Summary

• Providing skilled project management, revenue cycle and operational management services
• Fostering communication and cooperation between various functional areas and organizations
• Working as the liaison between individuals in Federal, State, and local regulatory agencies
• Expertise includes patient advocacy and case management services, patient assistance, education and adherence programs, reimbursement education and electronic medical records methodologies, project management, knowledge of state and federal programs targeted to assist under or uninsured patients, medical record review and knowledge of medical terminology and pharmacology to interpret various illnesses.

CONSULTING/INTERIM MANAGEMENT

Confidential

Implementation Project Manager

• Manage projects and lead project teams that support these services and activities and helping physician practices achieve Meaningful Use and PQRS
• Ensure successful completion of client implementations requests and related projects for the products and services that have been sold
• Educate and train clients on Allscripts Analytic Platform as well as other implemented components delivered
• Manage and provide leadership to the team engaged in the implementation process, as well as the re-assessment of previous implementations for improvement opportunities
• Facilitate kickoff meetings, host conference calls, track project status, identifying risks and escalate issues delays as appropriate Responsible for the overall transparency of project deliverables through the life cycle phases from development to delivery.
• Demonstrate ability to provide functional direction, technical expertise and leadership to team to ensure accuracy, efficiency and customer satisfaction Works across functional teams to ensure plans are sound with respect to scheduling, customer needs and company standards.
• Ensures that the project scope is clearly defined and documented at the onset of the project. Ensures the use of appropriate processes and standards throughout the development lifecycle. Demonstrate ability to provide functional direction, technical expertise and leadership to team to ensure accuracy, efficiency and customer satisfaction
• Develop/maintain implementation process documentation, incorporating project management methodology and provide internal/external training and coaching Manages project risks through the prioritization, planning, up to delivery. Seeks to understand the client's business and the hand-offs needed between the development systems, quality assurance and product teams, to deliver on the client's needs. Liaise across teams to resolve issues about enhancements and fixes. Keeps team appraised via project plans, meetings and discussion minutes of project tasks identified, tasks to be completed, and work not completed.
• Alerts stakeholders to potential scheduling risks, anticipates slippage and takes pre-emptive action.

Confidential

EHR Business Analyst/Meaningful Use Project Manager

• Work with providers to assess needs and drivers for EHR adoption
• Gather and develop business requirements for PM/EHR solutions that meet similar type of provider needs
• Work with vendor s to enhance PM/EHR product to make it easier for providers to do business electronically
• Assist vendor with implementation to better understand product and use by providers
• Assist in the creation and provide direct project management support of services for physicians, hospitals, and other providers to assist them in the implementation and use of electronic health records to improve care
• Assist eligible providers in registering and attesting for the EHR Incentive Program
• Manage projects and lead project teams that support these services and activities and helping physician practices achieve Meaningful Use and implementing EHR systems
• Deliver presentations and trainings on the CMS EHR Incentive programs
• Assist facilities in understanding and implementing Meaningful Use initiatives EHR systems and interface directly with coordinators, clinical area consultants, site managers, account managers, senior management and Federal State regulatory bodies via presentations or webinars
• Maintain ongoing communication with state agencies to determine state specific requirements for health information exchange HIE and Medicaid Incentive Program
• Assist facilities in the use of tools needed for reporting of Meaningful Use, including clinical quality measures, performance measures and reporting the information as required to Federal and/or State bodies
• Assist in the development of the Division of Physician and Community Services' balanced scorecard, goals, objectives, and measures

Confidential

MMIS Eligibility Business Analyst

• Gather, define and document business requirements
• Facilitate meeting discussions between business users, business analysts and technical analysts
• Document organizational policies and procedures in the context of system requirements
• Work with technical staff and business users to problem-solve and identify workable solutions
• Develop workflows that demonstrate current and proposed business requirements
• Prioritize the individual work load that involves multiple project assignments and deadlines
• Work with team leads, technical staff and key users to identify, track and manage project issues as they arise
• Answer questions and inquiries about system functionality.
• Provide user support, including training, help and instructions.

Confidential

Implementation Consultant/Project Coordinator

• Effectively educate and provide onsite- training sessions and support to all office staff and clinicians who will be end users of the Enterprise EHR system and Dragon Medical
• Exercise independent judgment to organize and plan Client sessions to ensure each session is tailored to the individual client need in respect to their specific practice workflow and procedures
• Assist, monitor, and document progress of designated practices progression through the required milestones of EHR implementation
• Assist practices in developing project plans, timelines and achieving required milestones.
• Contribute suggestions and/or preliminary drafts for new and/or improving existing training tools/documentation
• Perform clinical workflow process analysis/gap analysis and documents results using Microsoft Visio
• Maintain an understanding of business process management and business requirements of clients to better understand customer needs, while identifying, analyzing, and solving problems as they arise.
• Collect, gather, and organize clinical requirements from client for a deep understanding of client's needs so that they can be transformed into application and operational requirements.
• Attend client and internal meetings, as requested, to provide subject matter expertise on the software and/or ancillary applications.
• Provide recommendations/suggestions for product enhancements based on expertise utilizing software and real-world experience working with Allscripts client base
• Provide recommendations/consultation to management on areas for departmental or implementation process improvements
• Sustain detailed product knowledge for existing versions and new versions of Allscripts software
• Report and document results in Salesforce and to EHR Project Manager

Confidential

Healthcare Outreach Manager

• Train and educate Medicare members, Providers, and Health Associations on an electronic personal healthcare record in rural and urban areas of South Carolina
• Organize and conduct workshops
• Facilitate meetings with State Health Associations
• Maintain frequent contacts with Providers and Associations
• Call on physicians, hospital/skilled nursing facilities' management, discharge planners, senior centers, councils on aging centers throughout South Carolina to promote the use of an electronic personal health record.
• Maintain updated knowledge of Centers of Medicare and Medicaid Services policies and procedures

Confidential

Eligibility Project Implementation Manager

• Implement process workflow to establish a blue print for change and essential success for reducing self-
• pay AR days
• Reduce AR days from 45 days to 10 days by assisting our client with qualifying uninsured and
• underinsured patients for third-party funding
• Analysis of self-pay patients for SSI, SSDI, Medicaid, and other third-party funding
• Perform all necessary steps to secure funding
• Industry-leading reporting abilities to track dollars, pending status and charity
• Maximize receipt of third-party funds for uninsured and underinsured patients streamlines claim
• submission to the correct carrier, improves patient satisfaction
• Supervise on site to ensure proper coverage, adherence to standard operating procedure, and productivity
• Lead, mentor and train super users and maintain a high level competency and application of operational quality improvement projects
• Develop and follow the project timelines such as plan, define, and determine resources required to achieve realistic deadlines defined in the work plan
• Act as primary external with client and internal within the organization contact for implementation project
• Manage the customer expectations and liaison with the hospital project manager to ensure that the project is moving forward and meeting agreed upon deadlines and monitor service and quality of implementation
• Monitor patient accounts to check payments made by Medicaid

• Prepare and complete daily/weekly/monthly reports as required and work on client originated reports
• Work with IT support to compile monthly client invoices
• Direct liaison between Cymetrix and the client, the patient and outside agencies
• Participate in hospital based meetings as determined necessary by contract and need

Confidential

Healthcare Consultant

• Recognized the obscure cases that are frequently overlooked and may not appear to fall under most eligibility guidelines, which enabled me to obtain short-term funding solutions and whenever appropriate secured long-term Medicare conversions for patients
• Evaluated many factors other than financial criteria in decision-making process, such as the patient's mental and physical limitations, gender, age, living conditions, work history and education Advanced knowledge of Social Security Income, Social Security Disability Insurance, State Medicaid, Crime Victims, Charity Care, County Indigent Health Care Programs, and numerous other state, local and community benefit programs targeting indigent, underinsured or uninsured
• Increased productivity by reducing turn around times to provide State Medicaid to patients from 45 days to within 14 days and also by assisting and assessing needs of patients and hospitals, and other duties as needed to ensure that all referrals are reviewed timely and appropriately
• Increased profitability through focused and efficient time management increased the number of patients through interviewing patients in a hospital and/or home setting to assist them in obtaining maximum benefit coverage from state and federal programs by screening patients and their medical records
• Increased client interaction by maintaining ongoing communications with government agencies regarding status of claims. Provided updates and assistance to patients and hospital personnel and other staff as needed
• Team Player by traveling to many hospitals throughout the state to assist with healthcare revenue recovery
• Confidential

Reimbursement Healthcare Consultant

• Provided financial reimbursement support, case management, and advanced payer and reimbursement research to pharmaceutical companies, biotech, and medical technology manufacturers, and payers

• Internally trained on pharmacology
• Tracked industry trends and changes among payers, clients, competitors, and government agencies and understood the impact of trends and changes within the healthcare arena
• Assisted with the development of strategies and implementation programs to facilitate appropriate financial reimbursement aspect of pharmaceutical products
• Focused on reimbursement-related issues for new and existing technologies using a consultative approach through strategic planning, reimbursement consulting, and patient management services
• Increased productivity by reducing turn around time frame to provide reimbursement solutions to clients from 5 to 2 days
• Enhanced customer service by developing various training tools that allowed individuals to be more efficient in the implementation of reimbursement strategies

Confidential

Program Assistant

• Served as a team leader within a specialized team of Medicaid eligibility workers
• Provided case management services for clients who received Medicaid benefits
• Maintained updated knowledge of Medicaid policies and procedures and served as a resource to eligibility staff
• Delivered new hires training and training updates
• Focused on providing the highest quality service and 100 client satisfaction within accordance to deadlines
• Increased accuracy by providing thorough analysis when reviewing determinations for accuracy and adherence to the Medicaid program policy
• Increased client interaction by proactively interacted with clients to assist them with enrollment of healthcare benefits
• Increased productivity by resolving problem cases in accordance with other agency staff within 1 business day
• Self-directed by independently completed weekly and monthly reports indicating number of various Medicaid approvals and denials on a case by case basis