CRAIG CONOVER
Ballston Lake,NY
Summary
Healthcare professional with a broad skill set, including a background in social work, IT, and front-line Healthcare. Excelling in detailed analysis and subject matter expertise to ensure compliance with federal and state regulations through adept use of research, technology, and data-driven practices. Renowned for applying clinical insight to guarantee adherence to evolving regulations, supplying invaluable guidance to team members, stakeholders, and clients. Proven track record working with the New York State Department of Health (NYS DOH), Office of Mental Health (OMH), and Office for People with Developmental Disabilities (OPWDD) as a compassionate and professional Care Manager. Excellent communicator with strong organizational skills, superb understanding of data collection and performance metrics. Recognized for staff development leading to high performing teams and building team dynamics.
Overview
6
6
years of professional experience
1
1
Certification
Work History
Quality Assurance Analyst
GENESYS Consulting Services, Inc
03.2022 - 10.2023
- Provided analysis and subject matter expertise to evaluate performance of Social Adult Day Cares (SADC) across New York State and their compliance with Home and Community Based Services (HCBS) Final Rule
- Conducted professional on-site interviews remotely with managers, owners, and Managed Long Term Care (MLTC) providers that provided HCBS services through their agencies or organizations
- Created and established rapport with SADC and MLTC providers while collaborating and implementing actions needed to achieve proper remediation efforts that are satisfactory to NYSDOH and Centers for Medicare & Medicaid Services (CMS)
- Praised by several MLTC providers for being patient, caring, and creative to overcoming language barriers during interviews
- Created and managed professional literature for training and procedural guidance, provided training and video presentations to QA and QI
- Prevented team’s database from becoming fully corrupted when data integrity practices were not followed
- Copy saved caused the project to save the client up to 5,000 person-hours of work provided in the Database
- Entrusted with specialty tasks such as insurance mergers, improper data reporting, deviation investigation, and data alignment
- Conducted data audits to investigate and correct errors and inconsistencies.
Care Manager, Care
Design NY
04.2020 - 02.2022
- Monitored ongoing services by scheduling meetings, assessments, and home visits to communicate and collaborate with members of the program
- Determined through assessment as well as ‘wants and needs' to show which services will improve the adult or child i.e., Community Habilitation, Hourly/Drop-in Respite, Supported Employment, NYSTART, ACCESS-VR
- Developed and generated internal audits with the organization's EMR tool to run requirements analysis to figure out documentation and performance compliance metrics
- Demonstrated and proven knowledge of ePACESNY, PSYCKES, HIXNY, and EMR tool to find, store, and update information in the organization's Medicaid Data Warehouse for the finance department
- Created and shared spreadsheets and trackers to team members to support accuracy across various variables - assessments, life plans meetings, Level of Eligibility Determination, Notice of Decision, DDP-2, Service Amendment Requests
- Overseen specific tasks or cases based on subject matter expertise and ability to learn latest information and apply it to current situation(s).
Multi-Site Manager
Berkshire County ARC
09.2019 - 01.2020
- Delegated responsibilities and communicated ongoing needs with assistant management team
- Trained staff on how to use Microsoft Word and Excel to keep track of ongoing events and meetings, saved 8% on training and paper materials in the monthly housing budgets
- Completed and constructed monthly reports on expenditures and behavioral documentation for quarterly psychological reviews
- Trained, guided, and mentored a staff member that was promoted as one of my Assistant Managers
- Completed and generated monthly, quarterly, and semi-annual audits on billing, medication management, house finances, work request orders, and medical/ER binders to ensure proper record-keeping.
Program Evaluation Specialist
Whitney M Young JR. Health Center
11.2017 - 09.2019
- Led SAMHSA grant project to conduct intake assessments, extract data, and show trends
- Developed and improved data gathering templates and Excel workbooks to improve efficiency and accuracy
- Analyzed data to show areas for improvement and develop solutions
- Successfully enrolled twenty-nine individuals in less than 6 months, exceeding the yearly goal of twenty-five individuals
- Supported Hepatitis/HIV outreach team in extracting and generating reports of successful completion of treatments to Gilead Sciences, Community Treatment and Prevention Department (CPTS), and New York State's Medicaid Database Warehouse.
Managed Care Coordinator Home & Recovery Planning
Whitney M. Young, Jr, Health Center
- Obtained the role of Company Liaison that attended the state-level Lead Health Home meetings to communicate and collaborate on statewide challenges and successes
- Ensured Medicaid billable services were provided to members that are identified as substantial risk by New York State
- Developed and kept relationships with CDPHP, Fidelis, and MVP insurance to collaborate and coordinate a member's overall care and specified services
- Created, executed, and sent performance reports and analyzed data to discuss strategies for members accessing HARP and HCBS services and overall percentage of clients enrolled
- Analyzed individual and billing data to find trends and deviations
- Data analysis and creative problem-solving to develop and implement strategies that improved accessibility and enrollment rates for HARP and HCBS services.
Managed Care Coordinator
Whitney M. Young, Jr. Health Center
- Improved connection and linkage to the community through referrals and/or advocacy to obtain various resources i.e. Primary Care Provider, Psychiatric Services, and Affordable and Safe Housing
- Monitored 50 – 60 individuals that received billable services under the Health Homes waiver and achieved 100% billing success consistently
- Fluency and understanding into various local and state databases to oversee individual's overall care and Medicaid/Medicare status with ePACESNY, PSYCKES, MAPP, HIXNY
- Generated growth for the Health Homes program by boosting total number of individuals in the program from 137 to 230 in six months
- Embedded into the Mental Health Department to oversee and manage individuals with Serious and Persistent Mental Illness (SPMI), HIV/AIDs, and Hepatitis C positive
- Demonstrated ability to set up and foster professional rapport with multiple providers in the health center's three locations collaborating on better approaches to individual care
- Analyzed lab work involving viral loads, CD4, and CD8 helper cells to individuals who have been evaluated or receive regular testing
Education
Bachelor of Science - Criminal Justice
State University of New York At Delhi
Delhi, NY12.2013
Associates of Applied Sciences - Criminal Justice
Schenectady County Community College
Schenectady, NY12.2010
Skills
- Compliance
- Requirements Analysis
- Business Requirements Documentation
- Medicaid
- Waterfall & Agile Methodologies
- Quality Control
- Empathy
- Data Analysis
- Quality Assurance
- Stakeholder engagement
- Communication
- Training
- Critical Thinking
- Microsoft 365 Suite
- Microsoft Excel
- Cross-Functional Collaboration
- Customer Experience
- Adaptability
Certification
Qualified Mental Health Professional (QMHP) Certification
Basic Data Analytics Certification- 12/2018
Microsoft Excel Certification –12/2018
Tableau Ten for Beginners: Step by Step Guide to Developing Visualizations in Tableau 10 - 10/2022
Timeline
Quality Assurance Analyst
GENESYS Consulting Services, Inc
03.2022 - 10.2023
Care Manager, Care
Design NY
04.2020 - 02.2022
Multi-Site Manager
Berkshire County ARC
09.2019 - 01.2020
Program Evaluation Specialist
Whitney M Young JR. Health Center
11.2017 - 09.2019
Managed Care Coordinator Home & Recovery Planning
Whitney M. Young, Jr, Health Center
Managed Care Coordinator
Whitney M. Young, Jr. Health Center
Bachelor of Science - Criminal Justice
State University of New York At Delhi
Associates of Applied Sciences - Criminal Justice
Schenectady County Community College