Experienced Director/Manager with >20 years of successful leadership experience. Passionate about providing exemplary service to members while meeting metrics and expected outcomes. Interdepartmental projects have been successfully implemented. Well-respected by staff, peers and management, with high employee engagement scores. Seeking a Director position managing to deliver quality healthcare to establish a competitive business advantage. Extensive knowledge of Medicare, Medicaid and Dual-Eligible markets.
Utilizing clinical knowledge & business acumen to multiple projects from inception to launch
· Aetna Home Care Program & Multi-cultural Initiative (MCI)– Lead Manager for East Region for 3 initiatives
· Initiated and managing ACP Decisions pilot - 100 FCMs in 5 states on 3 clinical platforms in 3 programs
· Managed PA DSNP operations, reporting and successful outcomes
· Developed Behavioral Health CM program for Corporate Services – 4 BH Specialists co-managing with CMs
· Leveraged relationships with departments & provided streamlines, strategic approaches
· Tracked & exceeded performance targets for staff members and program tracks East
· Responsible for daily operations of CORE team – onboarding, key metric monitoring, reporting results
· Successful transition to clinical system, resource for management team, ad hoc reporting
· Effective collaboration of BH team with medical CMs
Start-up team for CMCM pilot & Participated on Task Force for CMS Dual-Eligible proposal, Face-to-face, comprehensive care management
Responsible for entire marketing function & enrollment process in start-up Nursing Facility Diversion program administered by the PA Department of Public Welfare (DPW) – known as PACE program nationally
Responsible for planning & marketing activities for home health agency (over 300,000 visits per year), hospice & developing Management Services Organization (MSO) for In-Home Services