Terri B. Email & Phone Number

Cincinnati, Oh, Us

Cincinnati, Ohio, United States

In 2019, I joined for a brief engagement and was later invited to lead operations in a $48M+ division across 23 counties in two states. I drive strategic planning, public policy advocacy, workforce planning, stakeholder engagement, operations, compliance, and growth. I also lead a team of five while managing a ~$55M budget, overseeing 160 staff members who provide home and community-based case management, recovery management, and waiver service coordination to Medicaid and Medicare… Show more In 2019, I joined for a brief engagement and was later invited to lead operations in a $48M+ division across 23 counties in two states. I drive strategic planning, public policy advocacy, workforce planning, stakeholder engagement, operations, compliance, and growth. I also lead a team of five while managing a ~$55M budget, overseeing 160 staff members who provide home and community-based case management, recovery management, and waiver service coordination to Medicaid and Medicare beneficiaries, including those aging or with disabilities. Additionally, I drive growth strategies and implement programs such as the Fee for Service Medicaid Waiver, Long-Term Services & Supports, Dual Eligibility Home & Community-Based Waiver, and Medicare Advantage for Substance Use Disorder Care Management.KEY CONTRIBUTIONS:► Improved incident reporting compliance from 91% to 97%+ in dual Medicare-Medicaid home and community-based waivers, exceeding contract requirement of 90%. ►Expanded lines of business by 270%+, transforming a $250K annual loss into a $1M profit through strategic partnerships with the health plan, more than tripling the client base from 840 members in 2022 to 2,730 in 2024.►Secured $100K+ funding through partnership with Aetna Healthcare, initiating a client self-direction pilot program.►Reduced turnover from nearly 10% to .75% through innovative staffing models and redistributing workload from clinical to non-clinical roles. ►Achieved 100% compliance in regulatory surveys (EQRO/ CMS / NCQA) by implementing a structured supervision model with regular chart audits, feedback loops, and error correction processes.►Instrumental in securing $600K+ funding to serve 500+ new clients through successful PACE expansion RFP, contributing expertise in care management strategies and dual Medicare-Medicaid-eligible population identification.►Spearheaded state-level policy changes, expanding the professional pool for case management and securing provider rate increases. Show less

Springdale, Ohio

In this role, I led strategic operations, policy development, and compliance for long-term care services and supports across nursing homes and community settings. I built and managed a team of six clinical supervisors (RNs and social workers) overseeing 80 clinical staff who provide case management to over 6K dual-eligible (Medicare and Medicaid) members across 13 counties. I also developed risk mitigation workflows/training and am accountable for applying federal and state policy at the… Show more In this role, I led strategic operations, policy development, and compliance for long-term care services and supports across nursing homes and community settings. I built and managed a team of six clinical supervisors (RNs and social workers) overseeing 80 clinical staff who provide case management to over 6K dual-eligible (Medicare and Medicaid) members across 13 counties. I also developed risk mitigation workflows/training and am accountable for applying federal and state policy at the program level, ensuring successful outcomes in external (EQRO/ODM/CMS/NCQA) and internal audits.KEY CONTRIBUTIONS:► Saved $187K+ after exceeding target metrics for nursing facility conversions by 50%+.►Reduced overall inpatient readmissions within 30 days of discharge by developing case management strategies, including increased patient contact protocols such as medication adherence checks and follow-up appointment scheduling.►Eliminated staff turnover, reducing from 30% to 0%, by implementing robust onboarding processes and efficient workflows. Show less

College Of Online And Continuing Education

(Remote Instruction • 2018 – 2020)I served as a remote instructor for undergraduate courses in healthcare quality management and regulatory compliance. Courses included:IHP 430: Healthcare Quality ManagementIHP 355: Healthcare Regulatory Compliance and AccreditationIHP 435: Performance Improvement Measures and Methodologies

Columbus, Ohio Area

In this role with the Ohio Department of Medicaid's provider oversight contractor, I was hired to provide supervision to a team of eight to twelve healthcare compliance investigators charged ensuring the health, safety, and welfare of 50,000+ individuals receiving home and community-based (HCBS) through Medicaid and dual Medicare/Medicaid programs statewide. I closely monitored state and federal Medicaid policies, and developed a deep understanding of the Ohio Administrative Code (OAC) rules… Show more In this role with the Ohio Department of Medicaid's provider oversight contractor, I was hired to provide supervision to a team of eight to twelve healthcare compliance investigators charged ensuring the health, safety, and welfare of 50,000+ individuals receiving home and community-based (HCBS) through Medicaid and dual Medicare/Medicaid programs statewide. I closely monitored state and federal Medicaid policies, and developed a deep understanding of the Ohio Administrative Code (OAC) rules regulating the Ohio 1915(c) waivers including the Ohio Home Care Waiver, Transitions Carve-Out Waiver, and the MyCare Ohio Waiver.KEY CONTRIBUTIONS :►Secured and maintained “Ohio Continuing Education Provider Status” for the firm from the State of Ohio Counselor, Social Worker, and Marriage and Family Therapist Board as well as the Ohio Board of Nursing.►Developed comprehensive curriculum for 17 statewide training sessions on internal compliance programs, enhancing knowledge/skills of Ohio Department of Developmental Disabilities certified providers of home and community-based services.►Orchestrated agency's talent development by creating a robust 9–month training curriculum to cultivate future leadership. Show less

Centerville, Ohio

As the founder of a company specializing in continuing education for healthcare professionals, I developed and tailored training programs for social workers and nurses, emphasizing client-specific needs. Collaborating closely with clients such as nursing homes, I designed customized year-long training calendars targeted at enhancing staff competencies. I partnered with Sinclair Community College Workforce Development to design continuing education courses credentialed by International… Show more As the founder of a company specializing in continuing education for healthcare professionals, I developed and tailored training programs for social workers and nurses, emphasizing client-specific needs. Collaborating closely with clients such as nursing homes, I designed customized year-long training calendars targeted at enhancing staff competencies. I partnered with Sinclair Community College Workforce Development to design continuing education courses credentialed by International Association for Continuing Education (IACET). Through this company, I delivered 21 distinct programs and 33 training events, providing over 700 continuing education credits. These programs were recognized for CEU credits by the State of Ohio Counselor, Social Worker, and Marriage and Family Therapist Board. Show less

Wapakoneta, Ohio

As an independent contractor provide in-home clinical social work assessment and counseling to seniors receiving services through the PASSPORT waiver program. Complete initial social work assessments, design individualized treatment plans, execute treatment plans, and reassess every 90 days. Coordinate services with the assigned PASSPORT case manager and other service providers as needed. Provide crisis counseling to clients as needed.

Grandview And Southview Hospitals

I managed the discharge planning department to provide services seven days a week, ensuring quality patient care while meeting length of stay initiatives. I oversaw staff assignments, maintained compliance with state and federal regulations, and provided training. I also consulted for the Medical Integration Department, tracked and analyzed referral data, and orchestrated discharge planning practices. Additionally, I streamlined joint replacement classes, established protocols for at-risk… Show more I managed the discharge planning department to provide services seven days a week, ensuring quality patient care while meeting length of stay initiatives. I oversaw staff assignments, maintained compliance with state and federal regulations, and provided training. I also consulted for the Medical Integration Department, tracked and analyzed referral data, and orchestrated discharge planning practices. Additionally, I streamlined joint replacement classes, established protocols for at-risk oncology patients, and served on several committees, including the Bioethics Advisory Committee and the West Central Ohio Community Care Transition Coalition.In my earlier role as a discharge planner, I identified and assessed patient needs related to admission, diagnosis, and treatment, developing intervention plans as part of an interdisciplinary team. I also educated patients and families on transitioning from acute hospital care to post-acute care. During my tenure, I served on the Bioethics Advisory Committee and created a resource packet for indigent or underinsured patients. Show less

Dayton, Ohio Area

In this role, I managed a caseload of approximately 20 families, consistently meeting and exceeding child welfare time mandates for investigation and documentation. My responsibilities included providing culturally appropriate direct casework services, crisis counseling, and intervention to children, birth families, and foster families. I also developed and monitored effective case plans, collected and presented accurate data in court, and developed/facilitated a diversity training program for… Show more In this role, I managed a caseload of approximately 20 families, consistently meeting and exceeding child welfare time mandates for investigation and documentation. My responsibilities included providing culturally appropriate direct casework services, crisis counseling, and intervention to children, birth families, and foster families. I also developed and monitored effective case plans, collected and presented accurate data in court, and developed/facilitated a diversity training program for Montgomery County staff. Show less

Master Of Science - Ms, Health Services Administration

Bachelor Of Arts - Ba, Social Work, Cum Laude

Activities and Societies: Social Work Honors Society Completed the Child Welfare Workforce University Partnership Program.