SUMMARY

• More than 16 years of experience managing health and human services programs. This includes specific experience as Director at the Confidential Human Resources Administration ( Confidential )/Division of Social Services ( Confidential ) Family Independence Administration, (managing over 9,000 individual and family cases on Public Assistance, including Medicaid, TANF and SNAP/Food Stamps), Assistant State Director for the Georgia Confidential, and former Administrator for VR, confidential, Washington DC.
• Provided oversight for the administration of eligibility systems, eligibility determination and case management processes of TANF, Cash Assistance, Medicaid, CHIP, Housing Assistance, Homelessness Prevention, Job Placement, Temporary Work Experience, Training and Education, Workforce Development, and coordination of Separate Medicaid and Separate Food Stamps Determination. Coordinated with other departments on Social Security Application and denial appeals, Child Support Services, Home Energy Assistance, Domestic Violence Support Services, Adult Protective Services and HIV /AIDS Services Administration.
• Experience background in multiple business - driven, transformational initiatives within state governments and federal funded programs across the country. Played support and advisory role in the development and implementation of state eligibility system integration and modernization projects, focusing on project management, business analysis, quality assurance, process improvement and change management, leveraging industry best practices.
• Knowledge of the Affordable Care Act (ACA), Medicaid waivers, CHIP, MECT, CMS certification requirements, and state eligibility regulations.
• Experience applying consulting skills in the analysis and resolution of business policy and procedural issues and conducting impact analysis on current and proposed programs.
• Formerly worked as a Case Manager, Vocational Rehabilitation Counselor, with several years experience in direct client service, managing client caseload, providing effective case management.
• Supervised and managed professional team of supervisors and managers.

PROFESSIONAL EXPERIENCE

Confidential

Consultant / Subject Matter Expert (SME)/Senior Business Analyst

• Participate in project start up activities including meetings with Project Sponsor, Business Owners, State Team, and other Vendors
• Support system development, document business case, business requirements analysis, project scope, trend analysis, current and future state, business workflows, functional and system requirements.
• Provide content contribution to Deliverable Expectation Document (DED), Status Evaluation and Assessment reports.
• Analyze documents and reports, prepare findings of report, collate information into meaningful reports.
• Monitor project process, milestones, project timeline, deliverables, and assist with project management tasks such as tracking and reporting project progress, maintaining project document repository, uploading documents on SharePoint, reviewing documents for quality assurance and quality control.
• Review and analyze reports, prepared findings and recommendations based on those findings.
• Provided subject matter expert information on policies and regulations applicable to the projects, in addition to providing team with up to date relevant information, guides, policy information, etc.
• Provided meaningful contributions to the preparation of deliverables report, identifying and prioritizing risks, highlighting deficiency, providing recommendations and recognizing adequate progress areas
• Identify CMS Checklists, MECT activities, artifacts, requirements definition, requirements traceability matrix, as relate to project
• Provided subject matter expert information on policies and regulations applicable to the projects, in addition to providing team with up to date relevant information, guides, policy information, etc.
• Participated in the preparation and presentation of Monthly Status and Deliverables reports.
• Created several templates for project activities.
• Record and prepare minutes of project and status work group meetings.
• Participated in writing two award winning proposals, and in conducting red team reviews.
• Attend and participate in procurement, and status work group meetings.
• Attended project meetings to maintain high-level awareness of project status and trends.

Confidential

Consultant

• Participated in multi-organizational, multidisciplinary teams to determine, articulate, and document workflows, functional business, implementation, and performance requirements for the modernization of eligibility business process.
• Familiarity with Federal and State policies, laws and regulations that impacts human service programs.
• Experienced in analyzing Business Requirements Documents (BRD), Functional Requirement Documents (FRD), Requirements Gathering techniques to verify and validate business and system needs, performing GAP Analysis, identifying risks, performing Risk Analysis, Feasibility and Impact analysis, and preparing Requirements Traceability Matrix.
• Provide IV&V Team Support. Conduct independent testing, review requirements and quality. Test different fields for adaptability and accuracy, test user cases. Follow established testing protocols, document test results and maintaining record of results. Submit reports of findings, ensure timely corrective actions, monitor change requests and change management process.
• Evaluate user requests for systems modifications or enhancements, determining the feasibility and compatibility with existing system functionality.
• Participate in the development of test cases, creation of test data, execution of test cases, and analysis of test results.
• Identify gaps, risks, and critical areas for testing, support quality assurance (QA) deliverable review process, and ensure applicable testing standards are used.
• Maintain knowledge of FNS policies and CMS Standards and Conditions.
• Participate in preparation of CMS quarterly report.
• Support efforts to define system, reporting, and component requirements for new systems that adheres to the State's future enterprise vision and incorporates ongoing State initiatives (i.e. HIE/HIT, Affordable Care Act (ACA)- Health Care Reform), Medicaid IT Architecture (MITA), and Medicaid Enterprise Technical Certification (MECT).
• Participate in Request for Proposal (RFP), state of need (son), and Request for Information (RFI) activities including research, proposal writing, evaluating RFP/RFQ/RFIs, and red team review.
• Experience in change management including strategic planning, business process analysis and redesign, program planning and implementation, and incorporation of automation to increase operational efficiencies in modernization efforts
• Experience applying consulting skills in the analysis and resolution of business policy and procedural issues
• Demonstrated ability to consistently meet customers’ needs; adapt quickly to new environments and learn new technology and business areas.
• Served on Implementation Change Management and Organizational Change Management Communities of Practice.
• Participated in meetings to maintain a high-level awareness of status, issues and risk trends in addition to presenting programmatic reports and feedback.

Confidential

Project Team Lead

• Led process improvement for customer system development and process streamlining across regions by conducting statewide interviews with regional directors and regional office staff
• Observed eligibility functions and operational processes in local offices to evaluate and assess issues related to organizational processes and work functions.
• Reviewed operations and established processes to assess work flows and recommend adjustments in staffing patterns, work process, and structures as needed
• Assessed and documented operational and budgetary impact of newly deployed system. Assessed and documented staff operational readiness for implementation of new system upgrade release
• Developed metrics that provided data for process management and indicators for future improvement, measuring performance against process requirements, identifying inadequacies and corrective action plans, analyzing quality data to detect unsatisfactory trends or weaknesses, summarizing results, and preparing data and reports depicting pertinent relationships.
• Led teams through assessments, analysis, benchmarking, documentation of current business processes, gap, development of infrastructure, and making presentations and recommendations for improvement initiatives to senior management
• Attend high level meetings facilitating exchange of information and ideas and discussing project updates.
• Developed and executed approved projects and identified cross functional requirements for accounting, contract management, resource management, and time tracking
• Submitted report of findings including recommendation for initiatives and actions plans for process improvement

Confidential

Assistant State Director / Director of Special Projects

• Co-directed and managed Georgia Confidential through the coordinated efforts of a State Director, Regional Directors, and a service delivery system comprised of more 800 state employees, community rehabilitation providers and contractors, and a budget of more than $90 million annually
• Provided oversight for the budget and contracts process, including performance and regulatory monitoring of community rehabilitation providers, vocational skills training providers, training and job placement providers, Career Centers, Workforce Development Vendors, and other agency vendors
• Provided oversight for workforce development, Ticket to Work, SS Programs. Increased SS reimbursement and recovery rate
• Co-directed the management of fiscal and operation budgets while allocating resources effectively and efficiently to various locations.
• Served as State Liaison for confidential, conducted programmatic visits and assisted with grant writing and grant renewal efforts.
• Demonstrated knowledge of the Social Security Act, and associated Title Grants, Rehabilitation Act, ADA- Americans with Disabilities Act, Public Law, Randolph Sheppard Vending Act, The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 confidential etc.
• Conducted strategic planning and established program objectives to meet the organization’s mission to people with disabilities. Developed plans to address for greater compliance, analyzed proposed policies, procedures and reports to identify service gaps and measure program and service effectiveness
• Administered contracts, grants, and other agreements according to policy standards, State, and Federal government guidelines
• Maintained knowledge of applicable federal and state disability, education and rehabilitation laws, rules, and regulations
• Analyzed performance data and led performance indicator discussions.
• Developed and sustained effective working relationships with internal and external organizations and state departments to promote rehabilitation programs and services
• Served on inter-agency committees and councils designed to effectively plan and deliver services to people with disabilities in a seamless fashion across the agency
• Assisted in the completion of annual and quarterly reports to the State Rehabilitation Council, the Commissioner of Labor, and the Federal Rehabilitation Services Administration
• Determined staffing needs and requirements, monitored interviewing and hiring procedures, and ensured training for all new employees to gain knowledge of governmental policies and practices according to their newly obtained roles. Compiled staff names for CSPD.
• Managed the client assistance and internal advocacy program designed to act on behalf of clients and resolve complaints and compliance issues
• Interfaced with governmental and other grantor agencies to expand business opportunities through various retail operations for the Business Enterprise Program
• Implemented different performance-based grants. Monitored vendor performance, reports and records

Confidential

Family Independence Administration

• Directed a staff of over 146, managed a public assistance case load of over 9,000 family and single individual cases, and supervise deputy directors and other supervisory level staff. Successfully managed the operations of Public Assistance/Welfare Centers responsible for providing public assistance services: eligibility determination, recertification and case management processes for: Medicaid, TANF/SNA, SNAP/Food Stamps, Cash Assistance, EBT, childcare, training, job placement, and back-to-work programs. Maintained knowledge of applicable Federal and State policies, laws, and regulations that impact public assistance eligibility programs
• Provided operational oversight for completion of Separate Medicaid/Separate Food Stamps Determination, Same Day Issuances, Home Energy Assistance, Housing Assistance, and referrals for WIC Program, Child Support, Adult Protective Services, and HIV/AIDS Services
• Directed and implemented Federal Welfare Reform initiatives. Provided leadership and oversight for eligibility determination, benefits awards, audits and sanctions, case management, redetermination, EBT issuance, work flow process, and operational management of Public Assistance /Job Center
• Maintained excellent eligibility determination process, timeliness, and error in benefits issuance records.
• Excellent operational records of fraud and abuse prevention and detection by focusing on increasing data analysis capability as well as using claims data to better identify fraud and abuse by effecting front end review and early detection to prevent inappropriate and fraudulent enrollments in public assistance programs.
• Collaborated with other departments that provided range of investigative practices and techniques that prevented welfare fraud through the intense use of data matches and data analytics to support verifications and investigative fieldwork
• Promoted staff training to ensure public health insurance coverage to "categorically needy" individuals, created awareness of Medicaid TPL, Medicaid Excess Income, Separate Medicaid Determination, Medicaid PA bundle, long-term care, etc. while aligning with agency and State goals to maximize federal payments and improve coordination of care.
• Incentivized staff to conduct careful eligibility assessment and verification of income and assets compared to the appropriate Medicaid and Food Stamps threshold, according to the applicant’s eligibility category and household size, and income within Federal poverty level
• Ensured accurate data entry in addition to prompt referral of clients as appropriate to other Medicaid administration departments including Medical Insurance and Community Services Administration for Medical Assistance Program eligibility determination for Medicaid and Family Health Plus and Home Care Services Program
• Improved program integrity by monitoring and reporting on the provision of flexibility, security, and automation to allow staff to manage and act upon verification results in a timely manner and increase the recovery of liabilities and claims
• Provided administrative, and discretionary resolution of client issues and complaints, assuring effective customer service process.
• Served as Paperless Office Systems (POS) and Model Job Centers Strategic Implementation Steering Committee member for development of modernized eligibility case management system and enhanced Public Assistance Center operations.
• Worked with contractual vendors in coordinating evaluation, assessments, verifications, training, medical services, child care services, job placement and job retention.