Dewan L. Stanback

***** *. **** ****** *****, FL 33617

addobk@r.postjobfree.com Cell 813-***-****

Education Nova Southeastern University

Pursing a Doctoral Degree in Health Science

Nova Southeastern University, Tampa, FL

Master of Science Degree in Mental Health Counseling

Saint Leo University, Saint Leo, FL

Bachelor of Arts Degree in Psychology with minor in Criminology

Bryant & Stratton Business Institute, Rochester, NY

Associates Degree in Business Management

Professional

Certification Florida Registered Mental Health Counselor, Intern

#IMH9510

Professional

Experience

2016 – 2020 Anthem Inc. Tampa, FL

Provider Network Manager, Behavioral Health / Long Term Supportive Services

Manages the development of network expansion for Behavioral Health and Long Term Care Services.

Oversees the negotiation of Managed Care or other payer contracts.

Responsible for daily activities of field-based Provider Network Consultants and Managers.

Identify team success and training opportunities through quarterly/yearly review and corrective actions plans.

Coordinate Cost of Care (CoC) initiatives by conducting Utilization Management quality reviews with providers and implement process improvements in a timely manner.

Provider collaboration to Compliance, Claims, Configurations, Credentialing, Utilization Management, and Case Management.

Resolve Client and Member Facing system concerns.

Analyze appeal request and submit projects by using Facets, Salesforce, Next Gen, Macess, Emptoris and Provider Contract Repository systems.

Monitor performance of Network Adherence, Access for members, Provider Satisfaction Surveys, Quality Audits, Provider Remediation, Community Mental Health, and Long Term Care partnerships.

Familiar with a variety of field’s concepts, practices and procedures, such as, Behavioral Health Injectable, Telehealth, Bridge, Statewide Inpatient Psychiatric Program, Assisted Living Facilities, Adult Family Care Homes, Adult Day Care, Skilled Nursing Facilities and Home Health agencies.

Dewan L. Stanback

2014-2016 Anthem Inc. Tampa, FL

Behavioral Health Case Manager

Provide Behavioral Health Case Management services to all members including: Health Risk Assessment, Comprehensive Assessment, Care Plan, Progress monitoring, Referrals and Lead contact for SIPP Case Management program. Co-Manage Disease specific programs for HIV/AIDS, Oncology, CHF, Diabetes, HTN, Asthma, Healthy Behaviors and ER.

Maintain a caseload of 100 members.

Meet with members at home, hospital or telephone as needed.

Link members with available community resources.

Follow up with members, local and state agencies as appropriate to track service outcomes and referral status.

Input accurate and complete data for all contact with members into QNEX plan database in a timely manner.

Adhere to plan policy, procedures and professional code of ethics.

Serve as mentor for new staff by assisting in the formal training processes and guidelines.

Other duties as assigned by supervisor, such as special projects to meet HEDIS measures.

2009-2014 BayCare Health System, New Port Richey, FL

BayCare Behavioral Health Academy

Mental Health Counselor, Intern

Counsel with emphasis on prevention; Work with individuals, groups and

families to promote mental and emotional health. Assist individuals with issues

associated with addictions, substance abuse, family, parenting, stress, anger and self-esteem. Responsible for case management during aftercare planning and

referral services.

2008-2014 BayCare Health System, New Port Richey, FL

Compliance/Grants and Contracts Supervisor

Perform internal audits for BayCare Behavioral Health Agencies on State and Federal product lines of business, service validation via claims history, facility reviews and administrative processes. Manage project oversight of external audits performed by State and Federal contractors (Managed Care, DCF, OIG, AHCA, DJJ, CARF, CMS, OSHA and Office of Civil Rights).

Monitor and report on Compliance and Corrective Action Plans related to audits.

Manage contract deliverables and regulatory requirements for Pharmacy, Acute Care Services, Access to Care, Encounters, Outcomes, Targeted Case Management, Grievance Procedures, Critical Incidents and Audit Schedules.

Oversee monthly budget development and monitor earnings, transactions, adjustments, revenue, bed day availability and program cost center actual expenses.

Track and trend Corporate Compliance monitoring of Policies and Procedures, High Level Oversight, Education and Training, Team Member Screening and Cost. Conduct internal HIPAA investigations as needed. Revise and deploy annual plans: Compliance, Auxiliary Aid, Diversity, Cultural Competency and Civil Rights Checklist.

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