• Ensuring full contract and regulatory compliance and execution of all deliverables• Oversee management of all operations including Finance, Operations, Utilization Management, Case Management, Provider Partnerships, Quality, Reporting and Human Resources• Effective delivery of services to Health Plan client, members, providers and all stakeholders• Create and implement strategic direction of the engagement center and all associated operations in the Hawai’i market• Create and implement business development opportunities• Develop internal communication approaches, audit functions and accountability controls• Foster key stakeholder relationships, including inside and outside the Health Plan client, the provider network, government and competitors

•Develop and nurture the service center’s cultural infrastructure/work environment to provide the organizational capacity to meet performance standards/metrics, contract specifications and operational efficiency. •Oversee management of all service center operations and effective delivery of services to client, members and stakeholders. Create strategic priorities and work plans for finance and budgeting, medical affairs, network management and regional operations, human resources, quality management, clinical operations, and administrative services. Provide strategic direction and tactical support to service center leadership staff and functional leadership. •Serve as the service center’s primary account manager/contract officer and delegate. Assume overall responsibility for compliance with terms of the contract, overseeing all contract-related activities and deliverables, ensuring all inquiries are responded to in a timely manner, and client expectations are met.•Build, develop, and maintain a positive relationship with the client, state/government agencies and with consumers, advocacy organizations, trade associations, public officials, and other stakeholders.•Lead negotiations with the client to develop performance standards, contract specifications, and utilization/administrative budgets.•Monitor financial performance of administrative and service expenditures with the overall goal of meeting optimal service levels, quality care, and fiscal targets.•Evaluate opportunities for new and expanded services and/or program design and development. •Develop internal communication approaches, audit functions, and accountability controls.

•Function as the only officer of the corporation for a not-for-profit, managed behavioral healthcare organization providing mental health services for anywhere from 50,000 – 100,000 Medicaid members (T-XIX and XXI) in the State of Washington. •Also included in responsibilities are more than 100,000 employees covered under the Employee Assistance Program (EAP) owned and operated by CommCare. •Oversee all clinical and financial operations, departments, and staff. Report directly to the Board of Directors. Additional responsibilities include functioning as Chairman of the Board for Alternatives EAP.

Responsible for all clinical operations, departments, and staff. Duties include account management, utilization management, network development, contract negotiations, quality improvement, customer service, marketing, credentialing, and I.T. Report to President and C.E.O.

Responsible for overall direction of and budgeting for the Utilization Management department. Duties include account management, utilization management, network development, contract negotiations, quality improvement, customer service, and marketing. Report to Vice President of Operations.

Responsible for daily oversight of the Quality Improvement and Utilization Management departments. Duties included quality improvement, utilization management, provider auditing, and customer service.

Responsible for the utilization management of Inpatient and Outpatient MH services. Conducted on-site as well as telephonic review of services to determine medical necessity and make recommendations to Medical Director. Functioned as customer service and provider relations representative as well as patient advocate. Responsible for identification and investigation of quality issues.