*Clinical Program Development- identifying medical populations in need of integrated care & working to develop provider relationships/contracts to improve care, patient experience, and cost outcomes; Responsible for ROI on quality, cost, and patient experience for targeted sub-populations
*Health Home Development - seamless integration of primary care and behavioral health services for medicaid and medicare consumers
*Seasoned behavioral health care professional with extensive experience in, and perspective on, all markets (Medicaid, Medicare, Commercial) and all MBHO models, including staff model, carve out and carve in models, and sub-capitated arrangements.
*Expert on health engagement processes, therapeutic relationship factors, & health coaching
*Developing, contracting and operating disease management programs via variety of pathways including medical home in vertical health delivery systems, nurse based health coaching interventions and targeted interventions for medically complex patients with co-occurring disorders.
*Evaluated/Analyzed market needs, opportunities and best pathway (build/ buy or acquire) to achieve targeted behavioral health care product solutions for different MCO models and different markets.
*P & L responsibility & C-suite experience for health care operations in a variety of settings.
Experience in negotiating and managing for internal and external constituencies to achieve strategic and operational goals.
*Psychologist with practical understanding and success in behavior change, personnel management & health coaching- certified Employee Assistant Coach.
Specialties: Speciality Medical Home Development for SPMI Medicaid Population
Coaching- (psychotherapeutic, employee, health coaching),
Health care Product Development,
Behavior Change,
Health Care Operations & Strategy
Regional Vice President, North Region Government Business Division @ Responsible for the administration, quality and cost outcomes of the Medicaid behavioral health programs for Maryland, New Jersey, New York, Indiana and Wisconsin. From November 2014 to Present (1 year 2 months) Editor @ The Medpedia Project is a long term, worldwide project to evolve a new model for sharing and advancing knowledge about health, medicine and the body among medical professionals and the general public. The Project provides a free online technology platform to any individual or organization that can benefit from its use, available at www.medpedia.com. Users of the platform include medical and scientific journals, medical schools, research institutes, medical associations, physicians, hospitals, for-profit and non-profit organizations, companies, expert patients, policy makers, students, non-professionals taking care of loved ones, individual medical professionals, scientists, etc. From 2009 to Present (6 years) Vice President, Clinical Programs and Behavioral Health @ Clinical Program development- provider collaborations targeting complex medical conditions; implementation, operational, & P & L responsibility
Behavioral Health- operational, P & L responsibility From January 2013 to October 2014 (1 year 10 months) Baltimore, Maryland AreaVice President @ Operations and Clinical Product Development Executive
Managed Behavioral Healthcare
Medical and Behavioral integration algorithm development From May 2007 to December 2012 (5 years 8 months) Vice President @ Clinical product development internet based coaching/wellness tools From 2005 to 2007 (2 years) Vice President @ Service center operations From 2005 to 2007 (2 years) VP @ Operations and clinical product development From 2003 to 2007 (4 years) Vice President @ Executive responsible for east coast clinical operations with focus on provider network strategies and contracting From 2003 to 2005 (2 years) Vice President @ Healthcare operations and quality management From 2000 to 2003 (3 years) Vice President @ Service Center Healthcare operations From 1996 to 2000 (4 years) Vice President @ Responsible for managed care behavioral health service center operations for commercial, medicaid, and medicare accounts (clinical, quality, provider relations, account management, claims, customer service) From 1995 to 1997 (2 years) Regional Director, Mid-Atlantic @ Behavioral Health operations for Mid-Atlantic Region
Direct clinical care From 1985 to 1996 (11 years)
PhD, Psychology @ Yeshiva University From 1978 to 1984 B.A., Psychology @ University of Michigan From 1972 to 1976 Charles Gross is skilled in: Medicaid, Medicare, Behavior Change, Disease Management, Healthcare, Behavioral Health, Health Home implementation and operations, Case Managment, Managed Care, Healthcare Management, Health, Hospitals, Utilization Management, Health Policy, Clinical Research
Websites:
http://www.amerigroupcorp.com/Pages/Home.aspx