Welcoming Dr. Alina Walden, Director of Operations
Roya Health is proud to welcome Dr. Alina Walden to our leadership team. A seasoned healthcare executive with a passion for whole-person care, Dr. Walden brings the expertise, vision, and drive to help us deliver even better outcomes for the complex populations we serve.
A Career Built on Complex Populations
Dr. Walden has spent her career at the intersection of clinical excellence and operational performance. Her experience spans Medicare, Medicaid, and commercial populations, with a particular focus on high-risk, behavioral health, and medically fragile patients, the exact populations at the heart of Roya Health’s mission.
Most recently, she served as Vice President of Clinical Services at Adobe Population Health, where she led enterprise-wide initiatives in value-based care, utilization management, provider engagement, and CMS risk adjustment strategy. Her track record of improving HEDIS quality performance and STAR measures, while simultaneously driving revenue cycle optimization and compliance, reflects the rare combination of clinical and operational depth she brings to every role.
“Exceptional patient experiences are achieved through engagement, accountability, and partnership across the entire care team.”
DR. ALINA WALDEN, DIRECTOR OF OPERATIONS, ROYA HEALTH
Credentials That Speak to Her Commitment
Dr. Walden earned her medical degree from New York Medical College and her MBA from the University of Phoenix, a combination that reflects her dual command of clinical medicine and business leadership. Her certifications demonstrate an even deeper commitment to excellence:
MD
New York Medical College
MBA
University of Phoenix
CPMA
Certified Professional Medical Auditor
CPCO
Certified Professional Compliance Officer
CPC
Certified Professional Coder
CRC
Certified Risk Adjustment Coder
LSS MBB
Lean Six Sigma Master Black Belt
A Perfect Fit for Roya Health’s Mission
Dr. Walden’s expertise in integrated care delivery, behavioral health integration, and population health management aligns directly with our approach to whole-person care. Her ability to bridge clinical operations, quality improvement, and financial performance gives Roya Health a distinct advantage as we continue scaling programs for complex patient populations.
Her core areas of focus include:
Value-Based Care
Population Health
HEDIS & STAR Measures
CMS Risk Adjustment
Behavioral Health Integration
Quality Improvement
Utilization Management
Revenue Cycle Optimization
Integrated Care Delivery
Healthcare Compliance
Beyond her professional accomplishments, Dr. Walden is a collaborative leader who believes patient-centered care is built on trust and accountability, values that run through everything we do at Roya Health. Outside of work, she enjoys reading, hiking, and spending time with her husband and children.
We are excited about what lies ahead. Please join us in welcoming Dr. Alina Walden to the Roya Health family.
What We Look for When We Hire a Clinician, and Why It Has Nothing to Do With Their CV.
By Dr. Shar Najafi-Piper, PhD | CEO & Founder, Roya Health
The CV tells us someone can do the job. It does not tell us whether they will be good at it here, with these families, in this kind of practice.
We look at licensure. We look at experience with children and adolescents. Those are the entry requirements, not the hiring criteria. By the time a licensed clinician, licensed clinical social worker, or licensed professional counselor is sitting across from us, we already know they are qualified on paper. What we are actually trying to figure out is something harder to name and a lot more important.
We hire for curiosity first
The clinicians who do the best work at Roya Health are the ones who remain genuinely curious about why a child presents the way they do. Not pattern-matching to a diagnosis and moving forward, but sitting with the question. Wondering. Wanting to understand the family system, the school context, and the history that arrived before this child ever walked through our door.
You can hear curiosity in an interview. When we ask someone to walk us through a complex case, the clinicians we want to hire slow down at the complicated parts. They do not rush to a resolution. They linger where things were unclear, where they had to revise their thinking, where they were not sure. That quality, the willingness to stay in the not-knowing, is what we are listening for.
A rehearsed answer moves fast. It has a clean arc: here was the problem, here is what we did, here is how it resolved. A real answer has more texture. There is usually a moment where the clinician says something like, "and honestly, I still think about that case," or "I am not sure we got that one right." Those moments tell us a lot.
Tolerance for ambiguity is non-negotiable
Outpatient behavioral health care with children and families is not a clean discipline. A child comes in presenting with anxiety, and six sessions in, you are also looking at a parent who is undiagnosed and unaware of it, a school environment making everything worse, and a sibling dynamic nobody mentioned at intake. The picture keeps shifting. The treatment plan has to shift with it.
Clinicians who need certainty early and get uncomfortable when a case does not quickly resolve into a clear clinical framework struggle in this work. Not because they are not skilled, but because the work itself does not accommodate that need. We surface this in the interview by asking about the messiest case someone has held. Not the hardest. The messiest. The one where nothing lined up neatly.
The clinicians we hire can describe that case with something close to equanimity. There is always care there, but also a grounded acceptance that complexity is the job, not the exception.
How someone talks about their hardest moments matters more than what they say
We ask everyone some version of this question: tell us about a time when the work was really hard. What made it hard, and how did you carry it?
We are not looking for a specific answer. We are looking for self-awareness, and for evidence that someone has actually reflected on the experience rather than filed it away. Clinicians who can talk about difficulty without either dramatizing it or minimizing it, who can name the cases that stayed with them, are the ones who tend to take care of themselves well enough to stay in this field long-term.
Burnout among mental health professionals in Arizona is real and well-documented. It is a workforce issue, yes, and a culture issue as well. We try to hire people who already have some relationship with their own limits, because that is the foundation on which everything else is built. A clinician who cannot hold their own experience is not going to be able to hold someone else's, not sustainably.
What integrated care means for the people doing it
Roya Health operates as an integrated behavioral health practice, meaning our clinicians never work in isolation. Therapists, prescribers, and care coordinators work from a shared picture of each family. That model was built for families, and it turns out it is also better for the clinicians inside it.
Working in a team reduces the professional isolation that accelerates burnout. Clinical supervision is built in, not bolted on. When a case is complicated, there is a room full of people who know the family and can think through it together. That is not how most behavioral health jobs in Phoenix are structured. It is how we have chosen to build ours.
What we are really building
When we bring someone onto the Roya team, we are not filling a slot. We are adding someone to a care community that families in the greater Phoenix, AZ area trust, often at the hardest points in their lives. That responsibility shapes everything about how we hire.
The CV gets someone in the room. What happens in the room is where the real conversation starts.
Dr. Shar Najafi-Piper is the founder and CEO of Roya Health, an integrated behavioral health practice serving children and families across the greater Phoenix, AZ area. Learn more at roya.health.
The question every parent asks me at the first appointment, and what I actually say back.
By Dr. Shar Najafi-Piper, PsyD | CEO & Founder, Roya Health
It usually comes near the end of the first appointment. Sometimes it comes out directly. Sometimes it comes wrapped in a longer story about school, sleep, or the last six months. But it is almost always there, and our clinicians have learned to listen for it.
"Am I overreacting? Is something actually wrong with my child, or is this just... normal?"
I want to share what we say back, because I think a lot of parents are carrying this question and not finding a good place to put it.
The first thing our team says is: the fact that you are asking means you have been paying attention. Parents who are overreacting do not usually spend months documenting patterns, adjusting routines, losing sleep, and finally making an appointment. That is not what overreacting looks like. What you did took effort and courage, and it started because you noticed something. That noticing matters.
The second thing is more clinical, and I think it is actually more reassuring once families hear it.
There is no bright line between "something is wrong" and "this is normal." That is not how child development works, and it is not how behavioral health works either. What our clinicians are actually trying to understand at a first appointment is not whether your child has crossed some threshold. We are trying to understand whether what you are seeing is getting in the way, and for whom. Is it getting in the way of your child's ability to learn, to make friends, to feel okay in their own body? Is it getting in the way of your family's ability to function? Those are the questions that matter clinically, and they are answerable.
A child can have anxiety that is real, that deserves attention, and that does not meet the criteria for a diagnosis. That child still benefits from support. A child can have a diagnosis and be doing remarkably well with the right tools in place. The label is not the point. The functioning is the point.
What we tell parents is this: you do not need to have figured out whether something is wrong before you come see us. That is our job. Your job was to notice that something felt off and to show up. You already did that part.
We also tell families something we mean genuinely: coming early is the right call. Our team has worked with families who waited three years because they kept hoping things would level out on their own. Sometimes they do. Often, they do not, and by the time the family arrives, there is more to address than there would have been. We are not saying that to create alarm. We are saying it because early support is almost always easier than late support, and we would rather see a family that turns out not to need intensive intervention than miss a window for a family that does.
The parents who ask if they are overreacting are, in our experience, the most tuned-in parents in the room. They are not catastrophizing. They are worried, which is different. They have been watching their child carefully enough to notice a shift, and they trusted that observation enough to act on it.
That is not overreacting. That is parenting.
If you have been sitting with this question, I want you to know: you are not being dramatic. You are being a good parent. And if you are in Arizona and looking for a place to start, we would be glad to be that place.
If you have been sitting with that question about your child, we would love to talk.
At Roya Health, your first conversation with our team is about understanding what your family is experiencing, not rushing to a label or a diagnosis. We see children and families across our Mesa, Phoenix, and Roosevelt locations, and our integrated care team works together so you are never the one carrying information between providers.
You do not have to have it all figured out before you call. That is what we are here for. Schedule a consultation at roya.health
I spent fifteen years watching the system fail the same kids. So I built something different.
By Dr. Shar Najafi-Piper, PsyD | CEO & Founder, Roya Health
She was 7 years old and had already seen 4 providers.
Her pediatrician had flagged behavioral concerns at her five-year well visit. A therapist was brought in. Then a developmental specialist. Then, a second pediatrician was consulted for a second opinion on the recurring stomach pain nobody could explain. Four providers across three different practices, none of whom had ever spoken to each other. The mother kept a three-ring binder. She brought it to every appointment and laid it open on the exam table like an offering, here, this is everything, please help us figure out what is happening to my daughter.
Maybe this sounds familiar. Your child has been seen by a pediatrician, a therapist, a specialist, and still nobody seems to have the full picture. You are the one keeping track of everything, carrying notes from one appointment to the next, repeating the same history to every new provider. You are doing everything right, and somehow the pieces still are not connecting.
That is the experience that led me to build Roya Health.
What I was watching was not a failure of individual providers. Every clinician in that child's care was competent and trying. The problem was structural. When a child has anxiety that manifests as stomachaches, the gastroenterologist treats the gut and refers to behavioral health. Behavioral health treats anxiety and refers back if symptoms persist. The pediatrician manages the middle and tries to hold the thread. Each provider does their piece. Nobody owns the whole picture. And the family, the mother with the binder, becomes the connective tissue between all of it. A role she was never trained for and never asked to take on.
This is not a rare edge case. It is how most of behavioral healthcare for children is structured in this country. Parallel tracks that run near each other but do not touch.
What happens in that gap? Kids wait. Families get exhausted. Symptoms that were manageable at seven become entrenched at twelve. The stomach pain becomes school avoidance. The anxiety becomes something harder to treat. By the time a family finds their way to integrated care, if they find it at all, there is often more to undo.
I spent years working inside systems I could not change. I adjusted my approach, pushed harder for communication across care teams, called pediatricians directly, and sent longer notes than anyone asked for. It helped at the margins. The structure remained.
Roya Health started from a simple question: what if the structure itself were different?
Not a referral network. Not a warm handoff. An actual integrated practice in which the psychologist, psychiatric provider, and medical team are in the same building, working from the same clinical picture and making decisions together. Where a parent does not have to be the one carrying information between providers who have never met.
The model we built is not complicated. It is just not how most outpatient behavioral health is set up, because building it requires solving problems that are easier to avoid. Shared documentation. Coordinated scheduling. Clinical team meetings that happen regularly and actually change care plans. Billing structures that support collaboration rather than penalize it. None of this is revolutionary. All of it takes work to maintain.
What it produces, in practice: the seven-year-old with anxiety and stomach pain sees a psychologist and a medical provider in the same visit. They leave with one plan, not two parallel ones. The mother does not need the binder, because our team already has the information.
I want to be honest about what we are still figuring out. Roya Health operates across three locations in Arizona and is growing. Growth creates the same coordination pressures we were designed to solve. The larger we get, the more intentional we have to be about not drifting back toward the fragmented model that is easier to scale. That tension is real, and I think about it often.
What I no longer think about is whether integration is worth the effort. I have seen what it changes.
The families who come to us often arrive depleted. They have been through the referral circuit. They are braced for another partial solution. The shift that happens when they realize our team has already talked, that the psychologist and the prescriber and the pediatric provider have a shared picture of their child, is not dramatic. It is quiet. A kind of relief that has been building for a long time.
That is what we built Roya for. Not the idea of integration, which is easy to put in a mission statement. The experience of it on an ordinary Tuesday for a family that has been carrying a binder for two years.
We have a long way still to go. But we know what we are building toward.
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Dr. Shar Najafi-Piper, PhD is the founder and CEO of Roya Health, an integrated behavioral health practice serving children and families in the Greater Phoenix area.
The Body Keeps Score: How Stress Shows Up Physically
What your headaches, your stomach, and your sleepless nights might actually be telling you.
You've been to the doctor. The tests came back fine. Nothing on the scan, nothing in the bloodwork worth flagging. And yet you're exhausted in a way that sleep doesn't fix. Your shoulders are up near your ears by 10 am. You've had a headache three days running, your digestion is off, and you honestly can't remember the last time you felt like yourself.
There's a reason the standard workup keeps coming back clean. The thing driving your symptoms may not show up on any of those tests, because it isn't structural. It's stress, and stress has a way of settling into the body so thoroughly that it starts to look like something else.
What stress actually does to your body
When the brain registers a threat, a difficult conversation, a financial worry, a relationship that feels unstable, or a job that never quite lets you clock out, it triggers a chain of physiological responses built for short-term emergencies.
Cortisol and adrenaline move through the system. Heart rate climbs. Digestion slows. Muscles tighten. Immune function pulls back. The body is doing exactly what it was designed to do when the threat is immediate, physical, and requires you to move fast.
The trouble is that most stress today doesn't resolve in three minutes. It doesn't resolve at dinner, or at bedtime, or the next morning. When the nervous system stays in that state for weeks or months, what was built as an emergency response starts producing wear in places you weren't expecting.
Where stress tends to land
Chronic headaches and migraines. Sustained tension in the neck, jaw, and shoulders is one of the most common physical responses to ongoing stress. That tension affects the muscles around the skull and base of the neck. A significant portion of people who deal with frequent headaches have never had a conversation about whether stress management might do more for them than another prescription.
Digestive problems. The gut and the brain communicate constantly, through nerves, hormones, and an immune system that runs partly through the digestive tract. Chronic stress disrupts that communication. Digestion slows or becomes erratic. Inflammation increases. The result often looks clinically identical to IBS, acid reflux, or general GI distress, which is part of why it so frequently gets treated as a purely digestive problem.
Sleep disruption. Cortisol follows a daily rhythm: higher in the morning and lower by evening, which helps the body wind down and rest. Chronic stress disrupts that rhythm. People lie awake at night running through conversations, unable to slow their thinking even when they're genuinely tired. Over time, poor sleep adds its own physiological load on top of everything else.
Immune suppression. People under sustained psychological stress get sick more often and take longer to recover. The same immune downregulation that makes sense during an acute physical threat becomes a liability when the stressor is ongoing and unresolved. Frequent illness, slow healing, and flare-ups of previously managed conditions are all worth paying attention to in this context.
Skin conditions. Eczema, psoriasis, acne, and hives all have documented ties to psychological stress. Cortisol drives systemic inflammation, and skin conditions are often inflammation made visible. Many dermatologists now routinely ask about stress and sleep, not as a soft add-on, but because the relationship between psychological state and skin is well established in the literature.
Chest tightness and breathing changes. Anxiety can produce symptoms that closely resemble cardiac events, such as a racing heart, chest pressure, shortness of breath, and a sense of something being wrong that you can't quite locate. It's one of the most frightening ways stress shows up physically, and one of the most commonly misdiagnosed.
Why treating each symptom separately doesn't get you there
A common sequence: someone comes in with chronic headaches. They get a neurology referral. They try a few medications. Some help, some don't. Nobody asks how they're sleeping, whether they've been having panic attacks, or what their stress level has looked like for the past year.
Or someone presents with GI issues. They get scoped, tested, and prescribed. Symptoms ease, return, ease again. The anxiety driving the whole picture goes unaddressed because it never made it into the conversation.
This is what happens when care is organized around symptoms rather than people. Not because individual physicians aren't skilled, most are, but because the structure of most healthcare doesn't build in time or incentive to look at how everything connects. You come in with a problem, the problem gets a code, the code gets a treatment. What's happening in the rest of your life is, at best, background.
The body doesn't organize itself that way. Psychological distress produces physical symptoms, and physical illness creates psychological distress, and the two reinforce each other in ways that don't respect departmental boundaries.
How we approach this at Roya Health
We built our practice around the idea that a therapy team and a primary care team working in separate directions, even toward the same patient, are missing something important.
When someone comes to us carrying anxiety, we're asking about sleep, digestion, pain, and energy. When someone presents with physical complaints that haven't responded to standard treatment, we're asking about stress, relationships, what their days actually feel like, and whether anything significant has happened in the past year or two. Our therapists, psychiatric providers, and primary care team work from a shared picture of the patient, not parallel charts that are occasionally faxed back and forth.
For a lot of the people we see, this is genuinely new. Not the individual care, they've often had good individual providers, but the experience of having someone look at the full picture and say, “These things you've been treating separately are connected.” Here's how we're going to address them together.
If your body has been trying to tell you something
Mental health and physical health have always been part of the same system. The separation between them is a function of how medicine is organized administratively, not of how the body actually operates.
Chronic symptoms that keep coming back without a clear physical explanation are worth taking seriously, not with alarm, but as information. Your body is not malfunctioning. It may be responding, quite accurately, to something that hasn't been fully addressed yet.
You don't have to keep managing each piece in isolation.
Roya Health offers integrated behavioral health and primary care services in Mesa, Arizona, and via telehealth across the state. If you've been dealing with symptoms that feel connected to stress or anxiety, or if you're not sure where to start, we're here.