Quality Assurance Compliance Program

Kimberly L. Edwards

**** ****** **** ** *** ****,

Lithia Springs, GA 30122

Cell: 770-***-**** ad5dpz@r.postjobfree.com

Professional Overview

Accomplished with broad expertise in options counseling, compliance program standards, quality assurance, waiver and housing assessments, and community resources within multiple regions of Georgia.

Core Qualifications

Active Listening Microsoft Office Proficiency

Administrative Management CPR Certification

Counseling Multi Data Systems Proficiency

Critical Thinking Meticulous Attention to detail

Care Plan Development and Implementation Interpersonal Skills Compliance Standards

Group Instruction

Perceptiveness

Specialized Instruction and Implementation

Team Building

Time Management

Clinical Assessments

Accomplishments

Facilitated knowledge sharing and best practice conversations to non-profit and community leaders via health fairs,

round table discussions, and specialized conferences to assist in sustaining a successful region.

Encouraged healthy lifestyles to promote active and independent living for older adults.

Promoted a full range of community resources to ensure that aging individuals can access basic services and remain

independent.

Performed and maintained regulatory compliance standards in accordance with DHS, DCH, & DCA policies and regulations.

Performed clinical assessments for disabled individuals (children and adults) to determine potential eligibility for Medicaid Waiver Programs (CCSP, SOURCE, NOW/COMP, ICWP, GAPP).

Education

Bachelor of Science: Family and Consumer Sciences, Child and Family Development, 1999

University of Georgia Athens, Georgia

Certified Information & Referral Specialist, 2007

Alliance of Information & Referral Systems

National Certification

Certified Options Counselor, 2014

Center for Aging & Disability Education and Research, Boston University,

National Certification

Experience

Community Healthcare Specialist (CHW) – Walmart Health

September 2020 – Current

Walmart Health Center – McDonough, GA

Meet with referred patients and conduct needs assessments, and provide Health and Wellness education. • help patients complete applications for benefits, (health insurance, Medicaid, Medicare, prescription assistance, etc.) • assist patients with organizing personal matters (financial and health records, scheduling appointments with Specialists, getting prescriptions filled) • work with patients to meet their health goals by contacting them in person, by phone, or in writing to ensure they have completed required or recommended actions. • Conduct weekly Nutrition Basics training classes using “My Plate” to assist patients that need nutritional support to combat chronic illness. • utilize electronic databases to document and maintain records of patient encounters and interactions. • Plan and create monthly Health Awareness displays and informative promotional materials. • Promote quarterly Health and Wellness events in the clinic and store. • provide feedback to health service providers regarding improving service accessibility or acceptability. • Marketing and sharing the way Walmart Healthcare is delivered at affordable, transparent prices and how it will impact communities and individuals saving them money and helping them live better. Provides assistance to patients to develop health management plans and goals; connecting customers with community resources (for example, senior centers, homeless shelters, food pantries); helping customer fill out applications for benefits (for example, insurance, food stamps); assisting customers with organizing personal matters (for example, financial and health records, scheduling appointments, getting prescriptions filled); and utilizing electronic databases to document and maintain records of customer encounters and interactions. Working with customers to meet their health goals by contacting clients in person, by phone, or in writing to ensure they have completed required or recommended actions; conducting interviews and providing coaching to identify and troubleshoot barriers and connect to additional resources as needed; providing feedback to health service providers regarding improving service accessibility or acceptability; working with state and federal public health programs to improve resources, services, and programs. Increases awareness and utilization of resources, services, and programs by conducting outreach for medical personnel or health organizations to implement programs in the community that promote, maintain, and improve individual and community health; continuously expanding knowledge and understanding of community resources, services, and programs; working with other community healthcare workers to create a directory of community resources; conducting group presentations and health screenings within the health center and community settings; collaborating with behavioral health and physical health care team regarding patients' problems and needs; and attending community meetings, health fairs, and community advisory committee meetings to understand community issues or build relationships with community members.

Compliance Officer – Central Office

April 2019 – September 2020

Department of Community Affairs – Atlanta, GA

Detailed knowledge and implementation of key information from IRS Section 42, IRS 8823 Guide, and HUD Handbook 4350

Identifies project deficiencies and non-compliance

Oversees a portfolio of properties in lease-up or stabilization with complex and layered federal program requirements

Reviews and processes management company change requests; evaluate property management performance as required

Oversees casualty losses to mitigate non-compliance and recapture

Reviews and regulatory agreements, LURCs, LURAs, and other source documents to determine enforceability of terms

Analyzes annual Owner Certificates to ensure compliance as required by the IRS and DCA

Works alongside Asset Management to provide circumspect oversight of file, physical, and financial compliance

Identifies properties with operational issues, investigates causes and facilitates problem resolutions; Works to resolve issues through collaboration with general partners, property managers, lenders, and governmental/regulatory entities

Conducts monthly on-site file audits

Housing Specialist – Norcross (North) Office

October 2018 – April 2019

Department of Community Affairs – Norcross, GA

Certifies initial eligibility determinations, annual recertifications, moves, and interim certifications for program participants

Implements regulatory compliance program standards for HCV participants, property owners, and property managers in accordance with HUD and DCA Administrative Plan rules and regulations

Completes subsidy calculations and adjustments for continued participation in the HCV program

Manages high volume caseloads and performs audits to ensure that all files conform to HUD and DCA Administrative Plan rules and regulations

Performs multiple and accurate mathematical calculations for Rent Affordability

Maintains effective communication with HCV participants, property owners, and property managers to explain regulations and violations and options to resolve violations

Conducts timely audits of Affordability for Rent Reasonable comparisons to ensure that units do not exceed comparable unit rents

Prepares and submits documents in accordance with HUD policies for the finalization of Housing Assistance Payment (HAP) Contracts

Coordinate with the inspections team for initial, special, and recertification inspections

Ensures that all required data for HUD 50058 reports are completed timely and accurately

Maintains high level of productivity and provides excellent customer service and support

Medicaid Eligibility Specialist – ABD Unit

May 2016 – October 2018

Department of Family and Children Services Atlanta, GA

Determined eligibility for Aged, Blind, and Disability Medicaid Assistance Programs.

Performed audits on high volume Medicaid caseloads to maintain regulatory compliance standards for ABD policies and regulations.

Implemented ABD compliance program guidelines in accordance with DHS policies Issues reports of non- compliance for timely corrections

Processed applications and reviews using appropriate criteria and policies consistently and according to established guidelines

Recorded and evaluated personal and financial data obtained from individuals.

Managed and performed yearly reviews of financial resources and/or trust accounts for skilled nursing patients

Keyed in a high volume of data using specialized office hardware and software.

Performs other professional responsibilities and specialized projects as assigned.

Senior Program Specialist

January 2005 to March 2015

Atlanta Regional Commission Atlanta, GA

Answered high call volume for ADRC Gateway I&R

Provided information and resources to consumers in the 10 county metro region.

Conducted intake screenings/assessments/level of care determinations for persons with chronic illnesses.

Managed high volume wait list for Georgia Medicaid Waiver Program (Community Care Services Program).

Implemented regulatory compliance program guidelines for Waiver participants and caregivers in accordance with Georgia Waiver and DCH policies and regulations.

Issued non-compliance reports for wait list clients and initials.

Participated in community health fairs, providing education and resources to consumers and healthcare professionals.

Attended and completed educational trainings to increased knowledge of community supportive services regarding aging and disabled consumers.

Used multiple data systems (Harmony/AIMS/ESP/CHAT/GHP Medicaid Portal) to assist aging and disabled

consumers with supportive services.

Maintained high volume client filing system for CCSP Wait List, CCSP Termination, and CCSP Withdrawals.

Attended weekly departmental meetings regarding statewide updates related to AAA.

Family Support Case Management, FICM II

March 2002 to December 2004

Department of Family and Children Services Marietta, GA

Implemented compliance program standards in accordance with employment services/workforce development care plans for TANF recipients in accordance with DHS employment services policies and regulations.

Issued non-compliance reports and ended participation in accordance with DHS employment services policies and procedures.

Managed high volume caseloads of active Medicaid clients.

Managed high volume caseloads of clients enrolled in vocational rehabilitation programs.

Conducted weekly orientations for initial workforce participants.

Fellowships and Awards

5 year Service Award - Atlanta Regional Commission - Jan, 2010

10 year Service Award - Atlanta Regional Commission - Jan, 2015

Presentations

AAA Health Fair Expo Community Presenter

Round table Leader for Hospice Case Managers administering in-patient transitional discharges

AAA Presenter/Speaker for CDC Professionals

AAA Presenter/Speaker for yearly Caregiver Conferences

Outreach Coordinator/Representative for yearly community health fair screenings.

Memberships/Scholarly Societies

HIPPA Member

Atlanta Regional Commission

AIRS Member

International Association for Information & Referral Professionals

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