-Provide functional and technical knowledge for NCQA/HEDIS across all plan departmental staff and deliver educational sessions to internal staff and external constituents as needed.-Coordinate Work Plan, team and resources for HEDIS/Consumer Assessment of Healthcare Providers and Systems (CAHPS) submission to Connector Authority and NCQA.-Design, run, and manage the data review process to ensure accuracy and integrity of data reports to meet regulatory and operational requirements.-Adhere to NCQA standards and work with Corporate Director of Accreditation in maintaining Plan’s NCQA accreditation.-Support the coordination of corporate compliance and external surveys as needed.-Monitor the creation of all project deliverables to ensure adherence to standards including design documents, test plans and operations documentation.-Support the project life cycle including requirements gathering, creation of project plans and schedules, manage resources, support HEDIS audit process, and facilitate project execution, deployment and closure.-Coordinate all data pulls and ongoing data management for HEDIS and QI project management databases for identified QI projects with department staff and corporate contacts. Evaluate sources for alternative data capture; assess ongoing methodology and results.-Maintain detailed project documentation including meeting minutes, action items, issues lists and risk management plans

 Educates providers and supports provider practice sites in regards to the National Committee for Quality Assurance (NCQA) HEDIS measures.  Provides education for HEDIS measures, appropriate medical record documentation and appropriate coding. Assists in resolving deficiencies impacting plan compliance to meet State and Federal standards for HEDIS.  Supports the development and implementation of quality improvement interventions and audits in relation to plan providers Develop Wellcare’s Behavioral Health HEDIS program Advises and educates large Provider practices and IPAs in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with NCQA requirements. Collects, summarizes and trends provider performance data to identify and strategize opportunities for provider improvement. Collaborates with Provider Relations to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters). Ensures assigned contract/regulatory report content is accurate and that submission adheres to deadline. Participates in and represents plan at community, health department, collaborative and other organizational meetings focusing on quality improvement, member education, and disparity programs, as assigned. Ensures accuracy in medical records for data collection, data entry and reporting. Enters documentation of findings in identified databases.

PROGRAMMATICOversee the implementation of all programs of the MHAPBC.Manage existing programs and develop new ones in keeping with organization’s mission and community priorities.Evaluate the quality of MHA programs through use of program outcome measures in keeping with funders’ requirements and good business practices.Assure compliance with contractual requirements and good program practices.Research and apply for grants. Track and monitor all grant related activities. FINANCIALPrepare and monitor annual operating programmatic budget.Analyze financial outcomes of programs. Monitor spending to ensure spending is within budgetary predictions and allowances.Partner with Financial Analyst to ensure compliance with funders’ requirements. Ensure financial reporting to funders occurs in accordance to timelines in contracts.ADMINISTRATIVESupervise staff as directed by the CEO.Participate in the development of the organization's plans and programs as a strategic partner. Provide training, consultation, and support on an as-needed basis for program and administrative staff.Assist with compiling, tracking, and monitoring program data as required by funders.Assure compliance with contractual requirements and good program practices.Oversight of IT management by effectively communication with IT Support; Ensure that employees have technology needs met; Maintain communication with IT Support.COMMUNITY RELATIONSDevelop professional relationships, and work closely and collegially with community partners.Gather information about community mental health needs and resources that could be used to help people with behavioral health issues. Assist the CEO with special assignments and any additional duties as deemed appropriate or as needed.

- Direct American Correctional Association Accreditation (ACA), Performance Based National Detention Standards Audit (PBNDS), National Commission on Correctional Health Care (NCCHC) Audits, Internal and Corporate Audits, and write corrective actions plans for all audits to ensure compliance.- Generate facility policy and procedure with key staff ensuring compliance with all laws, regulations and contractual agreements. - Review, compare, document contract changes to implement required procedural changes with managers.- Act as Office of Professional Responsibility Investigator (Internal facility personnel investigations)- Serve as Chairman of the Disciplinary Committee.- Serve as Prison Rape Elimination Act (PREA) Coordinator/ Investigator and HIPPA Privacy Officer.- Write facility newsletter and publish articles in the international newsletter.

- Prepared hospital for Joint Commission Accreditation and remained in a state of continual readiness for all accrediting agencies.- Wrote corrective action plans and analyzed findings from the Joint Commission Survey.- Optimized facility policy and procedure as well as ensured compliance with all laws, regulations and contractual agreements. - Planed and implemented quality and performance improvement projects.- Created Dashboards, Indicators, Priority Grids, and Strategic Plans- Facilitated meetings and lead Quality Council

• Completed intake and discharge planning• Lead group counseling • Conducted one on one counseling • Participated in treatment planning • Assisted in preparing patients for court• Testified in court on behalf of patients• Accessed risk and functioning levels of clients

• Provided court accompaniment to victims• Lead group sessions on domestic violence• Provided information and referrals • Provided support at pre filing interviews and depositions • Completed follow up with victims• Assisted other victim advocates with their case load

• Answer Help Line 211 (Information and referrals), Lifeline Hotline (suicide prevention), Braive Hotline (Veteran Hotline), HIV and AIDS Hotline and Parent Helpline• Short term crisis counseling• Distributed information and referrals • Kept records organized and confidential• Trained new volunteers • Supervised and provided feedback to volunteers