Project Manager versed in all aspects of project and personnel management. Results-oriented and high-energy professional with talent for leading by example and inspiring peak performance. Dedicated to fostering strong effective team relationships.
Skills
Project management
Project coordination
Project development and lifecycle
Problem solving
Business process development
Systems implementation
Schedule management
Client rapport
Productivity improvement
Data analysis
Experience
State of Missouri, 05/1998 to Current Rutgers University – New Brunswick, NJ,
Utilize the industry standard for project management processes as identified in the Project Management Body of Knowledge (PMBOK® Guide).
Manage the MO HealthNet Division (MHD)'s project to upgrade the IBM FileNet-based content management environment to the latest release version of the IBM FileNet P8 Platform 5.5.
Use project management methods of Waterfall and modified-Waterfall incorporating some Agile features such as detailing the schedule in waves and iterative releases.
Liaison to the Medicaid Eligibility Determination and Enrollment System (MEDES) project lead by sister agency and who's determinations directly impact the Medicaid Management information System (MMIS) administered by MHD.
Ensure contractor compliance with contract requirements and deliverables to adhered to the project scope and schedule.
Provide regular project status updates to executive leadership and project team members communicating via email, telephone, WebEx or face-to-face meetings.
Inform executive leadership of key risks and issues and assist with mitigation discussions, decision-making and resolution of the issues.
Create and modify various project management plans and other artifacts to better align with organizational objectives.
Review, approve and monitor contractor's Work Breakdown Structure to ensure the schedule was maintained. Provide guidance on mitigation strategies to bring the schedule back in line when delays occur.
Facilitate project meetings with stakeholders from MHD, Family Support Division (FSD), Information and Technology Services Division (ITSD) and contractor staff.
Communicate system issues to contractors and project leadership to determine impacts to the Medicaid Management Information System (MMIS).
Work with stakeholders and subject matter experts need on the project team to gain their support and engagement in the project as appropriate. Maintain effective working relationships with all project team members and stakeholders even in challanging circumstances.
Participate and/or oversee requirements gathering, design, testing, and implementation new large and small scale system functionality improvement projects.
Research system issues and improvements to increase productivity and system functionality.
Update MHD staff on the progress of system fixes, release information and the development of new functionality that will impact job responsibilities.
Mentor project coordinators and other staff members in learning and understanding project management techniques. Train coworkers in certain system functions and business processes so they can be an effective in their responsibilities.
Maintain an understanding of guidance from Centers for Medicare and Medicaid Services (CMS), federal and state laws and regulations relating to healthcare initiatives.
Coordinate the unwind of system changes made to accommodate federal mandates implemented during the COVID-19 pandemic and the resulting Public Health Emergency (PHE).
Supervised 3 staff members for a short time while researching system issues that occurred in multiple systems feeding the MMIS. Resulting in improvements to system functionality which increased productivity of other units in the agency.
Creating a new flexible benefit package with input from policy stakeholders that can be easily maintained and will meet the needs of our participants and providers.
Program Development Specialist, 01/2007 to 09/2016 MO HealthNet – City, STATE,
Work with agency management, executive leadership and contract staff in planning, evaluating and implementing MO HealthNet program changes.
Perform data analysis to provide fiscal impact/savings for changes to system functionality and ongoing tracking usage of certain program initiatives.
Mentor, assist and supervise work performed by subordinate staff to educate and ensure work is accurate and complete.
Communicate with staff at the CMS, other state Medicaid agencies, Missouri Hospital Association, State Legislators, provider offices and hospital facility staff regarding the policy and procedures of the Medicaid program in Missouri.
Evaluate and update system edits in the MMIS to align with program policy.
Maintain working knowledge of Federal & State laws, regulations & procedures of the Medicaid program.
Interpret information provided in Federal & State regulations for intent, meaning & effect on new & existing programs.
Explain policies & regulations to coworkers, other state agencies &
contractors.
Review and update state plans, regulations and MO HealthNet provider manuals.
Oversee implementation of system changes stated in State Plans, State and Federal Regulations and State Statutes.
Identify and report the need for administrative actions against providers billing MO HealthNet for Medicaid covered services inappropriately.
Chosen to move to a new project office as the sole representative and coordinator from the MO HealthNet Division on the Medicaid Eligibility Determination and Enrollment (MEDES).
Coordinated and assisted in the design of functionality MEDES.
Attended meetings and acted as a subject matter expert identifying impacts to the MMIS.
Provide updates to state agency leadership and contractors on issues encountered and progress made on the MEDES project as appropriate.
Performed downstream validation of testing performed by the MEDES project test team to look for impacts to the ITSD and MMIS systems as well as other downstream vendors receiving information from the MMIS.
Correspondence and Information Specialist, 04/2000 to 09/2006 MO HealthNet – City, STATE,
Assist MO HealthNet providers interpret and understand the complex MO HealthNet policies and procedures, including eligibility issues, in order to resolve difficult and sensitive complaints and inquiries.
Assist MO HealthNet providers in billing procedures and, when necessary, forward information regarding program abuse and misutilization to the Missouri Medicaid Audit and Compliance Division (MMAC) for administrative actions against providers.
Participate in meetings with professional staff and help identify and correct errors in the claims processing system as well as provide technical assistance to our Medicaid Unit Supervisor.
Study new and revised Medicaid procedures, rules, regulations, program changes and manual updates/modifications.
Assist in training new unit staff including being a mentor.
Medicaid Technician, 05/1998 to 04/2000 MO HealthNet – City, STATE,
Correspond and communicate with MO HealthNet providers in order to interpret and explain the complex MO HealthNet policies and procedures, including eligibility issues, in order to resolve difficult and sensitive complaints and inquiries.
Assist MO HealthNet providers in billing procedures and, when necessary, forward information regarding program abuse and misutilization to the Missouri Medicaid Audit and Compliance Division
for administrative actions against providers.
Participate in meetings with professional staff and help identify and correct errors in the claims processing system as well as provide technical assistance to our Medicaid Unit Supervisor.
Study new and revised Medicaid procedures, rules, regulations, program changes and manual updates/modifications.
Assist in training new unit staff including being a mentor.
Education and Training
Associate of Applied Science: Medical Office Occupations, Expected in 05/1994 State Technical College - Linn, MO, GPA:
4.0 GPA all four semesters
Phi Theta Kappa Member
Dean's List Honoree May 1994
: , Expected in Rolla Technical Institute - Rolla, MO GPA:
: HCPro's Certified Coder Boot Camp - Inpatient , Expected in Medicaid Integrity Institute - Columbia, SC, GPA:
Certifications
Project Management Professional (PMP) certification from the Project Management Institute - Sept 2019
Resumes, and other information uploaded or provided by the user, are considered User Content governed by our Terms & Conditions. As such, it is not owned by us, and it is the user who retains ownership over such content.
How this resume score could be improved?
Many factors go into creating a strong resume. Here are a few tweaks that could improve the score of this resume:
