Experience

KRJ Consulting, LLC

• United States
• Business Consulting and Services
• 1 - 100 Employee

• Independent Consultant

  • Dec 2020 - Present



MVP Health Care

• United States
• Insurance
• 700 & Above Employee

• Director, Behavioral Health

  • Dec 2017 - Nov 2021

• Director, Medicaid Services & Supports

  • Oct 2014 - Nov 2021

  Manages the program requirements for new programs required by Medicaid Redesign Initiatives including the Restricted Recipient, Medicaid Health Homes, Medicaid HARP Program, and Personal Care Services programs. Oversees the relationships with providers, members and internal HHP & MVP staff involved with these programs to ensure that the programs are operating in compliance with NYS regulations and Hudson Health policies.



Mount Saint Mary College

• United States
• Higher Education
• 300 - 400 Employee

• Part time Professor of Psychology

  • Oct 2004 - Aug 2015

  • Responsible for developing course outlines following the course description• Classes instructed: General Psychology, Developmental Psychology, Theory of Social Casework, Psychology of Women, Marriage and Family, Psychology of Personality, Psychology of Gender, Abnormal Psychology, Senior Seminar (Research Proposal Seminar), Psychology of Stress • Responsible for developing course outlines following the course description• Classes instructed: General Psychology, Developmental Psychology, Theory of Social Casework, Psychology of Women, Marriage and Family, Psychology of Personality, Psychology of Gender, Abnormal Psychology, Senior Seminar (Research Proposal Seminar), Psychology of Stress



Hudson Valley Cerebral Palsy Association

• United States
• Non-profit Organizations
• 1 - 100 Employee

• Director of Service Coordination & Home Services

  • Sep 2009 - Oct 2014

  • Manage and supervise all department operations• Train staff to meet state regulations, incorporate best practices. Provide oversight to staff to assure compliance with all regulatory bodies• Market program to individuals and advocates• Liaison with local school districts. Advocate for students at CSE meetings• Member of Taconic DDRO Training Consortium, and Putnam Independent Living Services (PILS) Round Table• Enhanced revenue cycle through changes in billing practices to offset department losses.• Member of various committees including: Incident Review, Corporate Policy and Procedures updates, and Human Rights• Revised department job descriptions to reflect regulatory changes



SLS Health

• United States
• Higher Education

• Marketing Consultant

  • Sep 2008 - Jul 2009

  • Established, maintained and developed referral sources with tri-state hospitals, psychiatrists, psychologists, social workers and professional groups• Participated in conferences as a service supplier• Marketed presentations to local mental health groups and to area county bar associations• Developed marketing strategies with marketing supplier• Directed maintenance and revision of company website• Identified growth opportunities in the marked and outlined steps needed to complete transition towards future growth• Developed and maintained referral sources listings• Liaison with insurance companies on pre-certifications, contract and credentialing negotiations



Ability Beyond Disability

• South Africa

• Systems Change Analyst

  • Feb 2002 - Jul 2007

  • Project Manager in the development and implementation of the Systems Change Project• Researched, analyzed and documented Systems Admission Administration, Referral, Intake/Admission, Billing, and Customer Satisfaction systems to be in alignment with new industry trends• Established criteria and processes required to implement project. Reviewed and edited requirements, process specification and recommendations related to the proposed project• Established pilot program. Developed and implemented plans and schedules, to ensure smooth transition to the new systems• Developed all training plans, identified best practices and coordinated implementation • Member of various committees including: Incident Review: As a Certified OPWDD Investigator responsible to investigate allegations of abuse and neglect. Reviewed documentation, findings / evidence and proposed specific programmatic and administrative recommendations.  Workforce Development for Acquired Brain Injuries: Developed and co-trained with Medical Director new employees on the Neuroanatomy, Behavioral Issues, and daily challenges employees would face working with individuals with acquired or traumatic brain injuries CARF: Member of Commission Accreditation of Rehabilitation Facilities Education Sub-committee

• Services Manager

  • 2005 - 2006

  • Managed Supportive Independent Living and In-home Habilitation Program• Developed positive working relationship with third party insurance and state funders, regulatory agencies (OPWDD & DOH), and promoted the “Regional Provider of Choice” program• Onsite Coordination: Met with prospective individuals and their advocates to assess needs and marketed programs and services. Completed financial proposals to funders



CIGNA

• United States
• Wellness and Fitness Services
• 700 & Above Employee

• Asst. Manager

  • 1984 - 1989