Melissa Shuman

Associate Director

Healthcare

Phoenix, AZ +1.602.528.8103

Areas of Expertise

Melissa Shuman is an associate director in the Healthcare practice.  She is a healthcare consultant and registered nurse leveraging extensive years of experience specializing in nursing, case management, education, patient throughput, and hospital leadership. She demonstrates expertise in data analysis, regulatory compliance, operational performance, contracting, payer auditing, denial and appeal process, medical necessity, status determination, and balancing cost containment against quality care. Additionally, she is a patient-centric leader who is focused on identifying and analyzing appropriate sources of medical management data, benchmarks, best practices from internal and external sources to ensure competitive utilization patterns, outcomes, appropriateness of care.

Select Engagements:

  • Led the restructuring of clinical operations to improve authorization process and decrease denial write-offs; utilized Denial Failure Points to make sure all possible points were captured to develop
    solutions for denial prevention/revenue cycle
  • Collaborated with client executives and front-line staff to re-design the process and roll-out solutions that would improve revenue cycle management, care management process, and achieve
    the best optimal solutions and break down implementation barriers
  • Worked directly with clients to provide clinical expertise and oversight for all clinical operations serving revenue cycle management
  • Collaborated on the development and implementation of the Case Management program, including goals, objectives, and standards of performance, policies, and procedures as well as a monthly CM dashboard across multi-regional organization
  • Co-led the implementation of solutions to drive financial and operational performance through change management and process improvement
  • Delivered multi-hospital management of Case Management Directors for multiple Regions; provided operational oversight including training, development, and management within the Case
    Management departments

Stay In Touch

Melissa Shuman

Associate Director

+1.602.528.8103

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