Robert T. Criscuolo, MPA, CCE

Summary

  • Upon retirement from federal service, created a business focused on advising organizations and individuals in areas of skill and expertise that empower performance improvements and enhanced revenue within a culture of corporate responsibility and integrity. The Compliance, Revenue and Integrity, LLC is a 1099 entity poised to engage federal business partners across a spectrum of revenue cycle related business improvements within the highly regulated federal health care market.
  • Over 37 years of government health care experience at the medical center, regional and national leadership levels.
  • Senior Executive and Chief Officer responsible forleading the Veterans Health Administration Compliance and Business Integrity(CBI) national policy and strategic direction for the Departments business and revenuecycle oversight efforts across over 150 heath care systems nationwide.Commanda value based, health care business oversight and corporate responsibility effortin support of a Just Culture in alignment with the organizations commitment to quality, accountability, patient safety and high reliability.The vision of the Compliance and Business Integrity (CBI) Program is to preserve veterans’ trust by achieving compliance excellence and unexcelled business integrity.
  • Introduced a patient centric/business practice domain of value into the quality measurement public trust milieu.
  • Executive leadership in strategically formulating, defining and implementing a robust and integrated system wide risk identification andremediationstrategyacross the domains of ethical culture, corporate compliance and shared value.Responsible for leadership briefings and coordinated communications to congressional oversight committees, stakeholders, advocacy organizations, local and regional government health care partners, VA executive leadership and industry professionals.

Skills and Expertise

Corporate Responsibility Risk Management Healthcare Compliance Executive Management Mentoring/Mediation

Leadership DevelopmentPerformance MetricsClinical/Corporate Relations Strategic Planning

Process Controls Financial and Regulatory Investigations Employee DevelopmentRevenue Cycle Government VA

Professional Experience

2011-2014 Chief Officer (SES) Department of Veterans Affairs,Veterans Health Administration (VHA) Office of Compliance and Business Integrity, Washington DC/Secaucus NJ

Senior Executive and Chief Officer, providing corporate level leadership forrevenue cycle and financial compliance oversight.Servant leader within the Office of Quality, Safety and Value weaving afinancial corporate level compliance oversight effort intoa business culture that balances the rigor of regulatory compliance with a commitment to business integrity and integrated ethics. Set the strategic direction for aVA central office staff of 50FTEE and for nearly 200 local and regional compliance programs and officers nationwide. Expanding well beyond the traditional compliance program elements to an integrated leadership approach that engages hundreds of insurers and health care system providers with nearly $10 billion in healthcare commerce.

  • Responsibility for the Compliance Strategic Plan that defines national policy for VHA business and revenue cycle oversight.Design of a national level Risk Management Solution that delivers an annual revenue and financial risk assessment and associated risk registry. Directs a national effort in the fields of compliance data analytics, risk, audit, education, communication, investigations, program evaluation, strategic and project planning.
  • Experienced advising healthcare operations in their dealings with the oversight community including the Office of the Inspector General, the Government Accountability Office, General Council, the VA Office of Business Oversight, VHA CFO and Business Office, regional corporate health care delivery leadership and the various congressional committees.
  • Senior leader guidingVHA compliance elements that deliverfinancial internal controls reflective of the need foraudit, data analytics, performance measurement, workforce development, investigation, hotline reporting, business improvement and communicationprograms that drive national and local business policies of accountability and revenue enhancement.
  • Led effort to deliver an industry recognized data analytics and virtual performance metrics platform of business and oversight measures and metrics.
  • Fostered an industry modeled project management, strategic mapping approach throughout all program elements’and policy development that sets direction for all levels of financial, revenue, quality, safety and internal controls in areas of business oversight, accountability and integrated ethics

2009- 2011 Director of Operations (VHA), Office of Compliance and Business IntegrityWashington, DC/Secaucus, NJ

Principal Director for nationwide business compliance and integrity operations.Operational leader for design and implementation of locally managed VHA compliance programs that support oversight of the administration’s multi-billion dollar revenue cycle operations.Responsible for the early detection and prevention of noncompliant revenue and clinical service purchasing practices and agreements thus demonstrating to our nations’ veterans and the taxpayer, public trust and commitment to accountability and organizational stewardship. Led efforts to design nationally dispersed standard business oversight systemsthrough the implementation of formal compliance program standards, strategies, handbooks, tools and procedures.

2000-2009 Senior Program Analyst (VHA), Office of Compliance and Business Integrity —Washington, DC/East Orange, NJ

With the inception of the VHA commitment to create a business integrity office starting in 1999 functioned as the senior most accountable official with responsibilityas the principal advisor to the Chief Compliance and Business Integrity Officer in matters of strategic direction, leadership engagement, budget and resourcing, program design and system wide implementation.

1999- 2000 Network Compliance Officer Veterans Integrated Network (VISN) 3 Bronx, New York

Compliance Officer for the NY/NJ VHA hospital network of five tertiary metropolitan, affiliatedhealth care systems.

1991-1999 Chief Medical Administration (Business Office) New Jersey Veterans Health Care System, East Orange NJ

VHA Medical Center business office management official. Responsibility for250 FTEE and associated health care support functions includingpatient accounts, medical records, privacy, FOIA, public affairs, congressional relations, revenue programs, stakeholder communication, emergency department, medical school business relationships, IT and telecommunications.

1976-1990 A series of positions delivering direct patient care within the rehabilitative medicine arena and administrative/managerial support positions within the range of patient care services.

Education and Professional Certification

Member, U.S. Senior Executive Service (SES) 2011

Veterans Health Administration—Healthcare Talent Management 2010

Certified Fellow Mentor

Council of Ethical Organizations—Health Ethics Trust 2006

Certified Compliance Executive (CCE)

Council of Ethical Organizations—Health Ethics Trust 2001

Certification, Compliance Professional

Fairleigh Dickenson University—Madison, New Jersey 1996

Master of Public Administration (MPA)

Fairleigh Dickenson University—Madison, New Jersey 1996

Certificate in Health Care Management

Long Island University—Brooklyn, New York 1976

Bachelor of Science (BS Special Education)

New York University- NY, NY 1979

Certificate in Orthotics and Prosthetics

Mount Saint Michael Academy- Bronx NY 1972

Member Council of Ethical Organizations Education Committee, Health Ethics Trust “Best Practice” reviewer, Certified Compliance Executive reviewer, Ethics Resource Center Procedural Justice and Behavioral Ethics Workgroup, faculty VHA Administrative Investigation Board training program, VHA Technical Career Field Mentor, Co-Chair VHA Business Compliance Committee Advisory Work Group faculty and Business Integrity Committee, member VHA Data Consortium, VHA Deputy Undersecretary for Health for Operations and Management Performance Planning Work Group, Co-Chair VHA Joint Work Group, Member Senior Executive Association, Trustee St. Francis Roman Catholic Church (Ridgefield Park NJ), Member, International Association of
Approved Basketball Officials, Member, NJ State Athletic Association Baseball Officials, among other positions of trust and leadership

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