Open to opportunities

Susan Bone

@susanbone

Message

Experienced registered nurse and case management leader driving quality and cost-effective care.

United States

Message

What I'm looking for

I seek leadership roles in case management or clinical operations where I can improve care coordination, drive KPI performance, and reduce costs through evidence-based programs and collaboration.

I am a Registered Nurse and Certified Case Manager with extensive experience managing complex case management programs across Medicare Advantage, DSNP, and commercial populations. I have led teams, overseen clinical operations, and driven performance improvements to reduce readmissions and contain costs.

I have direct experience managing markets and large teams—oversight of up to 36 certified case managers and 21 case managers in recent roles—and have been instrumental in program development, NCQA case management accreditation, and cross-stakeholder collaboration with payors and physician advisors.

I focus on evidence-based operations, measurable KPI performance, and collaborative care coordination to produce tangible savings and improved member outcomes. I bring strong critical thinking, time management, and multi-system experience to help organizations scale case management programs effectively.

Experience

Work history, roles, and key accomplishments

Current

Case Manager

Current

Sharecare

Jul 2025 - Present (3 months)

Manage commercial patient population as a third-party administrator, enrolling members via dialer into complex and short-term case management programs to ensure appropriate care coordination and outcomes.

Care Coordination Complex Case Management Enrollment KPI Tracking

Manager, Case Management

Perfect Health dba Concerto Care

Jun 2024 - Jul 2025 (1 year 1 month)

Managed three markets (RI, NC, NY) overseeing 21 case managers across Medicare Advantage, DSNP, and commercial plans and drove performance against KPIs while leading payor and vendor case conferences.

Team Leadership Case Management KPIs Medicare Advantage DSNP)Cross Functional Collaboration Payor Relations Performance Improvement

Case Manager

Perfect Health dba Concerto Care

Nov 2022 - Jun 2024 (1 year 7 months)

Managed Medicare Advantage members with complex needs, coordinating with providers and physician advisors to implement care plans that reduced readmissions and supported cost-effective treatment alternatives.

Care Coordination Utilization Management Discharge Planning Interdisciplinary Collaboration Medicare Advantage Member Assessment

Case Manager

Care N' Care Insurance

Jun 2021 - Nov 2022 (1 year 5 months)

Managed Medicare Advantage members with complex healthcare needs, performed assessments and care planning, and participated in interdisciplinary meetings to reduce readmissions and achieve cost-effective outcomes.

Medicare Advantage Case Management Chronic Disease Management

Case Manager

Aetna

Jan 2018 - Jun 2021 (3 years 5 months)

Managed contracted plan members with complex needs, collaborated with providers and physician advisors, and participated in LOS rounds and case conferences to produce cost savings for plan sponsors.

Care Coordination Utilization Review LOS Management Medicare Advantage

Case Manager

MedCost

Jun 2016 - Dec 2017 (1 year 6 months)

Managed contracted members with complex needs and performed medical consulting and utilization review to determine medical necessity, manage inpatient reviews, and identify quality-of-care issues.

Utilization Review Case Management Quality Assurance

Clinical Operations Manager

Accordant Health Services/CVS Health

Mar 2014 - Jun 2016 (2 years 3 months)

Oversaw clinical operations including 36 case managers and multiple clinical teams, led system enhancements, supported NCQA CM accreditation, and launched new program offerings to improve quality and growth.

Clinical Operations Team Management Program Development Process Improvement Reporting Stakeholder Management

Assistant Clinical Operations Manager

Accordant Health Services/CVS Health

Mar 2008 - Mar 2014 (6 years)

Monitored case manager productivity and quality, supported orientation and metric reporting, and participated in workgroups to drive program growth and meet health plan expectations.

Performance Monitoring Quality Improvement

Health Management Nurse

Accordant Health Services/CVS Health

Jan 2007 - Mar 2008 (1 year 2 months)

Assessed and documented patient health status, promoted wellness, coordinated services, and balanced quantity requirements with quality expectations for enrolled members.

Care Coordination Health Promotion Documentation