Education April ••••• – August ••••• Louisiana Tech University, Bossier City, La. Counseling/Master of Arts April ••••• – June ••••• Auburn University, Montgomery, Alabama Psychology/Bachelor of Science
April ••••• – Jan ••••• ValueOptions / Florida Health Partners Tampa, Florida Director of Quality Improvement/Compliance • Responsible for successful implementation and operation of the Value Options Quality Improvement Program for the Medicaid Prepaid Mental Health Program (PMHP). Assures that all functions are performed according to the PMHP contract. • Member of the VO National Compliance Committee, Tampa Service Center Utilization Management Committee and Co-leads the Clinical Quality Management Committee • Provides leadership for applying managed care principles, strategies and best practices to PMHP operations.
August ••••• – April ••••• Central Florida Behavioral Health Network, Inc. Tampa, Florida Director of Network Operations • Responsible for planning, organization and coordination of service delivery planning activities, network operations and initiatives. • Plans, organizes and coordinates development of Network Operations Plan, including annual evaluation of network activities related to the plan. • Directs and supervises key network staff responsible for information systems, utilization management and contract management. • Responsible for day-to-day network operations. • Maintains up-to-date knowledge of State and Federal regulations and serve as liaison with AHCA, DCF and third-party payors to ensure adherence to contracts and pertinent regulations.
September ••••• – July ••••• Agency for Health Care Administration Medicaid Tampa, Florida Medical/Health Care Program Analyst – Contract Manager • Responsible for planning, organization and coordination of strategic planning activities for the Medicaid Prepaid Mental Health Plan. Develop program goals, objectives and priorities of the Medicaid program related to Medicaid waivers and prepaid projects; • Review/analysis of proposed federal or state legislation, rules, regulations and policies related to Medicaid prepaid projects to determine the programmatic and fiscal impact; • Plan, organize, coordinate and develop program policy, management and contract compliance monitoring activities related to Medicaid Prepaid Mental Health Plan projects to ensure programs operate in accordance with state and federal laws, rules, regulations, and guidelines; • Plan, coordinate and conduct policy training and technical assistance for Medicaid prepaid projects to ensure consistency in program operations and conformity with state and federal laws, rules, regulations and guidelines; • Maintain up-to-date knowledge concerning the Florida Medicaid program, including pertinent federal regulations, state statutes, administrative rules, Florida Medicaid State plan, and Medicaid program manuals; maintain knowledge about Medicaid waiver regulations and processes.
July ••••• – August ••••• Gulf Coast Community Care Tampa, Florida Program Director/Partial Hospitalization, Day Treatment, Alternative Family Programs •••••; Monitor all services provided by the Alternative Family Program in Hillsborough county and the Partial Hospitalization and Day Treatment programs in Hillsborough, Pinellas, and Pasco counties; assure that all services are provided in an effective and professional manner •••••; Responsible for recruiting caregivers/sponsors for the AF Program through community presentations to various organizations; Provide initial and quarterly comprehensive mental health trainings to all AFP foster home caregivers •••••; Participate in the Quality Improvement Programs through monthly chart audits; Responsible for coordinating with the Client Records Department Director to ensure that all documentation meets Medicare, Medicaid, State and agency standards. Facilitate Utilization Review and Patient Care Review with staff psychiatrist to assure compliance with specific insurance requirements.
April ••••• – June ••••• Northside Community Mental Health Center Tampa, Florida Program Manager/Adult Targeted Case Management Program •••••; Plan and direct the day-to-day operations of the Case Management Program, developing goals and objectives; Supervise all Case Management staff (•••••) and evaluate staff performance •••••; Assure that high risk clients are identified and monitored, informing the Director of problematic cases; Assure that crisis intervention is provided and facilitate hospitalization when indicated •••••; Interview, hire, orient, and provide staff development for all case management staff •••••; Assure client records are maintained in accordance with Center policy and Medicaid regulations •••••; Assist the Division Director in facilitating program adherence to quality assurance, JCAHO and CARF standards; Complete reports, procedures, and program writing commitments; Facilitate Utilization Review and Client Care Reviews for compliance with established standards.
October ••••• – April ••••• Agency for Community Treatment Services Tampa, Florida Clinical Coordinator/Family Therapist – Youth Program •••••; Provide family therapy services to families of adolescents admitted to the residential treatment program and to families in the Youth Outpatient program •••••; Responsible for supervision of counselors and case managers at the long-term Group Home, the short-term Residential Treatment Unit, and the Overlay program at the Juvenile Detention Center •••••; Provide training for all staff in the Youth Program in the areas of substance abuse treatment and behavioral techniques to deal with delinquent youth •••••; Responsible for admission screening, assessment of children referred for substance abuse problems, and coordination of all admissions and discharges for the Youth Programs; Facilitate Utilization Review and Patient Care Reviews to assure compliance with clinical critieria.
Additional professional activities
••••• – •••••: Conducted statewide training for Substance Abuse providers related to Medicaid reimbursement for services; Assisted FADAA, DCF and AHCA in the implementation of a Robert Wood Johnson grant for Revenue Maximization efforts related to substance abuse funding.
••••• – •••••: Presented seminars at FADAA Annual Conference related to Medicaid Reimbursement for Substance Abuse disorders. ••••• – •••••: Assisted with statewide training of Medicaid providers related to Community Mental Health Services and Mental Health Targeted Case Management Services; Actively participated in the development of state policy related to Medicaid reimbursement of community mental health and targeted case management services. September ••••• – September ••••• Hillsborough Community College, Tampa Part-time Faculty/General Psychology; Development of the Life Span •••••; Responsible for instruction of undergraduate students, licensed practical nurses, and high school students seeking college credits in the above courses
January ••••• – November •••••: ADM Program Office, Case Review Committee Committee Member •••••; Committee meets monthly to review cases for children experiencing severe emotional disturbances and being referred for placement in residential treatment facilities Relevant Training
Florida Medicaid Management Information System – Query Path Training Agency for Health Care Administration – Tallahassee – ••••• Quality Improvement Systems for Managed Care Health Care Financing Administration, St. Louis, Mo. – ••••• Train the Trainer Certification for Person to Person Case Management Department of Health and Rehabilitative Services, Tampa, Florida – ••••• Person to Person Case Management Certification Department of Health and Rehabilitative Services, Tampa, Florida – •••••