Medical Mental Health

Valarie Nobriga, MBA, BSBM, LPN, PsyD

EDUCATION

University of The Rockies

Doctor of Psychology (PsyD) Industrial and Organizational Development with a specialty in Mediation and Conflict Resolution

University of Phoenix Hawaii

Master Business Administration (MBA), GPA 3.77, 2002 University of Phoenix Hawaii

Bachelor of Science Business Mgmt (BSBM), GPA 3.72, 2000 Kapiolani Community College

Practical Nursing (LPN) 1977

AREAS OF EXPERTISE

- Insurance Consultant & Employee

Benefits Consultant

- Data management

- Conflict management

- Health Insurance Portability and

Accountability Act (HIPAA),

- Managed Care

- Occupational Safety & Health

Administration (OSHA) compliance,

- Medicare,

- MedQUEST,

- ERISA,

- Taft Hartley,

- TPA,

- Medical Coding using ICD-9 & 10, CPT

- Healthcare Common Procedure Coding

System (HCPCS)

- TJC & NCQA Accreditation Review

EXPERIENCE

Tax Preparer.

Liberty Tax LLC., 2016 – Present

Tax preparation, personal & Business, amended returns Independent Employee Benefits Consultant

American Family Life Assurance Company (Aflac), 2013 – Present Hours: By Appointment, Commission Based

Flexible Spending Accounts (FSA), Supplemental Insurance products complimenting Major Medical benefits to employees with income during times of illness or injury. Owner/Consultant

Hale Ola Consultants, 2000 – Present

Hours: By Appointment, Rate: $Negotiable depending on service requested Notary Public Commission, Organizational Development Consultant, Wellness Consultant Admitting Manager

Kahi Mohala Behavioral Health Hospital, 2008 – 2009 Hours: 40 per week, Salary: $67,000.00 per year

Utilization Management Specialist

State of HI Department of Health Child and Adolescent Mental Health, 2003 – 2008 Statistical data analysis using SPSS software to obtain aggregate data, interpreted data of services rendered using the CAMHD array of services provided statewide, created data reports for tracking and trending over 2 year or eight quarter periods of time to determine the efficacy of the treatments and determine positive or negative outcomes. Case Manager

Pacific Administrators, Inc. – Hawaii Laborers, 2001 – 2003 Created and implemented the infrastructure for the Managed Care department, created the algorithms for the new utilization management software, EZ Cap, provided daily operations of the department including pre-authorization of medical & surgical services, medical review for medical necessity and appropriateness of requested services, claims examiner using ICD-9, CPT, and HCPGS coding, acted as liaison between Trustees, providers, and the union membership.

Nurse Reviewer

American Benefit Plan Administrators Inc., 1997 – 2000 URAC accreditation activities, pre-authorization of medical & surgical services, medical review for medical necessity and appropriateness of requested services, medical review, claims examiner using ICD-9, CPT, and HCPGS coding, acted as liaison between Trustees, providers, and the union membership.

Quality Improvement Specialist

Hawaii Medical Services Association, 1991 – 1996

Quality audits on participating managed care physicians, HEDIS data collection, NCQA accreditation, audit reports, identification of areas of deficiencies with corresponding corrective action plan development, facilitate improvement activities, periodic monitoring, and meetings with clinic administrators and medical directors to ensure compliance. CAREER ACCOMPLISHMENTS

Human Resources, Business Development, & Research

Employee Benefits Consultant

Intensive doctorate level (PsyD) coursework in Industrial/Organizational Development and workforce engagement and empowerment with a specialty in Mediation and Conflict Resolution, GPA 3.87.

Increased the Call Center/Admitting department productivity and admission rate for a free standing psychiatric hospital.

Created, Implemented, and managed the Managed Care department for a union self- insured medical plan Trust Fund office. Conducted state and federal compliance regulations research for the development of the Managed Care department.

Conducted research resulting in the development of the acute inpatient psychiatric reimbursement benefit for children and adolescents with severe mental health issues. AFFILIATIONS

State of HI Life & Health Insurance (Producer & General Agent) - 1982-1996, reactivated 2013

State of Hawaii Notary Public Commission 2010, expires 2014

FEMA NIMS Disaster Management Training 2007,

Administrative Legislative Liaison (A.L.L.) for the Dept of Health Behavioral Health Administration (BHA) 2006 Hawaii State Legislature,

Aloha United Way (AUW) Campaign Coordinator for the State of Hawaii Dept of Health

(DOH) Child and Adolescent Mental Health Division (CAMHD) - 2005,

UH & HI Outcomes Institute Public Health Data Management Training 2004,

Hawaii Association of Healthcare Quality (HAHQ) - 2000-2003

NASD Series 6&63 Mutual Funds - 1989

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