James Geralds
Summary
DEDICATED POLICY PROFESSIONAL AND PROJECT SPECIALIST WITH EXTENSIVE EXPERIENCE IN REGULATORY ANALYSIS, PROGRAM OVERSIGHT, AND EFFICIENT PROJECT MANAGEMENT IN HIGH-STAKES ENVIRONMENTS. COMMITTED TO ADVANCING FREE-MARKET PRINCIPLES, LIMITED GOVERNMENT, FISCAL RESPONSIBILITY, AND INDIVIDUAL LIBERTIES THROUGH EVIDENCE-BASED POLICY RECOMMENDATIONS AND STREAMLINED OPERATIONS. EAGER TO SUPPORT CONSERVATIVE AND LIBERTARIAN ORGANIZATIONS IN ACHIEVING POLICY GOALS ALIGNED WITH REDUCING BUREAUCRACY, PROMOTING ECONOMIC FREEDOM, AND ENHANCING PERSONAL EMPOWERMENT.
Overview
26
26
years of professional experience
Work History
Technical Project Specialist – Behavioral Health Policy Team
Kentucky Department for Medicaid Services (via University of Kentucky, Dept. of Biomedical Informatics)
01.2022 - Current
- Contributed to policy development and oversight in a state Medicaid program, focusing on regulatory compliance, fraud prevention, and efficient service delivery to support fiscal conservatism and reduced government overreach.
- Provided expert consultation on behavioral health policies, fee schedules, administrative regulations, and statutes to ensure alignment with state objectives and cost-effective practices.
- Analyzed claims patterns and fraud schemes in collaboration with managed care organizations (MCOs) and investigators, recommending measures to safeguard public funds and enhance accountability.
- Participated in interagency meetings to streamline operations across departments, advocating for policies that prioritize individual choice and minimize bureaucratic hurdles.
- Reviewed and advised on utilization data, grievances, appeals, and performance metrics (e.g., HEDIS measures) for six state-contracted MCOs, identifying opportunities for efficiency gains and waste reduction.
- Supported state assessments and pilot programs, including the Multisystemic Therapy Pilot and 1915(c) Children's Waiver Feasibility Study, with a focus on evidence-based, targeted interventions that respect family autonomy.
- Conducted comparative research on state programs, waivers, and initiatives to inform recommendations for leaner, more effective governance models.
- Served as a representative on committees, including the State Interagency Council, to advance policies promoting personal responsibility and community-based solutions.
Director of Occupational Therapy
Owensboro
01.2003 - 01.2022
- Led occupational therapy services for pediatric and adult populations across diverse settings, ensuring compliance with federal, state, and private payer guidelines while emphasizing efficient, client-centered care that aligns with free-market healthcare principles.
- Managed therapy teams serving home health, community living supports, outpatient, telehealth, and facility-based programs, optimizing operations to meet contractual requirements and reduce administrative burdens.
- Oversaw services for individuals with neurodevelopmental and behavioral health needs, focusing on personalized plans that enhance independence and reduce reliance on public assistance.
- Collaborated with interdisciplinary teams to develop cost-effective interventions, including equipment recommendations and home programs, promoting self-sufficiency and economic productivity.
Occupational Therapist and Consultant
Green River District Home Health
01.2003 - 01.2022
- Directed skilled occupational therapy for children under Kentucky Medicaid's EPSDT program, addressing neurodevelopmental and behavioral health diagnoses with a focus on efficient, outcome-oriented care.
- Implemented therapy strategies that supported early intervention and family empowerment, aligning with principles of limited government involvement in personal health decisions.
Occupational Therapist and Program Developer
River Valley Behavioral Health (Regional Community Mental Health Center)
01.2003 - 01.2014
- Provided specialized services in psychiatric, community living, and acquired brain injury programs under Kentucky's 1915(c) HCBS Medicaid Waiver, emphasizing rehabilitation that fosters independence and workforce participation.
- Developed and delivered training on ergonomics, safety, and restraint reduction to promote injury prevention and operational efficiency in high-risk environments.
- Participated in interdisciplinary teams to create individualized plans, including determining medical necessity for equipment, supporting market-driven solutions that enhance personal liberty and reduce institutional dependency.
Occupational Therapist
ResCare Inc. / Community Alternatives of Kentucky
01.2003 - 01.2014
- Delivered therapy services under Kentucky's 1915(c) HCBS Waiver for individuals with intellectual disabilities, focusing on community integration and self-reliance.
- Designed home and work programs to improve performance in daily activities, participating in team meetings to ensure efficient, compliant service delivery.
Staff Occupational Therapist
Family Home Health
01.2004 - 01.2005
- Evaluated and treated adults with orthopedic, neurological, and mental health conditions, managing discharge planning to facilitate smooth transitions and minimize extended care needs.
Staff Occupational Therapist
Fordsville Nursing and Rehabilitation Center
01.2003 - 01.2004
- Provided therapy in a skilled nursing facility, developing restorative programs and supervising staff to optimize resident outcomes and operational efficiency.
Director of Occupational Therapy
Wendell Foster Campus for Developmental Disabilities
01.2000 - 01.2001
- Managed a large therapy department serving pediatric and adult clients across outpatient, school, home, and facility settings, promoting independence through targeted interventions.
- Directed services for developmental disabilities, focusing on personalized care that supports family and community-based alternatives to institutionalization.
Education
Master of Science (M.S.) - Occupational Therapy
Rush University
Chicago, IL08.1999
Bachelor of Arts (B.A.) - Psychology
Western Kentucky University
Bowling Green, KY05.1995
Skills
- Policy Analysis and Regulatory Expertise
- Proven ability to interpret statutes, regulations, and administrative rules to provide actionable recommendations that align with mission objectives, emphasizing cost-efficiency and minimal government intervention
- Project Management Proficiency
- Skilled in delivering timely project outcomes in dynamic settings, adapting to shifting priorities while optimizing resources and reducing inefficiencies
- Data-Driven Decision Making
- Experience in reviewing quantitative and qualitative data to support policy positions, identify waste, and propose reforms that enhance accountability and taxpayer value
- Stakeholder Collaboration
- Effective at partnering with diverse teams, including policy experts, investigators, and finance professionals, to achieve targeted outcomes with a focus on individual rights and market-based solutions
- Communication and Technical Skills
- Proficient in Microsoft Office Suite (Word, PowerPoint, Teams), SharePoint, data analysis tools, and virtual collaboration platforms; adaptable to new technologies for operational efficiency
- Team Leadership and Independence
- Strong collaborator in group settings, receptive to feedback for continuous improvement, while excelling in self-directed roles to manage multiple priorities and drive results
- Organizational and Problem-Solving Abilities
- Expertise in process optimization, fraud detection, and resource allocation to support lean operations and effective governance
- Fiscal Oversight
- Demonstrated success in monitoring utilization, appeals, and program data to ensure compliance, minimize fraud, and promote sustainable, market-oriented initiatives
Timeline
Technical Project Specialist – Behavioral Health Policy Team
Kentucky Department for Medicaid Services (via University of Kentucky, Dept. of Biomedical Informatics)
01.2022 - Current
Staff Occupational Therapist
Family Home Health
01.2004 - 01.2005
Director of Occupational Therapy
Owensboro
01.2003 - 01.2022
Occupational Therapist and Consultant
Green River District Home Health
01.2003 - 01.2022
Occupational Therapist and Program Developer
River Valley Behavioral Health (Regional Community Mental Health Center)
01.2003 - 01.2014
Occupational Therapist
ResCare Inc. / Community Alternatives of Kentucky
01.2003 - 01.2014
Staff Occupational Therapist
Fordsville Nursing and Rehabilitation Center
01.2003 - 01.2004
Director of Occupational Therapy
Wendell Foster Campus for Developmental Disabilities
01.2000 - 01.2001
Bachelor of Arts (B.A.) - Psychology
Western Kentucky University
Master of Science (M.S.) - Occupational Therapy
Rush University
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