09/2014 to present, Oversee performance of all Case management/Utilization management functions per the defined partnership agreement for Ohio Department of Medicaid/ Market Place/ Medicare., Provide leadership and direction for identifying and implementing goals and objectives for the Diabetes Prevention Program (DPP) in partnership with Ohio Department of Health (ODH), Ohio Department of Medicaid (ODM), and Centers for Medicare & Medicaid Services (CMS), Manage the fiscal resources of the DPP and provide executive-level administration, including execution and management of the annual budget. Manage and evaluate the activities of DPP to ensure the achievement of short-term and long-term goals., Drive key performance indicator initiatives through strong partnership and routine with finance and community partners with the Medical Directors to translate the needs of the members into intentional clinical program design that delivers successful health outcome., Coordinate quality initiatives (ODM QIPs & PIPs, star ratings, contract reviews, etc.) to incorporate best practices to support population health into policies and workflows., Oversees the Healthcare Effectiveness Data and Information Sets (HEDIS) operations for all markets and products including setting strategies for maximizing STAR ratings, recognizing withhold dollars and reporting., Effectively manages a case management team and provides leadership and management of the services and activities of the regional case management function. Actively promotes an organizational culture committed to high quality customer service to clients and their families, physicians, and other members of the health care delivery system., Works collaboratively with the contracting department, provider relations and administrators for the development and maintenance of clinically appropriate, cost-effective case management processes. Develops policies and procedures to improve efficiency and ensure a focus on outcomes., Effectively manages the activities of the team, providing leadership and guidance by:, Performing interviews, recommending qualified candidates for hire, evaluating staff, counseling, and addressing unsatisfactory performance promptly and fairly, and administering corrective action., Identifies department goals and objectives, develops, and communicates action plans through regular staff meetings and other communications, uses team approach to problem solving and sets clear expectations., Identifies training needs and develops and participates in staff training., Provides a challenging and supportive environment and delegates appropriately. Seeks additional Training opportunities through outside sources., Develops monitoring systems and measurements and exhibits a customer service philosophy., Establishes monitoring linkages between Transitional Care and other internal entities and departments when necessary., Coordination of health care services- Directs the effective coordination of health care services to achieve program goals and objectives in accordance with ODM/ CMS requirement., Participates in and seeks educational forums for self and staff., Participates in and involves staff in professional organizations.