Debra Payne, RN, BSN 2602 Goodnight Trail, Mansfield, Texas 76063

dpfacb22@westpost.net *Cellular 817-308-4720 * Home 682-

518-0665
Summary of Qualifications
Seasoned professional with operational and case management experience in the hea
lthcare field. Expansive, entrepreneurial thinker with outstanding record of ac
hievement implementing new business strategies, delivering innovative solutions,
and facilitating healthcare start up operations. Possess solid business skills
, versatile attitude and prompt organizational and multitasking abilities as wel
l as strong problem solving abilities. Can identify issues, research solutions
and make effective decisions. Resourceful, intuitive communicator readily estab
lishes trusting rapport with colleagues and customers alike. Passion for excell
ence and customer service. Effectively uses an empowering, participatory manage
ment style that breeds accountability, teamwork, and continuous improvement.
Experience
Leprechaun LLC, Fort Worth, Texas 8/2007 - present
Manager Audit Services/Quality Assurance
Supervise a team of 7 nurse reviewers and 11 quality assurance nurses who perfor
m retrospective ICD-9 coding on Medicare Advantage group health plan members. Th
e team works to identify HCC codes to assist health plans in receiving the appro
priate severity adjusted payments from Medicare. Work with senior management to
develop and launch new Audit protection product as well as Prospective Review p
roduct. Responsible for all client requested audit deliverables.
Regency Hospital of Fort Worth, Fort Worth, Texas 4/2006 - 8/2007
Director of Case Management
Recruited to develop and oversee 2 new 44 bed start up LTAC hospitals in Dallas
and Fort Worth. Developed departments and recruited case managers and social w
orkers for case management department. Duties included aggressively managing pa
tient financial reimbursement during Medicare demonstration period. Worked as p
art of administrative team on initial state licensure and JCAHO surveys. Instru
mental in working to develop relationships with managed care companies and initi
ation of commercial contracts.
Kindred Hospital Fort Worth Southwest, Fort Worth, Texas 2004 - 2006
Director of Case Management
Responsible for managing the case management department of 78 bed LTAC hospital.
Duties include oversight of 6 FTE's including intake. Department is responsib
le for utilization management, discharge planning and financial management of Me
dicare and commercial patients.
* Identified need to expedite referral conversion time and developed master bed
control process managed by intake coordinator. Reduced referral to admission co
nversion time by 50%.
* Instrumental in redefining case management model to enhance capabilities to in
crease revenue through effective case management/physician communications. DRG
Impact Analysis demonstrated 200K to 250K monthly revenue impact by educating ph
ysicians on documentation and medical record integrity.
* Effectively achieved cost-effective, efficient patient care, making adjustment
s to market changes and economic climate affecting LTAC industry such as intro o
f Interqual criteria and CMS DRG weight and LOS adjustments on 7 of top 10 DRG's
.

Page 2
Payne, Debra
LifeCare Hospital of Fort Worth, Fort Worth, Texas 1999 - 2004
Director of Managed Care and Case Management
Initial position for LifeCare Fort Worth and Dallas - Director of Managed Care -
responsible for assisting in the negotiating of managed care contracts for both
hospitals. Also negotiated out of network LOA's. Transitioned to Director of
Case Management and Managed Care for Fort Worth which supervised the case manage
ment department for 70 bed LTAC hospital. With the onset of PPS, the position e
volved to Financial Analyst/Utilization Management Director. Created and launch
ed "PPS Strategic Blueprint" program, a hospital wide strategic plan designed to
retool processes and successfully launch hospital into navigating the new prosp
ective payment system.
* Hospital achieved $2 million over budgeted goals in first fiscal year in PPS.
Created many of the analysis tools for DRG and Physician performance.
* Managed care relationship development and negotiations resulting in the hospit
al meeting its revenue budget the 3rd quarter of operation.
* Designed and implemented Managed Care Utilization Review program for both hosp
itals which resulted in cost saving measures that further contributed to the cli
nical and financial outcomes of the patients. Also assisted corporate CFO in th
e development of the Managed Care Navigator* which was eventually utilized corpo
rate wide.
* Member of design team for the Case Management database project that assisted c
ase managers in more efficiently and effectively managing their caseloads.
Vencor Hospital, Fort Worth Texas 1998 - 1999
Regional Referral Center Manager
Position responsible for clinical and financial verification for all referrals f
or 13 hospitals and 38 nursing centers in the Southwest Region. Instrumental in
transfer of referral operations from Denver, CO to new start up in Fort Worth.
Also assisted in the creation and design of the district referral center for th
e Tarrant County area. Developed referral database management for key indicator
market reports.
Vencor Hospital, Fort Worth/THC Arlington Arlington, Texas 1994 - 1998
Nurse Liaison/Managed Care Coordinator
Responsible for coordinating insurance coverage including precertification and c
ontinued stay reviews for all commercial patients. Other duties included market
ing to the managed care sector and assisting to design and implement effective c
ommercial contracts. Also worked as Nurse Liaison responsible for account devel
opment and evaluation of potential patients. Territory included Mid-Cities, Arl
ington, Dallas and East Texas. Worked with the Director of Rehabilitation in th
e development of "Focus on Function" rehabilitation program.

Page 3
Payne, Debra
Meadowbrook of Arlington Arlington, Texas 1993 - 1994
Administrator
Responsible for clinical and financial operations of 30 bed post acute head inju
ry rehabilitation facility. Managed and coordinated organizational and program
matic activities. Provided analysis, managed budget and implemented strategic p
lans and managed multiple initiatives such obtaining initial facility CARF accre
ditation and certification by Texas Rehabilitation Commission. Developed and fo
stered effective
collaboration between medical staff, clinical departments and residential treatm
ent staff to ensure an integrated approach to providing services. Developed new
business strategies to enhance market share and improve overall performance by
the addition of CARF accreditation and TRC certification.
Meadowbrook of Arlington, Arlington, Texas 1989 - 1993
Director of Admissions and Marketing
Developed market for head injury treatment facility as premier facility of choic
e for North Texas area. Supervised a marketing staff of 6 FTE's in the networki
ng and development of key referral relationships.

Affiliations
Texas Head Injury Association
Certified Case Manager
Alliance for Texas Head Injury Facilities 1991-1993 Conference Planning Committe
e
Case Management Society of America
Phi Theta Kappa
Speaking Engagements
Speaker - "Case Management in the New Millennium" at the 2001 CMSA conference.
Speaker/Trainer - LifeCare Orientation Conference for new hospital acquisitions
References
Furnished upon request