Charlene Stevens

Partnered with vendors/delegates, senior leaders, physicians, and operational teams to improve care delivery programs, utilization metrics, and quality outcomes. Analyzed utilization and delegate performance trends and developed work plans to address care delivery gaps and barriers.

Performed after-hours telephonic pediatric assessment using approved protocols and guided families to the appropriate level of care. Provided clear patient and family education during high-concern calls.

Reviewed clinical information for SNF admission, concurrent review, and extended length-of-stay requests using MCG criteria. Determined medical necessity and appropriate level of care and collaborated to support timely authorization decisions for cost-effective post-acute services.

Assessed insured members telephonically to identify needs and barriers and developed individualized interventions to support optimal wellness. Supported patients and families with care resources, condition education, medication review support, and external community resources.

Managed an active caseload and partnered with patients and families to identify care needs and goals. Used InterQual criteria to support care planning, utilization decisions, clinical documentation, and discharge/resource coordination.

Led implementation and change management for an integrated electronic health record initiative across seven hospitals. Managed a multidisciplinary team and developed engagement, readiness, training, and communication strategies to support adoption of clinical information systems.

Directed home health operations, nursing staff, care managers, and client care coordinators while driving quality service delivery and operational performance. Coordinated services and referrals, negotiated vendor improvements, resolved billing issues, and reduced expenses through operational changes.

Worked as a Telephone Triage RN at Cook Children's Hospital.

Worked as a Telephone Triage RN at John Peter Smith Hospital.

Worked as a Director of Nursing at Brittlyn MHMR.

Worked as a PICU RN at Cook Children's Hospital.

Earned an MBA with a Project Management specialization from Aspen University in 2022.

Earned a BSN from Aspen University in 2017.

Completed post-RN/BN coursework at the University of Athabasca from 2009 to 2011.

Earned an RN Diploma from the Prince Edward Island School of Nursing in 1992.