Experience

MONTEFIORE NEW ROCHELLE HOSPITAL

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Director of Compliance

  • Dec 2020 - Present



Montefiore CMO/HMO

• Yonkers, New York

• Compliance Manager

  • Dec 2017 - Present

  Responsible for managing the CMO Compliance Program for the Montefiore CMO and supporting the Chief Compliance Officer; developing annual risk assessments and compliance work plans; analyzing and interpreting detailed and complex legal and regulatory notifications and updates involving Medicaid and Medicare managed care regulations, value based payment programs, and long term care; organizing department leadership to respond to regulatory requirements and audits, including tasks and due dates; coordinating response to external audits from government agencies and health plans covering the Montefiore CMO/ACO and MLTC plan (e.g., NYSDOH, CMS, OIG, OMIG, DFS). Development of annual MHMO, ACO and CMO compliance program review and risk assessment. Prepare for Board meetings and chair Compliance Committee. Develop process to monitor compliance plans, work plans and related policies and procedures that reflect the requirements, rules and regulations applicable to the MHMO, ACO and CMO. Develop and perform internal compliance audits for HIPAA privacy and security, FWA and general compliance. Analyze and document audit results for distribution to departments and leadership. Conduct audits of departmental compliance Corrective Action Plans. Show less



Healthplex, Inc.

• United States
• Insurance
• 1 - 100 Employee

• Vice President for Client Relations

  • Jul 2016 - Aug 2016

  Responsible for developing and maintaining strong business relationships with current and future clients for Healthplex, Inc. Developing programs and building strategies to ensure that Healthplex services meet and exceed client expectations. Reports directly to the President/CEO.

• Director of Quality Management/Compliance Officer

  • Jun 2008 - Jun 2016

  Responsible for Quality Management and Compliance programs for Healthplex, a dental planadministrator for commercial and government programs in New York, New Jersey, andConnecticut. Reports directly to the President and serves on various executive committees, chair of Compliance Committee, account manager for various client groups.



Hudson Health Plan

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Director of Regulatory Affairs

  • Apr 1996 - Feb 2008

  Developing and managing the regulatory affairs and compliance function for Hudson Health Plan, a health plan administrator for government programs in the Hudson Valley. Served as liaison to state government. Provide input and analysis of proposed and pending legislation, regulation, and government issues impacting plan operations to key personnel Developing and managing the regulatory affairs and compliance function for Hudson Health Plan, a health plan administrator for government programs in the Hudson Valley. Served as liaison to state government. Provide input and analysis of proposed and pending legislation, regulation, and government issues impacting plan operations to key personnel



Hudson Valley Health Systems Agency

• Hudson Valley, New York

• Senior Health Planner

  • Jan 1993 - Mar 1996

  Directed the planning activities of the Ryan White HIV Care Network and regional health planning councils. Served as liaison to government officials. Conducted analyses and assessments of health care service needs (Certificate of Need); created survey instruments and compiled data for health profiles and reports; developed resource directories, Mid-Hudson HIV/AIDS Service Delivery Plan, and regional HIV Prevention Plan. Organized and participated in advocacy activities to authorize legislation related to HIV/AIDS service development. Show less