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Behavioral Health Client Care

Location:
Maryland
Salary:
200,000
Posted:
November 03, 2023

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Resume:

PROFESSIONAL SUMMARY

Innovative healthcare leader with an exceptional track record designing, implementing, and managing integrated systems to achieve peak performance. Driven by a passion for building collaborative teams and optimizing stakeholder outcomes through organizational change.

PROFESSIONAL EXPERIENCE

PEACEHEALTH MEDICAL CENTER 2022 – Present

Behavioral Health Director and Acting CNO Eugene, OR

Responsible for all inpatient psychiatry services including accreditation, revenue, and utilization management as well as all clinical oversight across the campus.

●Leading operational effectiveness, clinical excellence, and personnel management across the center including the change management of hospital closure.

●Achieving exceptional audit results with DNV, Oregon Health Authority, and Medicaid/Medicare.

●Managing infrastructure, systems, and standards to achieve desired outcomes in Quality Improvement, KPIs, HEDIS indicators, IPFQR, and productivity metrics in collaboration with medical directors and department chairs.

●Overseeing fiscal and business planning (with operational budgets of $60-117M), as well as utilization review and revenue cycle. This included updating payor contracts, catching missed billing opportunities, rebilling for next level of care for eligible denials, unbundling services to optimize returns, and identifying non denial buckets for resubmission, ultimately saving $26M in the past year.

●Developing and supporting clinical processes to assure patient safety. Accountable for achieving or exceeding national benchmarks and quantitative targets.

●Overseeing our high utilizer initiatives to better connect these individuals with community partners for follow up care and reducing ED visits went from 13-18 per month to 2-6 per month for our most frequent utilizers and reducing our total number of frequent utilizers from 97 to 49.

PATHWAYS TO HOUSING DC 2021 – 2022

Chief Operating Officer Washington, DC

Growing and stabilizing this non-profit agency to achieve its mission of eliminating homelessness in the nation’s capital.

●Developed strategic and long-range plans and policies for overall business operations.

●Ensured regulatory compliance for all areas of responsibility.

●Planned, developed, implemented, and evaluated client care programs including identification of new clinical objectives, capital, and other resource requirements, expected operating revenues and expenses, allocation of space, and organization of program personnel.

●Lead continuous improvement efforts that promoted clinical excellence and cost efficiency, including operationalization of grant funding and overall budget controls ($30M)

●Established and maintained collaborative relationships with stakeholders that lead to measurable improvement in client care outcomes, financial goals, and quality benchmarks.

THE CONCERTED CARE GROUP 2014 – 2021

Chief Operating Officer Baltimore, MD

●Built this integrated healthcare company from the ground up, growing from 0 employees and patients to a $15M a year endeavor with 4 sites, over 2,000 patients, and 150 employees.

●Achieved the highest level of CARF accreditation and licensure for programs including OTP, IOP, OP, DWI, OMHC, Health Home, laboratory, PRP, PHP, Vocational, Recovery Housing, and Primary Care.

●Established partnerships with EHR (electronic health record) vendors to support integration with NPPES, PECOS, CAQH, Novitas, Optum, and Beacon Provider Connect.

●Developed specialized functionality within EHR systems for our unique integrated care settings, complying with all individual regulations, and offering unique integrated functionality for improved patient outcomes.

●Provided expert knowledge and guidance at hearings and neighborhood association meetings for controversial topics such as medication-assisted treatment for opiate users.

●Served as the Safety Officer with oversight of the Compliance Department and all QA/QI activities throughout all change management initiatives as we implemented new programs and developed new sites.

●Wrote and managed Strategic Plans for corporate goal achievement and highest safety indicators.

●Worked very closely with regulatory bodies, legislators, and national organizations to promote shared goals of patient safety, patient outcomes, community impact, and financial stewardship.

●Covered CFO role as needed, managed and developed budgets, achieved financial milestones for maximum ROI, and oversaw billing department for successful financial audits with CMS and Beacon Health Options (the Administrative Service Organization at the time).

●Worked closely with vendors, contractors, and state agencies to pursue business opportunities nationwide including a partnership with UCLA to create virtual reality trainings based on patient experiences and a residential treatment program in Colorado.

●Oversaw and negotiated all contracts including getting in network with payors, facility infrastructure and maintenance, medication and medical supplies, and supportive services.

●Covered all clinical and operational day to day functions, including HR, risk management, quality, marketing, and medical utilizing Microsoft Project and Asana.

UNIVERSITY OF MARYLAND MEDICAL CENTER 2009 – 2015

Director, Community Psychiatry Baltimore, MD

●Created a coordinated network of community programs to provide a lattice of wraparound care for highly complex homeless, mentally ill adults, to improve outcomes for those with medical and socioeconomic comorbidities through person centered care and exceptional crisis management.

●Established industry standing for exceptional compliance with the Social Security Administration, Joint Commission, HUD, COMAR, Medicaid, and other agencies within the Baltimore City Continuum of Care.

●Grew the programs to an all-time high of census and revenue derived from multiple service lines with a rate of denials less than 2%.

●Facilitated hospital committee operations to help achieve Magnet status for the hospital system.

●Established a pipeline of sustainable grant-funded opportunities for innovative care within a hospital structure, including HUD grants of $950k annually.

●Developed educational programs and presented within the hospital and provider community representing the hospital and all outpatient psychiatric programs.

JOHNS HOPKINS HOSPITAL 2008 – 2009

Psychiatric Nurse Baltimore, MD

●Supported an inpatient psychiatric unit serving individuals with neuro-memory impairments, substance abuse disorders, and schizophrenia.

●Developed a team that provided groundbreaking evidence-based individualized treatment to patients by using a balance of existing methodology and the newest paradigms of care.

●Developed new training modules for patients and worked closely to integrate a Day Program service line as a seamless continuum for patients leaving inpatient care.

●Developed new approaches to optimizing efficiencies and minimizing adverse events on the unit and improving HEDIS measures.

COMUNILIFE 2006 – 2008

Director, Residential Treatment New York, NY

●Restored a residential treatment program for individuals with psychiatric and medical disabilities from decertification when facing issues of noncompliance from the State of New York.

●Led initiatives on streamlining operational efficiencies, cost-effectiveness, and resource utilization for increased funding while implementing new tools with clinical informatics.

THE LIFE ADJUSTMENT CENTER 2005 – 2006

Clinical Coordinator Bronx, NY

●Grew an inter-borough network of care centers, serving the developmentally disabled, expanding services to include residential and day treatment levels of care.

●Headed the Quality Assurance Department, developing and monitoring proposals, procedures, protocols, budgets, state standards, certifications, and accreditation.

COMMON GROUND COMMUNITY 2002 – 2004

Clinical Director New York, NY

●Developed a DHS (Department of Homeless Services) funded shelter from the ground up which served 60 mentally ill men classified as “long-term shelter stayers” and achieved award-winning outcomes.

●Brought about strategic change to develop this program into a leader in clinical service provision for the housing unstable population.

●Achieved award-winning outcomes and recognition from the state for a successful model of coordinated person centered care.

THE NEW YORK STATE PSYCHIATRIC INSTITUTE & COLUMBIA PRESBYTERIAN HOSPITAL 1995 – 2000

Site Coordinator New York, NY

●Coordinated all aspects of two longitudinal studies, one researching the effectiveness of HIV risk reduction efforts in homeless mentally ill populations, the other examining the long-term effects of in utero rubella exposure.

●Developed, tested, and implemented new instruments leading to a 15% increase in grant funding.

●Developed sites around the country providing individualized interventions for teams struggling with budget and performance targets.

●Maintained tracking and trending of study outcomes using analytical software to stay aligned with programmatic and financial goals.

ADDITIONAL EXPERIENCE

Nurse for Corizon/Wexford at the Baltimore City Jail

2018

Commissioner for the Maryland Alcohol Tobacco and Cannabis Commission 2020 – Present

●Appointed by Governor Hogan

Senior SME, Substance Abuse and Medicaid for MEDKASA 2019 – Present

●Reviews SAMHSA grants and supports CMS contractors on Opioid Use Disorder (OUD) initiatives.

Policy Consultant and Grant Reviewer for SAMHSA 2018 – 2022

●Telehealth policy of behavioral health and opiate treatment program applications review

Grant writer

Community Counseling and Mediation 2002 – 2004

The Mount Sinai School of Medicine 2002

The Arab American Association 2003

●Wrote and submitted multimillion-dollar grant proposals for research related to autism, needs of the Arab American community in the post 9/11 aftermath, and social service utilization in economically challenged neighborhoods, ensuring compliance with NIH regulations, and coordinating participant recruitment and efforts between collaborative sites

Psychotherapist

Community Counseling and Mediation 2002 – 2003

asktheinternettherapist.com 2003 – 2009

Researcher

The Community Support Services’ Critical Time Intervention 1995 – 1996

The Santa Rosa Council on Aging 1994

The Muscular Dystrophy Association 1993

EDUCATION

M.A. (Applied Psychology) - Yeshiva University, Albert Einstein College of Medicine, New York, NY

B.S. (Nursing) - New York University, New York, NY,

B.A. (English & Psychology), Cum Laude - Sonoma State University, Rohnert Park, CA

LICENSURE & CREDENTIALING

RN (Registered Nursing): License #R181514, State of Maryland, Oregon, and Washington D.C.

Lean / Six Sigma: Black Belt Certified, #HR9KXVAJGD

Project Management Professional (PMP): Certified, #2647384



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