Alan Boardman Email & Phone Number

New York, NY, US

New York City Metropolitan Area

• Develop, implement, and manage the Behavioral Health Quality Management Plan and any related Quality Improvement Projects for all product lines.
• Continuously achieve top tier scores on critical HEDIS/QARR metrics for Behavioral Health measures that significantly improve health plan revenue. Employ data-informed strategies and effective interventions to improve.
• Implement strategic clinical programs designed to serve acute members with complex needs. Negotiate and execute of value-based agreements that emphasize recovery-oriented solutions.
• Emphasis on integrated case management programs that deliver holistic treatment and promote community-based recovery.

New York City Metropolitan Area

• Managed 12 health plan contracts serving 900,000 covered lives across multiple Medicaid, Medicare, Duals, and Exchange products. Contracts included risk bearing arrangements.
• Accountable for all contractual obligations including utilization trends, network management, operations, regulatory compliance, and staff leadership and development.
• Developed regional strategic plans and policies. Conducted data management and trend analysis.
• Conducted extensive network development activities to cultivate key provider relationships. Engineered and directed a team that executed performance management initiatives in preparation for value-based purchasing.
• Liaised with New York State regulatory agencies and participated in readiness reviews Statewide resulting in awards for all clients bidding on Health and Recovery Plans (HARP) contracts.
• Successfully led the implementation of Health and Recovery Plans (HARP) in downstate New York and the transition of Behavioral Health services for adults into managed care in accordance with New York’s Medicaid.

New York City Metropolitan Area

• Developed 4 Program Directors managing 6 health plan contracts serving 600,000 covered lives.
• Developed annual work plans and delivered monthly, quarterly, and annual performance reports to account leadership furnishing detailed trend analyses and strategies to maximize opportunities for improved treatment.

Tarrytown, New York, United States

• Led an integrated clinical team co-located at Hudson Health Plan providing utilization and case management services and quality improvement activities. Achieved 100% regulatory compliance during my tenure.
• Presented clinical and operational performance statistics monthly to health plan senior management.
• Co-directed the award-winning Westchester Cares Action Program that featured an interdisciplinary, field-based case management team that holistically addressed the medical, Behavioral Health, and recovery needs for.

• Managed 4 Clinical Supervisors and 36 associates delivering care management functions for over 750,000 covered lives in commercial and Labor and Trust accounts.
• Established and refined care coordination activities with Health Net medical management teams to promote comprehensive, strategic treatment planning.
• Developed and implemented operational enhancements and auditing processes to ensure quality control, increase efficiency, and maintain compliance with regulatory and accreditation standards.

New York, New York, United States

• Supervised a large clinical team serving the Behavioral Health needs of over 600,000 Health Net of the Northeast members.
• Established and maintained performance and productivity standards for clinicians managing acute, sub-acute and routine levels of care.
• Monitored case management interventions and provided clinical support to promote effective and efficient treatment.

Master'S Degree, Social Work

Bachelor Of Commerce - Bcom, Marketing