Candidate Information Name Available: Register for Free Title Behavioral Health Mental Target Location US-MD-Silver Spring Email Available with paid plan Phone Available with paid plan	20,000+ Fresh Resumes Monthly     View Phone Numbers     Receive Resume E-mail Alerts     Post Jobs Free     Link your Free Jobs Page     ... and much more Register on Jobvertise Free
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Candidate's Name , M.S.W.Street Address
EMAIL AVAILABLE PHONE NUMBER AVAILABLEEDUCATIONHoward University, District of Columbia,Washington D.C.Masters in social work M.S.W.LCSW is currently pending reactivation in progress.University Of Connecticut, Storrs ConnecticutBachelor of Arts  English B. A.SUMMARY:Over 25 years of proven direct administrative experience leading large complex behavioral health systems and in the delivery of direct services to the most vulnerable members of society.Extensive knowledge of /JCAHO/HEDIS/URAC/CARF/COA Accreditation standards/protocols and performance measures.Experienced in the assessment of Quality Improvement activities and the delivery of Health & Behavioral Health services to Medicaid, Commercial, Disease Management and Medicare Advantage populations.Manage Contracts at a strategic level including managing and navigating internal and external customer relationships.Demonstrated experience in Project Management, implementing a workplan, monitoring performance outcomes and reporting of project progress. Adept in the development of constructive reports defining project challenges and recommended solutions.Knowledge of the District of Columbia and the State of Maryland policies and regulations for implementing Behavior Health servicesStrong Supervisory skills demonstrated ability in leading clinical and ancillary teams.Working knowledge of Medicaid Medicare and Commercial fee for service billing as well as Value-Based Purchasing reimbursement modelsEffective oral and written communication skills, and proficient in the use of MS Office Suite, E Clinical Works (eCW), Excel, TEAMS, Zoom.SKILLS:Experienced healthcare administrator/with a specialty Subject Matter Expertise (SME) in supporting the Accreditation of behavioral health organizations.Provided Executive leadership transforming a three-million-dollar forty staff program into a 14-million-dollar Department, with Council on Accreditation (COA) accredited programs with expanded programming for individuals from early childhood to senior services.Introduced telehealth to the organization in behavior health and maintained service levels throughout the COVID pandemic.Achieved NCQA Accreditation for a Managed Care Organization located in six States acquiring 100% for two of the six states and all states passing above 95%Achieved COA Accreditation for a Federally Quality Health Center (FQHC) without contingencies during the COVID Pandemic.Provided Behavioral Health department leadership to a one-hundred-person staff multi-disciplinary group of professions in the delivery of outpatient behavioral health services.Raised more than five million in Federal and State Grant funds during tenure and developed collaborative data driven approaches to program implementation expanding access to care for all populations.Adept at working across silos with various staff to accomplish the goals of the overall organization; Comfortable working with executive staff to plan develop goals and identify results and outcomes with timelines to ensure progress is timely.Experienced and able to communicate at ease with senate, congressional staff, public media as required.EXPERIENCE:SENIOR DIRECTOR OF BEHAVIOR HEALTH.2015-2023 MARYS CENTER FOR MATERNAL AND CHILD HEALTH, (Marys Center) Washington D.C.Provided Executive leadership for the Behavioral Health Department to include, directing managing and coordinating the day-to-day operations for the Marys Center behavioral health Department.Provide administrative oversight for the behavioral health department budget pro forma analysis related to expenditures and revenue projections to ensure staff services were within the affordability of the Mary Center budget targets.Develop and sustain collaborative relationships with identified payor staff, in Quality Improvement, Finance and Claims audits and payments.Maintain regular meetings with senior staff to review policy and operational issues, solicit feedback and review individual work plans for various behavior health programs.Built strategic partnerships with behavior health providers,DIRECTOR OF QUALITY ASSURANCE2013-2014 SERVICE COORDINATION INC. Frederick MarylandManage a comprehensive integrated quality enhancement program in the human service field.Responsible for organizational achievement of our client desired outcomes by promoting quality performance throughout the organization.Ensures the development of an overall organizational quality improvement plan, program description, development of quarterly balanced scorecards and reports.MANAGER OF QUALITY ASSURANCE2012-2012 INNOVALON, Bowie MarylandMed Assurant Health PlanProvided support to quality initiatives in a managed care organization providing services to clients attempting to achieve a Five Star NCQA Accreditation rating.Provided HEALTH EMPLOYER DATA INFORMATION SET (HEDIS) reports supported by the external quality review process (EQRO) and organizational compliance with NCQA and URAC accreditation standards for utilization management, case management and related quality and appeals activities.SENIOR HEATLH POLICY ASSOCIATE2009-2012 OPTIMAL SOLUTIONS GROUP, College Park MarylandProject Director for the Federal Center for Medicaid and Medicare (CMS) quality improvement (QIO) and chronic improvementStaff conducted evaluations on Health Maintenance Organizations (HMOs) Improvement projects (CQIO). Led a team in the evaluation of 1800 QIO projects sent in by a national HMO for compliance and assessment with practice guidelines.Provided technical assistance to providers on QIOs that required improvements.DIRECTOR OF QUALITY2004-2009 APS HEALTHCARE, Silver Spring MarylandImplemented APS Healthcare Plan Utilization Review ProtocolsProvided leadership to the organizations quality improvement committee activities, developed, and tracked HEDIS performance measures.Implemented Health plan Accreditation processes.2002-2004 CHIEF PREVENTION AND SPECIAL SERVICES DIVISIONSubstance Abuse and Mental Health Services Administration (SAMSHA)Provided leadership to prevention and suicide prevention teams to provide information for the nation.Responded to requests from Congress related to prevention and treatment issues.2001-2003 DEPUTY DIRECTR DEPARTMENT OF MENTAL HEALTH, Washington, D.C.Managed the overall service delivery functions within the District of Columbia Department of Mental Health.Provided leadership to 125 multi-disciplinary staff in the development of accreditation compliance policies and procedures.