BY DR. HEAVEN PROVO, MBA, DNP, RN, CCM, PHNA-BC, NE-BC, LNFA, CAHIMS, FCM
I wear many hats: wife, mom, bonus mom, sister, daughter, and friend…all of which take priority for me. I would like to start by acknowledging my supportive family and God’s grace for every season.
Where do I begin? Is it with: My parents both worked on farmland while growing up and completed associate’s degrees? They worked in the social service arena, so I grew up understanding this passion for people and strong work ethic. I am a woman of multi-ethnic descent. I identify as Afro-Latina because my mother is Hispanic and my father is African American. What about the fact that the spotlight is not my comfort zone? I have always preferred to be behind the scenes, but my progressive leadership roles have nudged me forward. I did not seek out the accolades. Instead, I met the criteria by advocating, keeping patients, families and communities first, serving with excellence and working with a higher purpose. I have a strong appreciation for those who have journeyed with me along the way.
Nursing is a second career for me. My initial pathway was in hotel management. I worked my “way up” while completing my first undergraduate degree in social science and subsequent MBA. This was a necessity because not working was not an option. Tuition was due. and the hotel environment provided 24-hour operations and flexibility. The experience was invaluable as there are many parallel principles between the hotel industry and healthcare arena. They have a shared underpinning of customer service, staffing, revenue cycle, throughput and occupancy (i.e., bed capacity). The luxury hotel property always had VIP presence. This was a great experience but did not fulfill me at my core. I have always had a passion for helping others and improving their condition. After much prayer and deliberation, I pursued an accelerated BSN—18 hours of nursing courses over three very intense semesters. This was a huge leap of faith, and I was determined.
My nursing pathway began as a student nurse on an oncology unit while in nursing school, and I continued there after graduation. While caring for my patients, I often wondered, “Who is going to take care of them when they leave?” This prompted me to explore community-based agencies such as Federally Qualified Health Centers (FQHC), home health and other entities that bridged this gap. My next role was that of RN case manager for an FQHC, where I supported the clinic, made home visits to underserved expecting mothers and walked with them throughout their pregnancy to support a healthy delivery. Many of the moms were migrant workers or single-generation immigrants without immediate family support, while others were under-resourced. In addition to clinical support, our team was responsible for their Medicaid and WIC applications and collaboration with Medicaid managed care. This role also had the shared responsibility of cross-covering shelters for those without a home to provide nursing care on the weekend. Visiting vulnerable patients in their homes and transitional living settings provides a completely different perspective. Completion of my MSN prompted a return to acute care (academic medicine and DSH facility) as a case manager. I had a unique lens based on my experience in the community. I understood the complexities that patients faced paired with the capacity to meet them where they were. I remained eager to cross-train and take the assignments no one else wanted (including the emergency department). In addition to case management, the ED gave me the opportunity to learn more about behavioral health and UR aspects such as insurance notifications, network requirements, and authorizations in the acute care setting. This was also the springboard for my transition to utilization management. Within a year, I was the UM supervisor. The team was able to implement new ED collaboration to support the appropriate level of care, discharge planning from the ED and various denial mitigation strategies. These methods yielded strong patient and hospital results. After completing my DNP, I moved into a director role. I took the knowledge that I learned from the large academic institution and shared them with smaller community-based hospitals. I helped them to understand what they could do with fewer resources and how to bridge the community relationships to maximize outcomes. This resulted in reduced readmissions and length of stay, along with improved patient satisfaction. Completion of my terminal degree allowed time to reflect on other aspects of my professional development. In 2013, I passed my CCM exam!
I was subsequently blessed with an opportunity to relocate to Hawaii, where I served as the operations manager in collaboration with a large health plan. I was tasked with state-wide readmission reduction for hospitalized patients across multiple health systems. Our offices were based on Oahu, with RN and SW teams spread across the neighboring islands to support multiple hospitals. We followed our patients for 30 days post-discharge to ensure timely and appropriate follow up along with the connection to necessary community resources. We were also able to cultivate important relationships between medical management and hospitals. It was a heavy task, but I was able to travel between islands for work with some downtime in between. I stood on faith to see it through. We understood the mission and objectives for the statewide population that we served. The contracted team experienced amazing results and ultimately became staff members of the plan. I formed great relationships that I maintain today. We connect and catch up each time that I visit.
I returned back to the mainland in 2016. Since then, I have supported the launch of a successful accountable care organization (ACO) and provided leadership for national and international programs. I currently serve as an undergraduate visiting professor and graduate-level academic preceptor. The preceptor appointments are a labor of love (No honorarium). I enjoy paying it forward to empower the next generation of nursing leaders. In addition to volunteering in my community, I accept task force and volunteer requests from CCMC and CMSA at the local and national level.
In 2023, my 10-year anniversary as a CCM, I was recognized as an FCM. While this recognition acknowledges my contributions to professional practice, I also view it as another avenue to show my unwavering support for our practice and my commitment to supporting others. We are blessed to be a blessing to others.
I recently posted this statement on LinkedIn: “Sometimes, we stand on the shoulders of giants. Other times, we stand with them. It takes faith and courage to do both.” I believe this wholeheartedly. My journey to FCM has been a windy uphill road. As I reflect on my journey, it all had a divine sequence. I am grateful that each step progressively equipped me for the next level of service to others. Over the course of my career, I have both supported and led many initiatives and recognize that each leader is only as strong as their team. I believe that leaders should equip their team members with necessary tools to meet their personal/professional goals. Depending on the situation, we could be called upon to help someone navigate a familiar terrain or enter uncharted territory. Step out and be courageous. Embrace every step of the journey. #faithandwork
Dr. Heaven Provo, MBA, DNP, RN, CCM, PHNA-BC, NE-BC, LNFA, CAHIMS, FCM, has over 20 years in the healthcare arena, most recently serving as an independent consultant (ProClaim Case Management, LLC). Heaven holds a doctorate in nursing practice and a dual master’s in business & nursing, accompanied by multiple board certifications. She serves as the president of the Houston/Gulf Coast Chapter of CMSA and volunteers to support various non-profit organizations. Heaven has worked across the care continuum as a bedside clinician, case manager, community educator and nurse executive. Her objectives focus on improving patient outcomes and engaging care teams to become change agents in their care settings. She has been responsible for leading operations within health plans, large medical systems, accountable care organizations (ACO), and rural community hospitals with excellent results. Her initiatives have improved clinical targets, utilization, and care delivery metrics (i.e., readmission reduction, quality measures/care gap closure, and improved throughput while mitigating avoidable costs). Dr. Provo prides herself on facilitating excellent patient care and inspiring the next generation of nurses through innovation, technology, and evidence-based care delivery. She is a patient advocate and keeps them first in all that she does.