Cindy Garvin, MSW, LCSW

Cindy has more than 30 years of experience in healthcare administration with a proven track record leading clinical care management change across payer, provider, and vendor organizations. Cindy led collaborations involving UM, CM, quality, compliance, and credentialing, and also helped develop combined medical and behavioral health teams and operations. Her expertise in project management,  business analysis, and program development has resulted in successfully integrated care management and core system implementations. She also has created process improvements and best-in-class clinical programs to achieve CMS, NCQA/HEDIS, URAC, and JCAHO accreditation and compliance. Cindy’s ability to maximize profits through the creative development of efficient and productive operational, team, and marketing systems has exceeded organizational goals for service excellence, accreditation, and regulatory compliance.

Experience

  • Extensive clinical and administrative roles for medical and behavioral health organizations, project/program management, enterprise system implementations, regulatory compliance, special needs programs, quality improvement, HEDIS, and credentialing
  • Served as interim vice president of medical management for the largest Medicaid HMO in Minnesota. Developed CMS-compliant processes and policies to ensure ongoing accreditations for URAC and NCQA
  • Served as clinical subject matter expert and senior program director for software systems implementations (UM, CM/DM/PH, and quality and appeals and grievances) for a pediatric Medicare/Medicaid (CHIP, STAR, STAR Kids) health plan in northern Texas

Qualifications

  • Certified Case Manager (CCM)
  • Certified Professional in Health Care Quality (CPHQ)
  • Certified Project Manager (CPM)
  • Licensed Clinical Social Worker (LCSW)

Education

  • Master of Social Work, Healthcare Administration, University of Pittsburgh
  • Bachelor of Arts, Social Work, Pennsylvania State University