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sallie shuskeySallie Shuskey, RN

Senior Consultant

Sallie Shuskey is a Senior Health Plan Services Consultant with BluePeak Advisors, a division of Gallagher Benefit Services, Inc. A Registered Nurse and Certified Case Manager (CCM) with over 36 years of health care experience, Sallie has more than 18 years of experience with Medicare Advantage (MA) Health Plans in mid-level and senior leadership roles at local and national health plans. Sallie has served in roles ranging from Case Manager, Manager of Case Management, Health Services Director, Compliance, and Part D oversight.

Prior to joining BluePeak, Sallie served as Manager of Case Management with a national MA Plan, where she focused on care coordination specific to readmission reduction and off-cycle MOC improvements to enhance the transition of care process. Sallie developed process enhancements, trained, and led a team through the implementation, ultimately leading the team to achieve an 8% reduction in annual readmissions and increased enrollee satisfaction which contributed to an increase in Part C Stars Ratings. Prior to her leadership in Case Management, Sallie led a team through full implementation of an Institutional Special Needs Plan (I-SNP) in North Carolina and was accountable for ongoing senior level leadership to the clinical team. Sallie brings a wealth of experience in I-SNP and Duel Special Needs Plan (D-SNP) management and can provide a unique perspective to I-SNP plans as she previously served as a licensed nursing home administrator. In her role as Director of Health Services, Sallie developed and implemented performance improvement plans to prevent over utilization and improve health outcomes within contracted nursing facilities. During her time with this I-SNP plan, Sallie and her team were able to decrease the medical loss ratio while increasing quality of care and enrollee satisfaction.

At BluePeak, Sallie provides PACE Organizations, Special Needs Plans, and Medicare-Medicaid Plans with operations and compliance support, as well as operations support during CMS audits. Sallie serves as an Independent Validation auditor and conducts mock audits for ODAG, SNPCC, MMPCC, and PACE. In addition, Sallie provides consulting services for Model of Care (MOC) initial development and submission, off-cycle and schedule revisions review and scoring, as well as care coordination policy and procedure development and optimization. Sallie is the primary account manager and contact for multiple clients of varying size.

Sallie holds a bachelor’s degree in nursing from Chamberlain University School of Nursing and an associate degree in nursing from Randolph Community College. She is a licensed, registered nurse and a Certified Case Manager.

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