Behavioral Health Consulting

Responsible for overseeing the administration and strategic turnaround plan of a 40 bedfacility in two counties. Levels of care covered were, Detox, RTC, PHP and IOP. Assess andoptimize performance of existing earned revenue sources and identify ways to maximizerevenues. Review and modification of staffing plan in accordance with census. Identify currentmarketing plan and restructured to maximize ROI. Develop and support a balanced, cohesiveand effective management team. Ensure that facility operates in a financially sustainablemanner; Responsible for financial management, budget compliance, variance analysis andcorrective action plans as needed. Review insurance utilization and insure proper billing andtimely billing is being done. Review denials for trends with current payor mix. Restructurecore programs; Implement and maintain systems and processes for company growth andstability.

Responsible for overseeing the administration, programs and strategic plan of a 150 bedDetox/RTC/PHP Program. Direct supervision of the Utilization Review department overseeingthe appropriate utilization of client days and proper utilization of the full continuum of care.Assess and optimize performance of existing earned revenue sources and identify ways tomaximize revenues. Develop and support a cohesive and effective management team. Ensurethat facility operates in a financially sustainable manner; Responsible for financialmanagement, budget compliance, variance analysis and corrective action plans as needed.Strengthen core programs; implement continuous quality improvement initiative. Implementand maintain systems that support effective operations in accordance to Company policy andprocedures.

Contract negotiating, hospital credentialing, Staff Scheduling, Monitor and Trackadmission statistics, Attend marketing and networking events, Providing in-servicesand training to staff on clinical criteria and documentation, In-service on MedicareCerts, Creating policy and procedures, Provide assessments to determine theappropriate level of care for mental health admission or chemical dependency based onASAM criteria (Detox/Rehab/RTC/PHP/IOP) patients as well as dual diagnosis,Provide crisis intervention, triage crisis calls, Working with MajorInsurance Company’s for Pre-Certs, Verification of benefits, Maintaining accurateDOFR (Division of Financial Responsibility), Tracking of Payer Mix, Providingconcurrent Telephonic reviews to major insurance companies, Assessing Individualsfor 5150, Taking V/S and completing CIWA or COWS score