The 2022 Women Leaders In Consulting: Gretchen Case

Gretchen is a managing partner for The Wilshire Group, Associates, and was a founder of the firm in 2007. In her role as managing partner, Ms. Case is responsible for service line innovation, client engagement, staff recruitment and development.

Over the course of her career, Gretchen has worked with multiple academic medical centers, multifacility health systems and community hospitals, successfully managing several revenue cycle projects and operations. Engagements have focused on revenue recognition through chargemaster optimization projects, integrated charge capture strategies, Epic Systems installations, and hospital billing compliance and audits. Gretchen has extensive hospital revenue cycle operations experience and has helped many clients adopt more efficient work flows after EHR implementations, especially developing revenue integrity program. Additionally, Gretchen is an expert in hospital billing regulations and has assisted several clients in developing robust internal monitoring programs that mitigate compliance risks and successfully defend against denials by RACs and other audit entities.

Gretchen received her BA in Social Ethics at USC and her MPH in health care administration at UCLA. She participates in the local chapter of HFMA and serves on other hospital advocacy groups and has testified in front of both houses of Congress on much needed audit reform.

What do you consider your greatest personal or professional achievement?

I feel my greatest professional achievement has been developing Wilshire, with a trusted, longtime business partner. We've created a professional home for some of the most amazing people I've ever met and had the opportunity to work with. I could have only embarked on this journey due to the incredible operational experience I had at Cedars-Sinai as Executive Director of Compliance and Revenue Integrity for almost 20 years. I managed a team of superstars as we tackled some of the hardest issues to hit health care revenue cycle like the conversion to Electronic Health Records, national changes to financial assistance policy, transparency regulations and COVID. Growing Wilshire over the past 15 plus years has been my biggest challenge and my biggest reward. Some of our first employees are still with us and makes me feel very proud of the fact that we have created what we intended to. We have also established strong relationships with our clients. Many of whom we've been working with for over six years as a trusted partner. They turn to us when a need arises in Epic optimization work or revenue cycle interim leadership or advisory services. I have always enjoyed my work and I feel extremely fortunate to be able to say that. I believe strongly that has a lot to do with the individuals I've been able to work with through the years. I love it when clients bring us back for additional work and I love collaborating with our team.

What advice would you give to a female consultant just beginning her career?

Know your worth. You can develop and prove your worth for any business you'd like to succeed in by showing up, rolling up your sleeves, and being a part of the solution. No matter what the business, this is a fundamental approach to be successful.

In the beginning of my career, I found that focusing on learning the basics of all areas of the health care Revenue Cycle I was able to 'learn the language' and understand the interconnectedness of all the parts. From Access to Cash Posting, I was then better able pinpoint my areas of interest and passion. For me that was Revenue Integrity. In the middle part of my career, I began to focus my training and professional growth on those areas I enjoyed most and achieved a high level of expertise. Now, in the later phases of my career I can continue to provide thought leadership as well as bring others into the fold. Make sure you advocate for yourself. Ask for that raise! Ask for that position! And do so with confidence! And, when you reach a level of influence in your career, be sure to reach out to your sisters just stepping onto the ladder and help pull them up.

What's the best advice—personal or professional—you've ever received?

Always manage up as well as down', and to be aware of, and respect, the informal reporting structures as well as the formal. Examples of managing up, would be preparing your boss to present a project you are responsible for to an executive team. Anything from creating a deck to booking a short prep meeting, goes a long way. Another example is creating communications written in a way that they can be forwarded to others in the organization. Not only does this give you the opportunity to present what you feel are the major contributions from your work, your actions will be acknowledged and appreciated by leadership. In the early years of your career, making your boss look good, makes you look good. And it makes you a trusted partner which bodes well for advancement. Another example is making sure your boss never hears bad news first from anyone but you, preferably with a mitigation plan to resolve it.

Leadership takes many forms. We've all known those unique individuals who sit outside of a formal reporting structure; however, they are regarded by staff as a 'leader'. Someone who is trusted and respected by staff seen as an ally representing their best interests. Being aware of these team dynamics, when and where they exist, is a part of being politically savvy in your role. Often your direct reports may feel more comfortable letting trusted informal leaders know their thoughts more candidly than they may reveal to you directly.