Cheryl E. Johnson Email & Phone Number

Conway, Sc

Boise, Idaho

Responsible for the development, implementation and management of the Quality Management, Compliance and Training program for the State Medicaid contract in collaboration with the Chief Medical Officer and Executive Director. Responsible for oversight of all quality committee activities, develop and report outcomes, champion performance improvement across all business segments, leverage the allocation of resources to promote improvement and manage cost and oversee training of staff and network providers. Develop and manage the Quality Improvement Plan, Outcomes Management Performance Improvement Work Plan and Network Monitoring Plan. Responsible for operational oversight of the following functions: quality of care (QOC) and sentinel event investigations, customer satisfaction surveys, complaints, appeals, and network monitoring audits. Utilize Lean Management principles to develop, manage, and improve operational practices to meet and exceed performance standards. Maintain oversight of accreditation/regulatory readiness program (NCQA, URAC) through close enforcement of adherence to regulatory, contract and accreditation standards. Serves as resource to leadership team and external stakeholders. Plan, implement and coordinate performance improvement projects (PIP) in collaboration with external stakeholders and internal business segments such as; Member and Family Affairs, Credentialing, Networks, and Care Management. Direct and support individual staff and multi-disciplinary teams in their quality improvement functions to assure adherence to quality standards. Develop and manage departmental budgets to meet forecasting/cost savings goals.

Boise, Idaho Area

Responsibilities included leading the development and execution of clinical services business plans, strategies and goals for the organizations behavioral health products and services. Maintain oversight of accreditation/regulatory readiness program (NCQA, URAC) through close enforcement of adherence to regulatory, contract and accreditation standards. Collaborating with senior management to identify and align department efforts with the quality goals and objectives of the organization. Planning, assigning, and directing work; maintaining work process deadlines and staffing schedules; Managing productivity and reporting of quality activities; appraising performance and communicating action plans; providing team and project leadership; motivating staff and encouraging productive teamwork and harmony; ensuring that all team members are adequately informed of policy and procedural changes and providing a forum for associates to provide input. Managing and improving clinical services operations to meet or exceed internal and external performance standards and budgets. Assuring contractual and operational guarantees are met. Investigating quality, efficiency, attrition and other issues to identify opportunities for process improvement and implement action plans, as appropriate. Conducting clinical crisis assessments and referrals to individuals calling our 24/7 behavioral health call center. Providing expert guidance and consultation for employer organizations regulated by Department of Transportation’s (DOT) Drug- Free Workplace regulations.

Responsibilities included: Direct and oversee the quality assurance and improvement initiatives throughout the organization’s clinical areas, provide leadership, and encourage productive teamwork and harmony. Maintain oversight of accreditation/regulatory readiness program (NCQA, URAC) through close enforcement of adherence to regulatory, contract and accreditation standards. Management of daily clinical operations by directing all activities of the following departments: Case Management, Utilization Management, Medicaid Network Credentialing, and Network Management. Coordinate clinical processes with the Director of Member/Administrative Services to insure accurate flow of information and data between functional areas. Direct the Medicaid mental health provider credentialing function to insure that provider applications and site reviews are conducted to contract and company standards. Direct the provider network function to insure that both public and private sector networks fulfill contract requirements. Supervise the utilization and case management staff to insure adherence to policy, procedure and URAC standards. Provide clinical support and supervision to the state substance abuse care managers and clinical regional coordinators.

Management of the day-to-day operations of (Smithfield Foods) Medical Center, Pharmacy and Occupational Clinic to include: Supervision of 35 staff members; recruitment; budget preparation and monitoring; conduct annual employee training; develop, maintain and revise all clinical protocols and business office policies and procedures; complete monthly utilization reporting; oversee all Quality Improvement activities; monitors health center compliance with established standards for all respective disciplines; and work in conjunction with the Medical director to maintain operational efficiency.

Oversee case management function for individuals diagnosed with HIV/AIDS within Columbus county and surrounding areas; complete initial intake and client assessments; develop community resources; participate in a multi-disciplinary treatment clinic with Infectious Disease staff; provide clear and accurate documentation in progress notes and submit billable services to North Carolina Medicaid for payment.

Oversee the day-to-day operations of three residential substance abuse facilities and one outreach program; serve as the primary spokesperson; develop annual operating plan and budget forecast (2.5 M); review and revise policies and procedures; oversee and manage financial and accounting operations; develop outcome measures and report findings; develop and administer consumer satisfaction surveys; manager all Human Resource activities; coordinate staff development trainings; enforce confidentiality standards and guidelines for consumers, and staff; undertake public relations efforts; develop strategic and cost efficient marketing strategies; secure adequate funding through technical writing and other fund development strategies; obtain and maintain clinical licensure for all clinical programming.

Master Of Social Work (Msw), Clinical Social Work

Bachelors Of Social Work (Bsw), Social Work

Emsley A. Laney, Diploma, 3.5