* Dynamic results oriented executive level manager with experience managing Medicare and Medicaid programs utilizing a strong role model and detail driven work ethic that is organized, take charge professional with exceptional follow-through abilities and excellent management skills.
* Hands-on manager and critical thinker that communicates effectively with all organizational levels and possess a valuable blending of leadership, creativity/innovative and analytical skills that result in effective and efficient measurable outcomes.
( Shared Decision Making ( Procurement Management ( Operations Management ( Goal Setting & Planning ( Public Speaking
( Budget Development & Administration ( Cross-Functional Relationship Building ( Problem Solving ( Customer Service
( Productivity & Efficiency Improvement ( Analysis & Assessment ( Individual/Team Training & Development
October 2012 - Current
Integrated Health Care Consultant
Integrated health care consultant for both Medicare and Medicaid programs, which includes the dually diagnosed populations in either a carve out or all-inclusive contract. Providing integrated medical and case management approaches that address the medical, functional, social, cultural and behavioral health needs of each member.
2011 - September 2012
SCAN Health Plan Arizona, Inc.
Vice President of Medical and Case Management Services
Responsible for the compliance of program outcomes, oversight and integration of medical, behavioral and social care management of both the Medical Management and the Arizona Long Term Care System (ALTCS) Case Management departments. Accountable for the provision of timely and appropriate quality health care services related to prior authorization, utilization review and case management services for both Medicare and Medicaid programs.
* Key Achievements: