Quick Interview: view Salary range: $135,000 to $185,000 Willing to relocate: Yes Years of related job experience: 25 Highest degree earned: MSW, MA Accreditations: State of Michigan - Board of Social Work, Master's Social Worker Clinical and Macro License, Software: Advanced user with the following Microsoft applications; Word, Excel, Outlook, Visio. Intermediate user with Microsoft Project.
Highly accomplished healthcare operations leader with over 20 years of repeated success in crafting and implementing collaborative strategies to improve operations, control cost and drive revenue and profits. Possessing an expertise in process improvement initiatives within corporations. Skilled in planning and managing complex initiatives that achieve desired goals while maintaining high staff morale and meeting customer expectations. Repeatedly recruited into senior leadership roles based on demonstrated success in taking risks, executing strategy, improving client relations, and identifying growth opportunities.
EMPLOYMENT HISTORY
Organization: Please reach us for these details! Location: Avon, CT Job title: Vice President, Clinical Operations Years and months employed: 1 Year(s) 4 Month(s) Responsibilities: Oversee medical budget for Medicaid and Medicare behavioral health subcontract with health plan customer covering 2.5 million covered lives; six Medicaid state markets and Medicare in nine states. Responsible for coordinating operations between department leaders (e.g. operations, finance, network, claims payment) and developing/implementing clinical strategy in an effort to manage care costs. Key projects included:
Designed integrated care workflows, wrote clinical policies and developed training for Special Needs Population (SNP) Model of Care (MOC) behavioral and medical integration that met CMS guidelines. Strong emphasis on person centered care
Developed and put into operation community based enhanced 23-hour observation model and inpatient / emergency room diversion strategy to managed unnecessary inpatient and ER utilization and impacted cost of care.
Implemented first corporate defined telehealth services in Georgia with community mental health providers that increased access to services and specialists (e.g. Child and Adolescent Psychiatrists)
Developed dashboard which compared authorizations, claims and budget which visually illustrated variance to manage cost of care
Organization: Magellan Health Services Location: Phoenix, AZ Job title: Clinical Project Manager Years and months employed: 6 Month(s) Responsibilities: Supported public sector vice president of operations transition 25 community clinics from Magellan Behavioral Health Services to local provider network organizations. Key clinical projects worked on as part of transition included:
Improved Assertive Community Treatment (ACT) program fidelity assessment tool as first step to support improved program fidelity according to national standards
Consulted on and developed State of Arizona mandated ACT policies and procedures
Project managed Person Centered Treatment Plan redesign for EMR along with policy and procedure
Served as regional director overseeing operations and transition of clinics to community providers
Organization: Magellan Health Services Location: Nashville, TN Job title: General Manager / Account Executive Years and months employed: 2 Year(s) 2 Month(s) Responsibilities: As the General Manager of Magellan Health Services Nashville based public sector care management center, recruited to improve and oversee all operational activities (i.e. clinical care management, customer service, claims payment, finance, reporting, quality management, grievance & appeals, member relations, network development and contracting) related to fulfilling contract with State of Tennessee for TennCare (Medicaid) behavioral health (MI & MR/DD) and substance abuse services for priority and non-priority members.
At peak of contract managed 410 million dollar budget serving 1.2 million Medicaid members at-risk. In final year exceed EBITDA target by over 100 percent
Developed respected leadership team, renewed spirit of teamwork and increased level of overall staff satisfaction. Under my leadership staff satisfaction increased from 17 percent in 2006, prior to my arrival, to 88 percent in 2007 and 94 percent in 2008. This was in spite of impending employee lay-offs.
Evolved a client centered care system and culture among providers with a strong focus on recovery, resiliency, self-determination and choice
Developed strong collaborative relationship with behavioral health providers working toward a culture of quality away from a focus on compliance
As the Account Executive, maintained a quality relationship with the Tennessee Department of Mental Health and Developmental Disabilities and the Tennessee Bureau of TennCare. Re-established a respectful relationship with all stakeholders (i.e. customer, providers, advocacy groups) characterized by trust and accountability with a reputation for member focus and provider partnering.
EDUCATION
Institution Name: Michigan State University Location: East Lansing, MI Degree earned: MSW, MA Major/Concentration: Clinical Social Work / Clinical Psychology Year Graduated: 1983
Institution Name: University of Michigan Location: Ann Arbor, MI Degree earned: BGS Major/Concentration: General Studies Year Graduated: 1977
