Contributing Writer

• Sep 2022 - Present

Director, Seriously Mentally Ill Grievance and Appeals

• 2014 - Sep 2022

Presently manage staff of twenty one including master’s level clinicians, registered nurses and support staff Ensure proper processing of Seriously Mentally Ill ("SMI") Grievances, SMI Appeals, TXIX/XXI Appeals and claim disputes in accordance with Federal and State rules Successfully transitioned the program to a highly functioning system as evidenced by a 100% compliance rating with the Administrative Contract Review with the state of Arizona in September 2015 Presently manage staff of twenty one including master’s level clinicians, registered nurses and support staff Ensure proper processing of Seriously Mentally Ill ("SMI") Grievances, SMI Appeals, TXIX/XXI Appeals and claim disputes in accordance with Federal and State rules Successfully transitioned the program to a highly functioning system as evidenced by a 100% compliance rating with the Administrative Contract Review with the state of Arizona in September 2015

Director, Eligibility and Care Services

• 2013 - 2014

Successfully designed and implemented the grievance and appeals system for the Crisis Response Network to process all applications for SMI benefits in Maricopa County Managed eleven employees including five licensed psychologists, overseeing timely processing of Seriously Mentally Ill applications in accordance with state laws Ensured compliance with the Arizona Administrative Code by conducting monthly and quarterly internal audits Exceeded the minimum performance standard of 90% for all performance audits completed by Arizona Department of Behavioral Health since implementation on January 1, 2014, with an overall score of 98% Show less

Operating Manager, Grievance and Appeals Department

• 2007 - 2013

Managed department of eighteen including J.D. degreed investigators, master’s level clinicians and support staff Ensured proper processing of approximately 3,500 cases annually through six Federal and State grievance and appeal processes Developed relationships with staff, filing parties, providers and community stakeholders to foster trust, respect and a collaborative approach to resolving concerns and explaining the grievance, appeals and notice processes Hired, trained and mentored grievance and appeals team, resulting in increased staff retention, and improved efficiency Trained Grievance and Appeals staff in regard to laws, rules and procedures relating to grievance and appeals matters Reviewed and approved grievance investigation findings and decisions including those in cases that were likely to result in civil litigation and investigations requested by Arizona Center for Disability Law and the Office of Human Rights Maintained collaborative relationships with Department of Behavioral Health staff allowing for informal resolution of concerns and development of mutually agreed upon process for addressing procedural irregularities Utilized data to assist the Regional Behavioral Health Authority in identifying systemic problems and improved performance thereby reducing fair hearings and saving over 100 hours of administrative work per month Show less

Consumer Rights Appeal Manager

• 2004 - 2007

Managed nine employees including master’s level clinicians and four appeals coordinators Oversaw the timely processing of appeals for the SMI and Title XIX/XXI recipients in accordance with federal and state laws Developed and maintained a workflow that processed over 2,000 SMI, TXIX and SMI Eligibility appeals annually Ensured compliance with the Arizona Administrative Code by conducting monthly and quarterly internal audits Applied a clinical perspective to the expectations of the Arizona Administrative Code provisions pertaining to behavioral health and Department of Behavioral Health standards Provided support and direction to behavioral health care recipients needing a higher level of department contact in order to resolve issues Reviewed case decision letters to ensure consistency with Department of Behavioral Health interpretations and applicable law and policy requirements Conducted and mediated informal conferences which focused on assisting those seeking an SMI determination by identifying relevant documents and assisting in navigating through the Arizona behavioral health system Show less

Psychotherapist

• 2001 - 2004

Certified Functional Therapist for at-risk youth, families and adults seeking cognitive behavioral approaches to success Provided in-home counseling to families seeking effective solutions to difficult adolescent mood and conduct disorders Assessed and evaluated clients while supervising intake procedures Provided guidance and training for staff including conflict resolution techniques Developed and implemented behavioral health treatment plans with an emphasis on individual and family success Show less

Supervisor, Behavioral Health Care Clinician

• 1999 - 2001

Recognized as Staff Member of the Year 2000 Founding member and developer of the Genesis Program for Youth Responsible for safety and support of an eight-bed adolescent residential treatment facility Facilitated individual and group therapy with an emphasis on behavior modification and cognitive behavioral module Recognized as Staff Member of the Year 2000 Founding member and developer of the Genesis Program for Youth Responsible for safety and support of an eight-bed adolescent residential treatment facility Facilitated individual and group therapy with an emphasis on behavior modification and cognitive behavioral module