Jonida Duque
Healthcare & Human Services Leader
Summary
Highly skilled leadership and professional experience in designing and implementing business plans, procedures, and strategies. Skilled at setting comprehensive goals for growth and performance, while overseeing operations and employees. Quick and firm decision-maker possessing excellent communication and organizational skills. Recognized for successfully collaborating with internal and external stakeholders to develop solutions and solve operational and technical problems. Highly organized, detail-oriented and passionate about team building and directing high-performing teams.
Overview
14
14
years of professional experience
Work History
Director
Central Community Health Partnership (CCHP), a program of Open Sky
Worcester, MA
04.2020 - Current
- Provide leadership and management of CCHP's Community Partner Program by overseeing the delivery of integrated care coordination for 1,750 individuals enrolled in CCHP's Behavioral Health (BH) Community Partner Program and 1,000 individuals enrolled in CCHP's Long-Term Services and Supports (LTSS) Community Partner Program
- Ensure program operates in compliance with contractual obligations and service delivery standards
- Use key performance indicators to monitor and manage CCHP (BH and LTSS) budget and staffing requirements
- Lead the development and implementation of CCHP's strategic plan
- Doubled membership and revenue while improving program operations
- Represent the program to Executive Leadership for internal and external partners, and external organizations including MassHealth and ACOs/MCOs.
- Chair of eHana steering committee which oversees collaboration between 18 Community Partner Programs in using our EMR system.
- Use data to interpret and demonstrate effectiveness of program.
- Monitored office workflow and administrative processes to keep operations running smoothly.
- Worked closely with organizational leadership and board of directors to guide operational strategy.
- Optimized operational processes using analytics tools to address client-specific metrics.
Senior Clinical Care Manager
Central Community Health Partnership (CCHP), a program of Open Sky
Worcester, MA
03.2018 - 04.2020
- Provided clinical oversight and coordination for approximately 1,000 individuals enrolled in the Central Community Health Partnership's Behavioral Health (CCHP BH) Community Partner Program
- Managed a team of 3 BH Clinical Care Managers and 20 Care Coordinators who provided integrated care coordination to individuals struggling with severe mental illness and substance abuse
- Developed and maintained relationships with MassHealth, ACOs/MCOs, Department of Mental Health, community organizations, medical and behavioral health providers to meet needs of the program
- Developed, implemented, revised, and evaluated policies and procedures.
- Reviewed the assessment and person-centered care plans for clinical appropriateness, appropriate service referral/utilization and integration across all health domains.
- Coached and trained newly hired employees so that each understood job responsibilities and requirements of positions.
- Represented organization at all community events, answering questions, providing details and giving informative presentations.
Ancillary Contract Manager
Fallon Health
Worcester, MA
02.2015 - 05.2018
- Responsible for the analysis, negotiation/renegotiation, implementation, readjustment, evaluation, and continuous improvement of all functions of provider contracting
- Managed financial and operational issues related to contractual provider arrangements
- Responded to both internal and external customers regarding provider contractual arrangements, both for contract implementation and ongoing operations
- Experienced managing the following contracts: Beacon Health Options, BHCPs and LTSS providers under Medicaid ACO Program, Fiscal Intermediaries, ASAP (Aging Services Access Points), Durable Medical Equipment, Adult Foster Care, Group Adult Foster Care/ Assisted Living, Adult Day Health, Acupuncture, Nutrition, Speech Therapy, and Audiology providers.
Senior Navigator
Fallon Total Care
Worcester, MA
05.2013 - 02.2015
- Maintained navigator responsibilities and caseload of 85 members
- Assisted members with coordination of care within an integrated care organization
- Provided dual eligible members with assistance to navigate health care systems
- Coordinated care and communication between Integrated Care Teams
- Completed in home, institutional, or office visits as needed to coordinate member's health care
- Developed program workflows and facilitated training sessions to educate staff on processes
- Provided weekly technical and educational assistance to staff at second program site in Holyoke
- Facilitated and provided oversight of ER Initiative, in an effort to meet Quality Measures relative to transitions of care.
Detox/Milieu Counselor
AdCare Hospital
Worcester, MA
12.2009 - 05.2013
- Facilitated group and individual educational sessions in an inpatient detox and rehab setting.
- Conducted intake assessments and treatment plan with focus on acute psychosocial needs of patients
- Collaborated with family members and referral sources to coordinate treatment.
- Supported aftercare planning for continued recovery after treatment.
- Facilitated a project to address hospitalizations within 30 days to support complex needs of individuals.
- Participated on multiple occasions in a live radio talk show on “Coping with Addiction” for WCRN.
Education
Master of Science - Healthcare Administration
Worcester State University
Worcester, MA 05.2001 -
Addiction Counselor Education Program -
Westfield State University
Worcester, MABachelor of Science - Psychology & Health Education
Worcester State College
Worcester, MA 05.2001 -
Skills
Strategic planning and execution
Performance Analysis
Operations management
Collaborative Problem Solving
Relationship Building
Highlights And Skills
- Recipient of Worcester Business Journal 40 under 40 Award in 2021
- Leadership Worcester Alumna,
- 2021-2022 Cohort Leader for Coalition for a Healthy Greater Worcester,
- Fluent in Albanian, Proficient in Spanish.,
- Knowledgeable in Medicaid service delivery and services,
- Passionate about integrating care and supporting individuals and systems with social determinants of health needs.
Timeline
Director
Central Community Health Partnership (CCHP), a program of Open Sky
04.2020 - Current
Senior Clinical Care Manager
Central Community Health Partnership (CCHP), a program of Open Sky
03.2018 - 04.2020
Ancillary Contract Manager
Fallon Health
02.2015 - 05.2018
Senior Navigator
Fallon Total Care
05.2013 - 02.2015
Detox/Milieu Counselor
AdCare Hospital
12.2009 - 05.2013
Master of Science - Healthcare Administration
Worcester State University
05.2001 -
Bachelor of Science - Psychology & Health Education
Worcester State College
05.2001 -
Addiction Counselor Education Program -
Westfield State University