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Mental Health, Quality improvement, accreditation

Location:
Baltimore, MD
Posted:
February 17, 2015

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Resume:

MILDRED WILLIAMS L.I.C.S.W.

*** ******** **** **. *** Odenton, Anne Arundel 21113 Cell: 301-***-**** acocm5@r.postjobfree.com

PROFESSIONAL PROFILE:

Over 25 years of proven direct administrative experience leading large complex

behavioral health systems and the delivery of direct services to the most vulnerable

members of society

• Extensive knowledge of NCQA/JCAHO/HEDIS/URAC/CARF Accreditation

standards/protocols, and performance measures

• Providing leadership, strategic planning and implementation project plans to accomplish

organizational goals

• Experienced in the assessment of quality improvement activities, and the delivery of

health and Behavioral Health services to Medicaid, Commercial, Disease Management,

Medicare Advantage populations

• Proven ability to manage contracts at a strategic level including managing and navigating

internal and external customer relationships

• Demonstrated experience in implementation and management of project changes,

outputs, monitoring and report of project progress, and the development of constructive

reports defining project problems, and solutions

• Knowledge of the state of Maryland policies and regulations for implementing mental

health services or substance abuse services under COMAR;

• Considerable experience in ground-up program development, implementation, budgeting

and data collection;

• Working knowledge of Medicaid, Medicare, and commercial fee for service billing

• Strong supervisory skills; Demonstrated ability in leading and managing teams;

• Effective oral and written communication skills;

• A demonstrated team player;

• Proficient in the use of electronic health records and care management software programs

including data analysis and reporting;

• Proficient in MS Office Suite; Demonstrated history of going above and beyond assigned

job duties.

AREAS OF DEMONSTRATED COMPETENCE:

• Planning and Evaluation of Behavioral Health Programs

• Clinical Supervision

• Business Development federal, state, and local grants

• Strategic Planning

• Budgeting and fiscal Management and Oversight of standard operating procedures

• Quality Improvement/Performance Measurement Activities

• Effective oral and written communication skills

• HIPAA HITECH Compliance

• External Quality Review (EQRO) reporting and audit processes

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• Project Director (contract) for the Center for Medicaid and Medicare Services

• Balanced Scorecard Protocols

PROFESSIONAL EXPERIENCE:

Director, Quality Assurance 02/2013 – 12/2014

Service Coordination Inc. – Frederick, MD

Manage a comprehensive, integrated quality enhancement program in the human service field.

Responsible for organizational achievement of or client desired outcomes by promoting quality

performance throughout the organization. Ensures the development of a overall organizational

quality improvement plan, quality assurance program description, and development of quarterly

balanced scorecard measures and reports.

Manager, Quality Assurance 04/2012 -12/2012

Innovalon, Bowie Maryland (MEDAssurant Health Plan)

Provided support to quality initiatives in a managed care organization providing services to

clients working to achieve “five star” NCQA accreditation rating. Performed internal employer

audits of service documentation and developed reports. Responsible for providing Health

Employer Data information Sets (HEDIS) reports supported the external quality review (EQRO)

processes, and ensured organizational compliance with NCQA and URAC accreditation

standards for utilization management, case management, and related quality activities.

Senior Health Policy Associate 04/2009 – 12/2012

Optimal Solutions Group, College Park, Maryland

Project Director, for the federal Center for Medicaid and Medicare (CMS), quality improvement

(QIO), and chronic improvement quality projects (CQIO). Staff conducted individual evaluation

of health maintenance organization (HMO) project information. Led team of multi-disciplinary

staff evaluation of 1800 QIO projects sent in by national HMOs for compliance assessment and

corrective action. Provided support to senior leadership in new business activities as member of

presentation team. Trained industry medial/clinical staff in evaluation results and provided

technical assistance in the development of effective quality programs. Supervised project team

staff to include information technology clinical and data driven activities. Compliance and

project results evaluated via an interactive dashboard depicting organizational results.

Director of Quality 03/2004 – 07/2007

APS Healthcare Inc. Silver Spring, Maryland

Responsible for the development, implementation, and monitoring, of APS Healthcare Plan

Utilization Review protocols. Provided leadership to the organizations quality improvement

committee activities; developed and tracked HEDIS performance measures

Chief, Prevention and Special services Division 04/2002 – 03/2004

Substance Abuse and Mental Health Services (SAMHSA), Rockville Maryland

Provided leadership to the /school-based mental health teams prevention efforts for the nation;

responded to requests from congress, and promoted suicide prevention efforts via grants that

supported national suicide prevention activities.

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Deputy Director, Department of Mental Health 04/2001 – 04/2003

District of Columbia, Washington, D.C.

Managed the overall service delivery functions within the District of Columbia Department of

Mental Health. Provided leadership and oversight of all operational programming and directed

125 multi0disciplinary staff in the development of policies and procedures. Worked

collaboratively with community provider agencies that deliver community-based services

amongst private, public and not for profit programs and hospital systems in the District of

Columbia.

Chief of Adult Mental Health & Substance Abuse 04/1996 – 04/2001

Montgomery County, Maryland

Senior Official appointed by the Montgomery County Executive, and confirmed by the

Montgomery County Council. Responsible for the Adult mental health and Substance Abuse

Services within a complex 1600 staffed health and human services organization. Developed

effective implementation strategies, for 40 performance measures,/outcomes for all behavioral

health programs. Supervised 90 multi-disciplinary professional staff and provided oversight to

outpatient clinic, inpatient residential, elderly housing programs for the emotionally disabled.

Director, Arlington County Department of Mental Health Services 01/1995 – 07/1996

Arlington, Virginia

Responsible for the administration and clinical supervision of mental health services for

Arlington County residents.

Director, Office of the Special Master 1994 - 1995

District of Columbia, District Court, Washington, D.C.

Responsible for the oversight of the Office of the Special Master tasked with implementing a

comprehensive review of the District of Columbia’s mental health services.

Director, North Community Mental Health Clinic 1987- 1994

Ensured the availability of a comprehensive range of continuous medical and mental health

services for 2,000 enrolled individuals in a catchment area of 290,000 residents; representing

50% of the District of Columbia’s mental health population. Supervised 125 multi-disciplinary

staff delivering community based services.

Education

Masters in Social Work MS.W

Howard University District of Columbia, Washington D.C.

Bachelors of Arts- English B.A

University of Connecticut, Storrs Connecticut

Licenses

State of Maryland Social Work Independent (LICSW)

District of Columbia, Social Work

Communications Experience

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Public Media, WPFW radio, WHM Channel 32 Television, WTOP radio news Channel 4,

Montgomery County News Channel 21, Washington Post, Gazette Newspaper, The Journal

Newspaper, Mental Health Weekly Publication; Children’s Hospital “Clinical Proceedings”

article.

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