HCBS Program Director and Budget Management expert
|Career Status:||Actively looking|
|Willing to relocate:|
|Willingness to travel:||Willing to travel|
25 years experience in the Area Agency on Aging systems, multi-state experience with Medicaid fee for service and Pre-Paid Ambulatory Health Plans
MA Organizational Management, University of Phoenix, AZ, USA 4.0 GPA Summa Cum Laude
BS Applied Sociology, with a minor in Business Administration, University of Rhode Island, RI, USA
Region IV Area Agency on Aging, St. Joseph MI
Care Management Director 04/2008-10/2016
With my leadership and vision and management, grew annual revenue of MI Choice Medicaid Waiver HCBS Program by 35% over eight years
Redesigned department into specialized work teams which increased staff capacity, staff satisfaction, and work outputs by 15%
Co-developed new work methodologies to transform program operations that allowed for new cost-share revenue stream and also increased market penetration by 20%
Mentored Nursing Home Care Transitions team that became one of the top producers in Michigan. Established a billing system that generated an additional $100,000 annual in revenue.
Co-authored first ever Policy manual for the Care Management department; earned a perfect 4.0 score from Michigan State Department of Health and Human Services auditors
Achieved a perfect 4.0 in compliance with CMS HCBS standards on Annual Quality Review Score from 3rd party auditors on annual chart review/home visit interviews with clients
Educated and informed the public and other professionals about Agency programs and services during public speaking engagements
Analyzed work components, reduced costs by redesigning work tasks, directed increased teamwork with other departments
Led and mentored two key Supervisory staff – Supervisor of Operations/Product Development/LMSW and Quality Management Supervisor/RN – to optimized program outcomes and operations
Supported all clinical team members with Agency support. Limited license staff had on-site supervision. Licensed staff RN BSN BSW MSW could attend CEUs on work time with Agency paying reasonable registration fees. Helped motivate and retain team members.
Interpreted annual contracts and program manuals into daily tasks. Monitored and verified every aspect of contract compliance for MI Choice Home and Community Based Services Medicaid Waiver Contract. Actively partnered with all departments in the Agency including Intake, Data, Fiscal, Marketing to achieve full contract compliance.
Administered $10M annual revenues for MI Choice Home and Community Based Medicaid Waiver services program with both fee-for-service and managed care per-member per-month reimbursement methodologies. Investigated and resolved billing problems to increase monthly revenues.
Investigated every client appeal filed. Wrote testimony, led witnesses, had 100% success rate upholding Agency decisions to reduce or terminate services as reviewed by Michigan Administrative Law Judges
Handled all high level calls from client’s attorneys, the Attorney General’s office, advanced client problem resolutions.
REAL Services – Director of Budget Management and Quality Assurance
Compile $7.5M annual department budgets. Managing monthly reconciliation of fifteen different budgets totaling $5M, and oversee another $400K in various administrative budgets. Project future costs to balance fiscal year with no carryover. GAAP, A122, and A133 Circular Audit experience.
Lead staff in program development from concept, to program design, to implementation, evaluation, and successful operation. Implement Advantage Initiative Eldercare friendly communities, and Milton Consumer Directed Homemaker programs.
Sought after presenter at Medicare Part D community education seminars in multiple counties in north-central Indiana.
Coordinate planning and goals for department of 100+ staff.
Responsible for overseeing Quality Assurance staff and polices, billing department, 75 vendor contracts, and auditing of these agencies.
Successful grant-writing abilities to expand capacity or sustain current programs. Continually offered ideas and suggestions to improve operations and reduce costs.
Research and redesign of agency allocation mythology.
REAL Services – Director of Case Management
• Responsible for management of department of 45 staff members, over 1100 active clients utilizing eight State/Federal funding streams in five-county area with $1.7M budget.
• Slowed staff turnover to a crawl.
• Supervised Pre-Admission Screening department that processed 5000 requests annually for people applying for long-term care facility placement in our service area.
• Supervised five different HCBS Medicaid Waiver programs. Had the highest number of Assisted Living applicants & the #1 average in the State getting people home from the hospital or nursing home.
• Introduced cost saving ideas and work enhancement ideas that were implemented.
• Volunteered to administer FHA-Insured Home Equity Conversion Mortgage program – wrote manual, attended national training, trained counselors in-house, billed HUD, and handled grant writing.
• Represented Indiana before Indiana Senate sub-committee on 317 MR/DD program.
• Represented the Agency in appeal hearings heard by with Administrative Law Judges with client/service appeals and staff/unemployment appeals. Won 100% of hearings.
• Elected by peers as President of Case Management Professional Membership Unit in 1997, 1998, and 2002.
- Budget Management, eldercare, HCBS, leadership, LTC, LTSS, PAHP, Program development, public speaking