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Work Background
Massachusetts General HospitalSenior Medicaid ACO Program Manager
Nov. 2020Boston, Massachusetts, United StatesWork across Primary Care, Specialty, and Emergency Department to design, implement, evaluate, and scale population health management programs for the MGH Medicaid Accountable Care Organization (ACO). Work closely with MGH Medical Directors, physician executives, and MGB Healthcare staff to translate organizational goals and strategies into executable projects that interweave into practice and department operations. Identify complex variables that influence myriad stakeholder goals in a matrix environment and collaborate to set strategic direction to address them. • Apply value-based care frameworks in all aspects of planning and decision-making to ensure patient experience, health outcomes, and total cost of care are always at the forefront. • Design and manage the integrated workplan including inter-workstream dependencies • Develop strategic plans and manage new projects from pilot to steady state including the Medicaid Flexible Services program and the Social Determinants of Health primary care screening and navigation program with diverse stakeholders. • Provide guidance and direction to external vendors, staff, and colleagues to transfer knowledge and best practices • Identify risks and barriers to effective implementation and leverage relationships and strategies to move past them • Demonstrate experience working in workgroups around complex healthcare challenges to drive effective decisions and programs • Facilitate critical project meetings, help drive strategic decision-making, and manage stakeholder expectations to optimize impact of Medicaid ACO initiatives to improve and focus care on specific needs of MassHealth patients • Work with PHM leadership to manage budget and quality measures to drive value and trend for the hospital while optimizing programming for patient care
Massachusetts General HospitalSenior Project Specialist - MGH Medicaid ACO
Mar. 2017 - Nov. 2020Performance Analysis and Improvement -Department of Population Health Management• Design and implement workflows in collaboration with 26-site primary care staff to institutionalize Social Determinants of Health screening and navigation systems • Design framework and workflows to implement Medicaid ACO Community Partners program for 26 primary care sites with community organizations to decant appropriate care coordination and behavioral health services for Medicaid patients • Work with vendors to implement Medicaid Flexible Services program and manage internal staff to enroll patients in intensive housing and nutrition programming • Work with staff across the hospital to build a network of care coordination staff and help design and institutionalize tools to help standardize the highest levels of care management for MGH • Develop in-service events for care coordination staff to improve skills sets imperative to good care management work • Ensure Quality Assurance systems are interwoven into project design and process builds. • Design continuous assessment and improvement of workflows especially during periods of optimization and scaling •Co-manage budget and manage process for grant recipients to enhance their work related to Medicaid ACO patients
South End Community Health CenterPractice Manager - Operations and Quality
Nov. 2014 - Oct. 2016Boston, MAAdapted and strengthened administrative support systems to respond to organizational changes and worked with internal departments and institutional partners to develop quality systems which use data to inform front-end processes and clinical outcomes. Project Management • Designed and directed project to create systems and tools to report clinic assistance and application volume for Medicaid and MCOs for federal government agencies. Managed ongoing staff training to increase skills development and hone tools. • Directed project to create systems of coordinated care involving communication and data exchange with external stakeholders, internal system design, and constant quality improvement cycles through execution. • Developed data mining and reporting process and templates for gathering clinic operations administrative data for C-suite and Board of Directors reporting. • Directed project to reconfigure workflows for referral department to decrease response time and increase information and communication between staff and with external stakeholders. • Developed patient grievance administrative and resolution standard operating process, tools, and reporting structure for clinical management use. Quality Assurance and Improvement • Managed data from an ACO and five insurance companies to initiate systems and operations for population management and care coordination and maximize reimbursement to the health center. • Led administrative component of core operations and finance team charged with design, testing, and implementation of EPIC electronic medical record health center-wide. Operations • Managed 14 front line administrative staff from insurance coordination, referral coordination, medical records, and registration and trained in processes, procedures, and data mining processes. • Managed teams to develop and operationalize systems for capturing population health and operational data for reporting, coordination of care, and quality improvement.
Upham's Corner Health Center and Upham's Elder Service PlanQuality Assurance and Process Improvement Manager
Oct. 2013 - Nov. 2014Dorchester, MAOver a one-year period, developed and implemented new Quality Assurance and Process Improvement (QAPI) structure at 500 employee health center. Worked closely with clinical and operational departments to identify and prioritize areas for improvement with a focus on improving clinical outcomes and the reduction of risk health center-wide. Highlights of project included: • Gap analysis of both operation and risk environment in order to ensure optimal implementation across departments. • Designed curriculum and trained staff at all vocational levels on clinical and operational performance improvement to guide and foster discussion around QAPI integration, fostering staff participation and motivation, and recognizing and understanding both intended and unintended consequences of the process improvement process. • Developed pharmacy prescription workflow audit process to decrease errors and risk as well as patient wait time. Shared metrics to help staff understand root cause of errors and recommended systemic improvements. • Designed Participant Satisfaction survey and Employee satisfaction survey. Collaborated to ensure validity in administration. • Led team to implement health center PCMH-required pre-visit form via a PDCA process; analyzed operational and form data to inform ongoing improvement and data collection opportunities
Bunker Hill Community CollegeGED Instructor
Jan. 2011 - Apr. 2011Boston, MADeveloped curriculum and taught weekly 5 hour class for GED preparation for 12 students from varying ethnic and cultural backgrounds.
John Snow, Inc. (JSI)Operations and Program Manager
Aug. 2008 - Oct. 2013Boston, MARan day-to-day operations and executed projects that impacted operations for 3 state Smokers’ Helpline funded by the CDC and state Departments of Public Health. Worked closely with clinical management and state public health staff to operationalize state goals and strategies to reach more smokers and increase cessation rates. Participated with National Quitline Consortium to improve work, data collection, and federal support of all quitlines. Project Management • Led creation and execution of standard operating procedures and quality tools to measure productivity. Trained staff and managed ongoing process improvement. • Led project to design and execute kaizen inventory system for nicotine patch shipping. • Designed and managed pilot project to compare different clinical approaches by developing tools, quality systems, and standard operating procedures for selected quitline staff. • Designed and managed offsite work protocols and risk management project. Operations and Human Resources • AR/AP review and auditing; Vendor relations for supply management, inventory, billing • Hiring, firing, execution of performance improvement plans and ongoing training of 11 operations staff and interns. • Development and maintenance of flexible staffing structures to respond to volume of calls due to increased funding and media. Quality Assurance and Improvement • Creation and maintenance of service tracking systems and evaluation of productivity and progress of staff. • Database logic restructuring and testing for new and improved initiatives. • Implementation of HIPAA compliance protocols. Data Analysis • Analysis of data on productivity and completion rates by staff member to ascertain best practices for impacting client decision-making to continue cessation services. • Following referral trends for 20+ referring institutions to determine impact of on-site trainings and implementation over time.
Self-EmployedSAT Coach/Tutor
Jan. 2008Private SAT teacher/coach for high school students preparing for the exam. In-home practice and skill development in Eastern, MA. Tutor multiple subjects with elementary and middle school students.
John Snow, Inc. (JSI)International Project Coordinator
Sep. 2005 - Dec. 2008Boston, MA• Acted as the primary home-office contact to USAID-funded health projects in Ukraine, Indonesia, and Liberia in providing substantive guidance to the project with an understanding of the projects’ goals, objectives, and structure; as well as attention to the geopolitical, cultural and legislative constraints that bind them. • Primarily responsible for all aspects of project management of two USAID funded contracts – Ukraine Reproductive Health and Family Planning and Indonesia Health Services Program – including financial monitoring of $45 million of budgets, contract management, subcontractor coordination, consultant recruitment, responding to technical requests, and liaising with USAID Missions on all contractual, administrative and financial matters. • Coordinated U.S.-based procurement for projects and ensured that USAID procurement regulations are followed. • Made field visits to monitor administrative and financial procedures, to conduct on-the-job training for locally-hired project staff, and to provided other support for the Chief of Party. • Oversaw all aspects on-site of start-up for Ukraine Reproductive Health and Family Planning Project and Liberia Rebuilding Public Health Services projects in country. • Contributed to the development and refinement of the JSI/Boston project support systems and procedures including organizing skills building and professional development workshops for department, and a reorganization of orientation methods and systems. • Participated in the development and writing of proposals for new business development,
New England AIDS Education and Training CenterProgram Coordinator/Events
May. 2001 - Sep. 2005Boston, MA• Worked as part of team to develop and manage 5-20 educational seminars per month for twelve statewide venues. • Collaborated with and provide guidance to local & state agencies about educational program development & delivery. • Created and managed internal accounting and budgeting systems to ensure fiscal accountability. • Oversaw of programming budgets totaling $250,000 annually. • Developed and managed electronic and manual documentation systems used to comply with federal and state continuing education regulations. • Developed of administrative filing and communication systems to improve daily organizational operations. • Overhauled provider database system thereby allowing organization to target a 300 percent increase in providers. • Enhanced marketing efforts to incorporate email and web-based marketing helping to increase attendance by 300% from 2001-2005. • Supervised five volunteers and interns in preparing various programming materials. • Acquired clinical knowledge of HIV disease and service delivery.
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