Position Desired: Director of Community Health & Wellness Location Desired: Atlanta, GA Area of Expertise: Administration-Management
Compensation Desired: Salary Travel Desired: Some Travel
Diligent and driven supervisor who has achieved success in a variety of roles with increasing levels of responsibility. An extensive background in Government Healthcare Programs. Proven ability to implement corporate policy, train new employees on government programs, and negotiate contracts for multiple jurisdictions. CORE COMPETENECIES • CMS Grant ACA • Social Services Revenue Cycles Management • Outreach Leadership
PROFESIONAL EXPERIENCE KALEIDA HEALTH SYSTEMS, Buffalo, NY 2013 to 2015 SUPERVISOR FACILITATED ENROLLMENT Managed the CMS grant project for school-based, community outreach and enrollment activities. Assured project implementation, administration, data collection, evaluation, budgeting and communication to stakeholders. Established a centralized referral process to capture uninsured children in Buffalo’s inner city. Assistant Project Director • Set-up schedule of outreach activities in coordination with public schools and community partners. • Developed staff policies and procedures in compliance with CMS grant regulations. • Drafted and prepared semi-annul and final grant reports to stakeholders • Audited staff performance to assure goal attainment New York State Navigator • Resolved consumer enrollment barriers within the New York State of Health Benefit Exchange through communications with HANYS and NYS Marketplace Integration. • Supervised a team of 17 Navigators/CACs. • Trained new-hire staff to conduct business in the New York State Marketplace. • Maintained up-to-date knowledge applicable to changes with state and federal laws and regulation.
MED ASSIST, Amherst, NY 2008-2011 PROJECT MANAGER /ELIGIBILITY Versed in contract negotiations with hospital patient finance, administrative staff and physicians. Assisted the Vice President of Marketing in securing new client contracts and managing existing contracts. Managed the oversight of work plan functions, due dates, and budgets. • Oversaw operations for 11 hospitals in Western, New York. • Designed all aspects of new project initiatives focused on self-pay outcomes. • Developed work- flow process and coordinated quality assurance standards by studying each client’s requirements. • Reviewed program needs and recruited qualified staff. • Managed 11 patient account representatives in determining Medicaid eligibility, charity care, insurance verification, billing and collections. • Evaluated program performance against expectations • Improved communication efficiency as primary liaison between departments, clients and vendors. • Maintained compliance with company and legal requirements • Managed operations in accordance with budget requirements. • Completed quarterly and yearly audits. • Reviewed and approved billing invoices and expense reports.
Regional Medical Center, Memphis, TN 2006-2008 SUPERVISOR, ELIGIBILITY Developed the scope and goal for self-pay outcomes through revenue cycles management., trained and managed seven (7) patient account representatives to ,identify self-pay patients and screen those patients for state, county and/or Federal eligibility assistance programs.
• Improved communication efficiency as primary liaison between departments, clients, vendors’ social services. • Maintained compliance with company and legal requirements. • Versed in all aspects of eligibility projects from concept development to execution and launch. • Established the departments policies and procedures • Reviewed program needs and recruited qualified staff. • Managed processes for determining Medicaid eligibility, charity care, insurance verification, billing and collections. • To increase staff knowledge and skills, provided continuing education opportunities for Medicaid programs in Tennessee, Arkansas, Missouri, Mississippi and Social Security Disability. • Maintained positive relationships with government regulators, health care providers, patients and families.
Fidelis Care, Amherst, New York 2001-2006 LEAD MARKETING REPRESENTATIVE Through a combination of relationship building, event coordination, and community relations actives, supervised a team of 17 facilitated enrollers. Demonstrated a high level of expertise with federal and state health insurance regulations, increased new membership into managed care by 87% annually. • Resolved enrollment barriers by meeting weekly with the enrollment team to track changes in policies and effectively communicated findings to the staff. • Fostered strong partnerships with health care providers and community associations. • Prepared and presented productivity reports to the Regional Marketing Director. • Liaison with the Erie County Department of Social Services, responsible for all face-to-face interviews with caseworkers.
EDUCATION Associate Degree in Liberal Arts in Science- Erie Community College, Williamsville, New York