
| |
Laura Sherron, RN, CCM is a Nurse Coach who has over 26 years of nursing experience. She previously worked as a Case Manager for 12 years in various capacities including: Managed Care Coordinator for a home health agency and an infusion provider, Case Manager for an insurance company and a Workman's Comp Case Manager. Recently, Laura worked as the Lead Case Manager for 11 colleagues at one of the nations largest providers of disease management and wellness programs. Her clinical experience includes Staff Nurse in the hospital in the medical ICU and Coronary Care Unit and as an Infusion Nurse. |
| |
Libby Radford, RN, CM, CCM is a Nurse Case Manager with 8 years of case management experience working with PPO's, TPA's and HMO's. Her clinical backgroud is diverse with experience in various clincal settings including: emergency department, emergency department manager, certified first assistant in the operating room, ICU, diabetic teacher, OB/GYN and medical-surgical nursing. |
| |
Linda Dixon, RN, CCM is a Nurse Coach with 23 years of medical experience. She worked as a Case Manager for five years specializing in several areas including: high risk obstetrics, infertility, pediatrics and oncology. She was a Medical Advice Nurse for six years working with Kaiser Permanente and an obstetrical home health nurse with Matria. For 3 years she served as a Case Manager Senior Specialist managing rehabilitation, extended care facility, high risk maternity and oncology case managers. She is a subject matter expert for extended care facilities. Linda has clinical experience working in Intermediate Care Nursery, Gyn Oncology, Postpartum/Antepartum and Family Practice in both hospital and clinic settings. |
| |
Linda Ownbey, RN, BSN, CCM is a Nurse Coach. Linda has over fifteen years of medical experience and has worked as a Case Manager, Health & Safety Administrator, Industrial Relations Manager, Health Services Administrator, Patient/Doctor Coordinator, and Office & Occupational Health Nurse. She has clinical experience in a variety of medical areas, including orthopedics, medical-surgical gynecology and obstetrics. She currently serves as the Vice-President of the Western North Carolina Safety Council and Vice-President of the Western North Carolina Rehabilitation Professionals. |
| |
Lynn Stano, LPN is a Nurse Coach with 26 years of clinical experience. She worked in an OB/GYN office and was the Admissions Coordinator for the Brian Center. The majority of her work experience is in Industrial Nursing. Lynn worked at Lexington and Ethan Allen Furniture where she coordinated and implemented wellness programs and focused on ergonomics, OSHA and Safety Compliance and annual safety and health training for all employees. |
| |
Margaret Ursprung RN, CCM is a Nurse Coach who worked for five years as a Complex and Oncology Case Manager. Prior to this, she was a Congregational Nurse for six years where she advocated for two church congregations developing, coordinating and organizing educational programs to promote healthy life styles. From 1990 to 1996 she worked at Carilion Health System in Roanoke, VA as a hospital oncology nurse and was chemotherapy certified. |
| |
Melinda Cook, RN, CCM is a Nurse Coach who has previously worked as a Case Manager for 8 years in various roles including: Onsite Utilization Review Nurse and Short Term and Complex Case Manager. She also worked as Director of Resource Management at a hospital for 10 years and Director of Utilization Review/Quality Assurance at a TPA for four years. Melinda has several years experience working in a variety of clinic settings. |
| |
Merle Gottheim, RN, BSN, CCM is a Nurse Case Manager who has 15 years case management experience. The most recent experience was working as the Lead Case Manager for a PPO company focusing on oncology and transplant patients. Prior to this, Merle performed utilization review analysis and was the Clinical Case Manager for another PPO company. Merle has 16 years of clinical experience in OB/GYN and medical-surgical nursing. |
| |
Merylin Davis, RN-C, BSN, IBCLC is a Nurse Coach with 32 years of clinical nursing experience. She has practiced clinical nursing in the areas of medical-surgical, newborn nursery, neonatal intensive care nursery, and obstetrical nursing. She also has experience in providing patient education classes, as a postpartum home visit nurse, and as a private and hospital based lactation consultant. She is certified in inpatient obstetrics and is an International Board Certified Lactation Consultant. |
| |
Michelle Kling, RN, CCM, CLNC is a Nurse Coach who previously worked as a Case Manager Specialist for 6 years, a Maternity Management Continuity of Care Coordinator I and II and was a Case Coordinator for a hospital which incorporated both utilization review and discharge planning. Michelle’s clinical background focused on medical and surgical nursing, obstetrics and newborn and neonatal nursing care. |
| |
Nancy Wineland, RN, CCM is a Nurse Coach who has been in nursing for 40 years. She recently worked as a Telephonic Nurse Coach for a large, nationally recognized company who provides disease management and wellness programs. She has 16 years experience as a Complex Case Manager. Her clinical experience is as a hemodialysis nurse. |
| |
Patty McOwen, RN, BSN, CCM is a Nurse Case Manager. Patty has been in case management for twenty years and her expertise includes group health insurance, catastrophic, worker’s compensation, auto liability and disability case management. She created and implemented the short term disability case management program at BMS and is also involved in long term disability cases. Her clinical experience is broad, including adult and adolescent psychiatric, medical-surgical, orthopedic, physical and functional rehabilitation, family practice, home health, and urgent care. |
| |
Sylvia Hobbs, RN, CCM is a Nurse Case Manager. She has eight years of experience as a worker's compensation case manager. Her previous clinical experience includes trauma and cardiovascular intensive care, post acute care and home health nursing. |
| |
Teresa Griffin, RN, COHN, CCM, CCP is a Nurse Coach who brings with her over 25 years of nursing experience. She previously worked as a Field Case Manager, Population Health Manager, where she initiated a new PHM program within a small TPA, Health and Disease Case Manager and an Occupational Health Nurse Manager for multiple company sites, including Colbond. Clinical background includes supervisor for a skilled nursing facility and hospital experience in critical care and medical-surgical nursing. She will be working from her home in Asheville, NC. |
| |
Teresa Knox, RN, CCM joined BMS in 2003 as a Disease Management Nurse and has previously served as a Director of Medical Management where she successfully developed, implemented and directed an in-house case management program. In addition, she has served as a case management team leader. Teresa has clinical experience in a variety of medical areas including gynecological surgeries, newborn nursery, postpartum, high-risk obstetrics and medical-surgical nursing. |
| |
Traci O'Neil, RN, CCM is a Nurse Coach who has over 14 years of nursing experience. She previously worked as an Admission and Discharge Nurse at CMC-Pineville, a Medical Case Manager and as a Utilization Review Nurse. Clinically, she worked as a Staff Nurse in the hospital on a medical floor and on the psychiatric unit. |
| Utilization Review Manager |
| |
Cynthia Smith, RN, BSN Cynthia has worked in the field of managed healthcare for eighteen years and has held positions as a Concurrent Review Nurse, Provider Relations Representative and Operations Manager. She has worked in a hospital Quality Resource Department where she performed chart reviews and facilitated discharge planning. She has experience in a variety of healthcare settings including geriatrics, medical-surgical and home health. |
| |
Corrie Marean, LPN is a Utilization Review and Precertification Nurse. Corrie has previous experience with Utilization Review in a hospital setting, where she also assisted in quality management, physician compliance and event reporting. She has several years of experience as a head triage nurse for a family practice. Corrie is currently pursuing her degree as a registered nurse. |
|
| Internal clinical expertise is a necessity for any TPA to effectively control clients’ health plan costs and ensure that these cost effective services are delivered in a patient-centered environment. In 2005, BMS renews our commitment to providing superior internal clinical expertise to clients and their Plan members. Our mission statement incorporates our philosophy regarding clinical management:
“Our mission at BMS is to establish, develop, and maintain enduring client partnerships by providing efficient and accurate claims administration, exceptional customer service, thorough and fully integrated medical management, and comprehensive employee benefits consultation.” |
| "If all of your case workers are as helpful as Carolyn Recard you have a 100% agency. She is not only professional, but also helpful to patients."
"My case worker, Carolyn Recard, was as good as they come. I believe with a wonderful personality and always there to help. Thanks to all."
"Everything was handled for me with care and any questions I had were answered promptly with my case worker. I think all patients should be involved one on one with a case worker."
"I was completely satisfied. ALthough my cancer has spread to my lungs, hopefully my new treatment will be responding."
"I would not change a thing. They called and showed their concern from the time I came home from the hospital. I was back at work three months and they still called and asked 'did I have any questions, or could they help me in any way.' No, I would not change a thing. The CareConnex person I had was the best. Thank her and the company very much. I thank god to have known her."
|
|
