Talented Program Manager bringing 19-year record of success in spearheading programming development and day-to-day management. Performance-oriented, driven and creative with good program pitching and organizational skills. Diplomatic in resolving conflicts and building consensus between operational areas. Customer-oriented Program Manager with over 19 years of experience in strategic planning and complex problem-solving. Expert in networking, marketing, cross-functional communication, employee supervision and process improvements. Decisive leader ready to leverage background in program management to expand organizational success.
· Monitor and track staff performance
· Provide training to staff on policy interpretation, technical skills and employee development to meet mandated requirements
· Interface with both staff and customers to resolve complex problems
· Troubleshoot various customer and system issues
Prepare and implements internal operating policies and procedures pertaining to the unit
· Review QC error reports: SNAP, Medicaid, IV-E and TANF case reviews,
· Monitor error trends to focus on training needs by utilizing the Rushmore program
· Monitor caseload reports: NDNH Matches, PARIS Matches, Applications, Renewals, Claims etc.
· Collaborate with the Supervisor and Senior Workers to establish cohesive business processes and consistency with training methods
Work jointly with program Consultants during Sub-Recipient Case Monitoring to resolve any errors discovered
· Prepare and review appeal summaries
· Collect and prepare all necessary information to support the agency's action
· Directly speak with outside attorneys, appeal officers, Facility Administrators, Funeral Directors, various employers etc.
· Collaborate with program Consultants and The Commonwealth Attorney to achieve a desired outcome
Represent the Agency during the hearings
· Screen applications for KSAs to select potential interviewees; Schedule interview appointments
· Develop appropriate interview questions and interview selected candidates
· Establishes program goals and objectives
· Manage personnel related issues within the unit
· Apply the Standards of Conduct if appropriate
Complete annual Performance Evaluations for each unit member
· Process AG applications timely; update VaCMS, MMIS, and AgTRACK; complete case actions; and send Notices to clients
· Make changes based on annual updates for AG Rates and the Personal Needs Allowance
· Take action on all reported changes within required timeframes
Determine on-going eligibility by completing an annual review
Monitor Program Compliance:
· Record Review Findings in Rushmore system for all Benefit Programs for each worker as each case is read, use results for performance evaluations.
Review QC error reports.
Monitor MedPend reports, Medicaid Statistical Reports, Adapt pend reports, Data Warehouse Reports.
Process and Maintain the AG applications:
· Process 97% of all AG applications timely, update Medpend and MMIS system, complete case actions as necessary and complete the NOA.
Complete an annual review of continued eligibility for each on-going case timely.
Manage Caseload distribution:
Compile statistical data for each caseload monthly using various system reports; Data Warehouse, ADAPT, SNAP APPTRAK, VaCMS
Manage Quality Customer Service:
· Receive client complaints and investigate situation, respond to disgruntled clients, ensure that all workers are treating clients with dignity and respect. Provide guidance to workers on difficult cases.
Handle all Benefit Program appeals.
Manage new and on0going training of my staff:
· Monitor training of new workers by reading their case records and assigning them to a veteran worker as a mentor.
Meet with mentor to obtain daily/weekly updates on the progression of the trainee.
Oversee the Fraud Investigator:
· Validate each referral prior to sending it on for investigation.
· Discuss each case with Fraud Investigator if intent to defraud is debatable.
Answer policy questions and provide guidance for Fraud Investigator.
Maintain Match Reports:
· Review Interstate Match report quarterly to identify possible duplication of benefits in multiple states at the same time.
· Make appropriate fraud referral.
Complete the Benefit Impact Statement based on the results of each investigation.
Monitor staff performance:
· Complete Semi-annual and/or annual performance evaluations for staff.
· Use Rushmore readings, QC findings, founded client complaints etc…
Recognize the ability/willingness to over achieve and/or assist others.
Assist with development and implementation of business processes when changes are needed in the daily function of the agency. Reassignment of staff responsibilities.
· Access reports in VaCMS and Data Warehouse (daily, weekly and/or monthly) to monitor deadlines along with various discrepancy reports needed to properly manage workload assigned.
· Process 97% of regular SNAP applications according to program guidance - within 30- days of receipt; expedited SNAP within 7-days of receipt; Medicaid within 45-days.
· Process all SNAP & Medicaid applications with 100% payment/enrollment accuracy (VaCMS and MMIS).
· Explain programs Rights and Responsibilities to ALL applicants to include signing the Rights & Responsibilities form for SNAP; per policy guidance.
· Process 95% of SNAP and Medicaid recertification/renewals within the month they are due.
· Process all SNAP & Medicaid recertification/renewals with 100% payment/enrollment accuracy (VaCMS and MMIS).
Process 95% of SNAP Interim Reports by the end of the month in which they are due per policy guidance.
Monitor all cases for changes and implement 95% of those reported within the month they are due/discovered.
Identify and report all possible fraudulent situation.
Calculate overpayments/underpayments both Fraud and non-fraud while working with the Fraud Investigator to compile all relevant information to substantiate the claim.
· Document ALL cases (manual and electronic) in a manner that the actions taken are legible and clearly explained.
· For LTC cases: enter Patient Pay into VaCMS (checking the bridge of information into MMIS) with 95% accuracy.
I am very proactive and invested in my career. Over the years I have attend every training and seminar made available (that worked with my schedule) to strengthen my knowledge, skills and abilities. As I've developed my skills I've been selected by management to serve as a Program Ambassador and Program Mentor as new programs, systems or trainees were being introduced to my unit. I firmly believe that we never stop learning - so we must always be looking for ways to better ourselves. I also believe that it is our duty to invest in the growth of our co-workers; especially while working in a team environment. I work best under a strong and cohesive culture. So I believe that sharing and giving are both fundamental elements needed to achieve this.
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