Project Coordinator Resume Profile

Summary

Seek a leadership position in healthcare focused environment where I can bring my content expertise, project management experience and relationship skills to benefit strategic and operations management.

WORK EXPERIENCE

Confidential

Program Manager

Provide program management oversight in the development of resources to support practice engagement in network's Patient Centered Medical Home PCMH initiatives: NCQA PCMH content resource guide, chart review training and audit operations, NCQA PCMH IT roadmap, behavioral health integration proposal and strategy, etc.
Prepare NCQA PCMH interpretations and recommendations as NCQA PCMH content expert
Produce and deliver presentations to consultants, practices, leadership and IT partners

Confidential

Project Manager

Provide project management and business analysis oversight for cross-departmental initiatives that include areas such as IS, Compliance, Clinical, Contracting, Care Management, Sales Marketing, etc.:
Annual Data Validation Audit of CMS Reporting CMS Star Ranking Program
Clinical/Rx Operations for 18,000 Member Conversion Pharmacy Wrap Product Implementation
SNP/SCO product development CR, Marketing/Sales Compliance Remediation Project
Member HOS/CAHPS-like Survey Follow-up ANOC/EOC eDelivery Implementation

Confidential

Consultant

Provide consulting services in the following areas:
State Medicaid HIT Planning Health Insurance Exchange
Revenue Cycle Maximization Prescription Assistance Programs
Process Evaluation Assessment Policy and Process Development
Documentation Billing Compliance Regulatory Review Reporting
Management Status Reporting Clinician Training Education
Data Analysis Reporting Proposal Development
Project Management Credentialing Contracting
Conducted As-Is Assessment for Medicaid Electronic Health Records EHR Incentive Program
Implemented credentialing and contracting process for a university clinic initiating fee-for-service billing
Developed and managed state hospital's Medicare professional per diem billing Time Studies
Conducted review of Medicare enrollment and reconciliation process for Medicare managed care plan
Identified and implemented outpatient insurance verification and authorization process to decrease denials
Compiled Patient Accounts policy and procedure manual for a state hospital and a mental health facility
Provided quarterly documentation and billing audit status reports for a skilled nursing facility

Confidential

Project Manager

Managed a multi-HMO grant using automated healthcare claims to predict and compare health outcomes
Coordinated a surveillance focused multi-epicenter grant using hospital data and medical records
Directed grant submissions, renewals and communications with funders
Developed and managed budget tracking systems for Technical Research Group
Supervised Research Assistant and Administrative Assistant

Confidential

Project Coordinator

Supported academic and research activities for Associate Dean of Research
Managed operations for academic research group investigating nutrition aging:
Budget Management Communications Grant Preparation
Purchasing/Supplies Presentation Design Literature Research and Summation
Participated in the development of course materials
Recruited, trained, and supervised work-study students
Participated in publication and presentation development

Confidential

Patient Financial Counselor/Senior Patient Services Coordinator

Established and directed coordination of the following:
Insurance Protocols Patient Financial Counseling
Billing Collection Policies/Procedures
Acted as On-Call Administrator and managed quality improvement operations
Trained and supervised associates
Participated in implementation and evaluation of hospital management software

Confidential

Admissions Coordinator

Confidential

Teaching Assistant-Behavioral Science Department

Confidential

Admissions/Medical Records Coordinator

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