SENIOR CONSULTANT Resume Phoenix, AZ - Hire IT People

SUMMARY:

Integrated and Coordinated Care
Pharmacy including Utilization Management
Behavioral Health
Utilization Management including Medical Necessity and Clinical Practice Guidelines
Child Welfare
Member Services
Provider Services
Compliance including Fraud, Waste, and Abuse
Patient Centered Medical Homes
Consumer Directed Care
Technical Writing
Strategic Planning
Competitive Analysis
Client Management
Consulting Team Leadership
Specialization in network development strategies including provider identification, recruitment, letter of intent (LOI) acquisition, and contract negotiation.
Expertise in comprehensive program evaluation and strategic planning for compliance, training, and best practices auditing.
Development of clinical program models, policies and procedures, and performance monitoring systems.
Provision of program management training concerning effective budgeting, analysis, and compliance.

PROFESSIONAL EXPERIENCE:

SENIOR CONSULTANT

Confidential, Phoenix, AZ

Responsibilities:

Licensed behavioral health practitioner who provides consulting services to profit, non - profit, and governmental entities
Design and develop Request for Proposal (RFP) and Intent to Negotiate (ITN) responses for nationally-recognized organizations bidding on Managed Care Organization (MCO) contracts such as Medicare and Medicaid.
Content Management including federal, state, and contract requirements

Confidential, Phoenix, AZ

Clinical Director

Responsibilities:

Clinical manager responsible for the program development and administration of an innovative, direct service delivery department designed for the intervention and diversion of Out of Home placement of children.
Responsible for the coordination and implementation of the Child and Family Team process, recruitment, training, and clinical development and supervision of teams that participate in the provision of culturally diverse, wraparound services aligned with Best Practices, the Arizona Practice Model and HIPAA.

Clinical Program Supervisor

Confidential, Phoenix, Arizona

Responsibilities:

Licensed clinical supervisor responsible for the program development and administration of all facets of rapid, comprehensive and culturally diverse behavioral health service delivery to youth and families.
Responsible for the clinical consultation for all departmental Behavioral Health Services including General Mental Health and Substance Abuse Out-Patient Treatment for children and their families.
Accountable for the review of all Out of Home, Seriously Mentally Ill Determination, Additional Service Request, and Single Case Agreement considerations, as well as, for the clinical and operational development of the Child Protective Services Co-Location collaborative effort.
Participated in ongoing monitoring and evaluation, best practices auditing, quality management practices, and agency-wide procedural development.
Licensed therapist responsible for the delivery of therapeutic services to general mental health clients, with a specialization in addiction and co-occurring disorder services.
Participated in Confidential intake and assessments, individual service plan development, Child and Family Team processes, and Group and Individual counseling services to adults, children and families.

Clinical Program Supervisor

Confidential, Glendale, Arizona

Responsibilities:

Licensed clinical supervisor responsible for the organization and development of Confidential innovative pilot program designed to be a collaborative effort of community resources that provides rapid and comprehensive substance abuse recovery services for culturally diverse families with children involved with Child Protective Services and with overriding substance abuse issues.
Responsible for the recruitment, training and supervision of clinical staff that provide intensive, wraparound services including intervention, recovery, and ancillary support services focusing on family dynamics and addiction issues.
Responsible for the identification, contract negotiation, utilization and claims management of nontraditional service modalities such as Equine Therapy, Wilderness Experience, Acupuncture, and Naturopathic Detoxification and Treatment.