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April Parker_CV_10312016

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April Parker_CV_10312016

  1. 1. Curriculum Vitae April Tripp Parker, MS, LPC PERSONAL INFORMATION Telephone: (919) 260-5561 Email: aparkerunc@yahoo.com EDUCATION Masters of Science The University of North Carolina at Chapel Hill, Chapel Hill, NC Rehabilitation Psychology and Counseling Degree received: May 2003. Master’s Thesis: “Parent Education: Literature Review and Workshop Development” Chair: Stacy Carone, Ed.D., LPC, CRC Bachelor of Arts The University of North Carolina at Chapel Hill, Chapel Hill, NC Major 1: Psychology, Major 2: Women’s Studies Degree received: May 2001 LICENSECURE Licensed by the North Carolina Board of Licensed Professional Counselors License Number: 4870, Effective date: March 4, 2005 EMPLOYMENT Director of Utilization Management 7/2012-Current Alliance Behavioral Healthcare, Durham NC Administrative and Clinical supervision to Utilization Management Supervisors (3) and Utilization Management Care Managers (28). Responsible for planning, directing, administering and coordinating utilization management and care management activities of the MCO, related to Mental Health, Substance Abuse and Developmental Disability services. Oversee a core component of the MCO that ensures individuals receive the correct level and intensity of services that result in positive outcomes. Developed systems to monitor the appropriate utilization of both Medicaid and state funds. Ensure compliance with CMS, Code of Federal Regulations, state and general statues performance measures outlined within NC DMA and NC DMH contracts in addition to URAC HUM and applicable CORE standards. Developed and monitored processes to ensure high cost/high risk consumers receive appropriate care management follow-up and referrals. Provide education and technical assistance to internal as well as community stakeholders concerning departmental procedures and requirements for processing of authorizations. Monitored for implementation of service in accordance with clinical coverage policy, practice guidelines and evidence based/best practices. Co-Chair the Utilization Management Committee to ensure oversight of Clinical Operations performance standards and service utilization. Facilitated the design of the Utilization Management Dashboard. In conjunction with the Medical Director, Chief Clinical Officer and Chief Financial Officer, created utilization management packages and benefit plans that support the delivery of evidence-based practices. As a member of Senior Leadership, participate in strategic planning development for the MCO. Designed data reports to inform authorization benefit packages for Medicaid and State funded services. Staff member to internal Alliance Committees including Credentialing Committee, Community Relations Committee, Clinical Care Management Team, Clinical Advisory Committee and Rate Setting; advisory member to Quality Improvement Projects and panel member to Provider Reconsideration meetings. Director of Utilization Management 5/2011-6/2012 Durham County Government (The Durham Center), Durham NC Provide administrative and clinical supervision to five (5) CAP MR-DD Care Managers, six (6) licensed Mental Health/Substance Abuse Care Managers and one (1) Care Management Supervisor. Administrative oversight to implement UR procedures and work flow to meet NC State Medicaid Utilization Review standards and state funded IPRS for both Behavioral Health and CAP MR-DD. Manage onsite reviews from DMA/DMH for Utilization Review to ensure contractual requirements were being followed and reporting documentation required by the DMA/DMH. Monitor Utilization Review to ensure compliance with URAC accreditation policy and procedures. Work in collaboration with community partners providing technical assistance on the Utilization Review process. Provide feedback and problem solving strategies in response to IT development and implementation. Represent The Durham Center at state and local provider meetings in providing overview and feedback on the Utilization CV_a_parker, p. 1 of 3
  2. 2. Management process. Oversee the UM Waiver readiness workgroup in preparation of Managed Care Organization implementation. Co-Chair the UM Committee responsible for reporting out on the monthly monitoring reports. Care Management Supervisor 1/2011-5/2011 Durham County Government (The Durham Center), Durham NC Provide administrative and clinical supervision to 5 CAP MR-DD Care Managers and 1 clerical support staff. Administrative oversight to implement UR procedures and work flow to meet NC State Medicaid Utilization Review standards for CAP MR-DD. Provide training on Medicaid Utilization Review criteria and Due Process to non-licensed staff completing CAP MR-DD reviews for Medical Necessity. Provide oversight and clinical review for Dual diagnosed MH/DD CAP recipients requesting Medicaid funded mental health services. Managed onsite review from DMA/DMH for CAP Utilization Review to ensure all contractual requirements were being followed and reporting documentation required by the DMA/DMH. Work in collaboration with community providers providing technical assistance on the Utilization Review process. Provide feedback and problem solving strategies in response to IT development and implementation. Care Management Specialist II 2/2008-1/2011 Durham County Government (The Durham Center), Durham NC Perform professional and administrative work implementing and coordinating services of community service providers to ensure economical and effective utilization management for consumers of Mental Health, Substance Abuse and Developmental Disabilities Services. Job responsibilities include case reviews to monitor provider clinical performance and adherence to clinical practice guidelines and best practice standards. Make service authorization decisions based on developed criteria. Provide screening, triage and referral for Durham County residents seeking mental health, developmental disabilities and substance abuse services. Conduct utilization reviews to monitor service use across MH/DD/SA populations. Self Employed, Therapist 5/2007- 2/2008 Contract position with B&D Behavioral Health Services, Durham, NC Provide direct client centered mental health services to consumers referred for mental health outpatient therapy services. Populations served include clients ranging from ages 4 years to adults 60 years old with single and dual diagnosis including mental health and developmental disabilities. Provide therapy in office and in home to address individual therapeutic goals. Services provided include play therapy, family therapy, and individual cognitive behavioral therapy. Provide clinical supervision to provisionally licensed clinical intake team including group and individual supervision focused on assessment, diagnosis and recommended levels of care. Reviewed intake assessments to confirm medical necessity for diagnosis presented and Utilization Review of recommended services. Reviewed service definitions and coverage policies to ensure requested level of services met medical necessity. Monitored Person Centered Plans for clients to assess for appropriate therapeutic interventions and updated plans as needed. Collaborate with community supports including case managers, therapeutic mentors, families, school systems, Department of Social Services, and medical providers to ensure continuity of care. KidSCope Therapist 9/2004 – 5/2007 Orange-Person-Chatham Area Program, Hillsborough NC Chapel Hill Training Outreach Program, Inc., Hillsborough, NC (Divested from Area Program while employed) Provide mental health services to children ages 0-6 years and their families where there are social, emotional and/or behavioral concerns. Services include assessment, prevention, screening, direct play therapy, family therapy, parent education and support, case management, development of service plan goals, crisis intervention, as well as program planning and consultation. Performed utilization review and submission for medically necessary level of care services to the LME and later to Value Options. Maintain up-to-date Medicaid approved medical records. Collaborate with state and local agencies including Head Start/Pre-K agencies, Hillsborough Exchange Club, Guardian Ad Litum program and Pediatricians. Participate in interagency and interdisciplinary team meetings. Populations served include children and families who have experienced abuse or neglect, foster and adoptive children, loss of parent/family member, domestic violence, substance abuse, family conflict and dual mental health/developmental disabilities diagnosis. Provide individual therapeutic services in the home, childcare, and clinical setting. Person centered planning with children and their families to address therapeutic goals with a primary focus on building healthy family relationships. Provide mental health consultation to Orange County Childcare centers focusing on identifying children in need of further evaluation and mental health services. Classroom support provided to model and consult on the use of supportive classroom strategies. Recommendations provided to lead teachers to support the social and emotional development of the children in their classrooms. Reviewed and made CV_a_parker, p. 2 of 3
  3. 3. recommendations on Ages and Stages Social Emotional (A&S SE) Questionnaire with Orange County Head Start. Provided training to Head Start teachers on identifying and referring for mental health services. PACT Educational Specialist 3/2004 – 9/2004 Orange-Person-Chatham Area Program, Hillsborough NC Full-time position providing weekly direct educational services to children in the Infant-Toddler Program, ages 0-3 years with or at risk for developmental disabilities. Administer developmental assessments to develop and monitor educational goals for each child’s Individual Family Service Plan. Served as Child Service Coordinator for children through July 1, 2004. Facilitated team meetings to arrange, coordinate and monitor developmental services. Coordinate with the Children’s Developmental Services Agency to transition children for service coordination. Inclusion Specialist II 9/2003 – 3/2004 Community Partnerships, Inc., Durham, NC Full-time position providing screening and professional community based services in direct inclusion support to children ages birth-3 years, with developmental delays. Provide daycare consultation and technical assistance to childcare providers to identify classroom needs regarding individuals with, or children at risk for, developmental disabilities. Work with families, Children’s Developmental Services Agency (CDSA) and other community resources to identify and assist families in meeting individual and family needs. Assist families in developing and implementing goals on the Individual Family Service Plan regarding community inclusion support. Parent Educator, KidSCope Parent Education Program 1/2004 – 3/2004 Orange-Person-Chatham Area Program, Hillsborough NC Part-time contract position co-facilitating and assist in developing weekly adult parent education classes. Work with families who are at risk or have been adjudicated for abuse and neglect with preschool age children to promote healthy parent-child relationships. Assist families in developing family goals and appropriate developmental expectations for their children. Coordinator Assistant, KidSCope Parent Education Program 5/2003 – 7/2003 Orange-Person-Chatham Area Program, Hillsborough NC Full-time contract position providing administrative support to program coordinator. Analyze program evaluation inventories. Review parent education workshops for further program development. Organize the program’s Smart Start End of Year Evaluation. Assist in developing, planning, and facilitating weekly parent-education classes. Research grant opportunities and assist in writing and applying for grants which resulted in $10,000.00 in grant funds to continue support for the Parent Education Program. Play Therapist and Parent Educator Intern 8/2002 – 5/2003 Orange-Person-Chatham Area Program, Hillsborough NC Part-time practicum during fall semester and full-time internship during spring semester. Masters level internship providing play therapy and case management for child and family services to children ages 0-6. Diagnose DSM-IV disorder(s) and eligibility status for mental health services provided by KidSCope. Develop and implement children’s social skills group. Co-facilitate and assist in developing weekly parent-education classes for parents who are at risk or have been adjudicated for abuse and neglect. Assist in parenting classes for parents of sexually abused children. Counselor Intern 1/2002 – 5/2002 The Hill Center, Durham NC Masters level practicum providing individual weekly counseling sessions to middle school age children with learning disabilities, Asperger’s disorder and emotional dysregulation. Supervised onsite by the School Counselor in one-on-one session planning and implementation. PROFESSIONAL INTEREST Primary professional interest is to promote best practice service delivery through identifying treatment barriers and solutions to whole person care. CV_a_parker, p. 3 of 3