Manager Medical
Resume:
Healthcare Executive
Experience professional with solid history of success in state government, limited liability medical corporations, and nonprofit organization environments. Strong ability to develop and lead organizations that meet and exceed designated goals and expectations. Demonstrated skills in developing and implementing programs and initiatives that enhance operational efficiencies.
Proven expertise in managing operations. Strong leader highly adept in supporting and achieving objectives. Well-versed in overseeing projects from concept to completion ensuring on-time, on-budget, and on-target results. Extensive background in medical billings and medical claims.
Key Competencies
●Strategic Planning and Implementation
●Team Building and Leadership
●Budget Development and Oversight
●Staff Training and Development
●Client Relationship Management
●New Program Development
●Project Management
●Regulatory Compliance
●Crisis Management/Process Improvement
●Microsoft Office Suite
Career Experience
State of Arkansas, Department of Human Services, Office of Program Planning and Quality Assurance, Little Rock, AR
Program Administrator, 2007-Present
Oversee planning and development for Arkansas State Medicaid Bureau programs and services. Establish and execute program goals and objectives, short- and long-range plans, and policies, procedures, and projects. Analyze program and service delivery for effectiveness and state and federal regulation compliance. Devise corrective tactics and updates and convey technical and administrative needs to up to 13 program personnel. Arrange internal and external information communications. Propose and present program-operating data. Author proposals, reports, policies, and sit on committees.
Key Contributions:
●Study, recommend, and prepare legislation for Arkansas Medicaid Program.
●Decipher program operation options and advise on contract, grant development, and special projects.
●Designed and introduced statewide newborn screening program with Medicaid agency and Division of Maternal and Child Care.
●Served as lead on 2010 ICD-10 implementation for State of Arkansas System and Policy.
New England College, Online
Per Diem Instructor, 2006-Present
Teach Health Program Evaluation, Healthcare Services in the 21st Century and Case Management for the Health Care Administration online courses to up to 13 students each semester in Bachelor of Science Program.
Key Contributions:
●Create class curriculum normally reserved for full professors.
State of New Hampshire, Department of Health and Human Services, Office of Medicaid Business and Policy, Concord, NH
Manager, 2001-2006
Liaised with state, federal and provider agencies to resolve complex federal and state Medicaid and WIC policy issues. Facilitated clinical, legal, and compliance team expertise to administer reimbursement initiative design, development, and execution. Formed and maintained key relationships to investigate and solve issues in provider community and state sister agencies. Counseled surveillance/utilization review, finance, and medical case management utilization review leadership on medical coding and reimbursement. Researched and created Medicaid modernization options. Secured and negotiated external contracts. Oversaw information technology and improvement of request for proposal process.
Key Contributions:
●Implemented successful cost savings reimbursement procedures, case management, federally qualified health clinics, physicians, and hospital reimbursement methods.
●Designed and initiated internal historical reimbursement repository.
●Devised and launched efficient policies and procedures for continuous process improvements
●Organized and hosted highly rated three-day national conference for Washington DC, national supplemental food program.
●Prepared and introduced statewide newborn screening program with Medicaid agency and Division of Maternal and Child Care.
Additional Experience
Finance Manager State of New Hampshire Department of Health and Human Services, Office of
Community and Public Health, Bureau of Women Infants and Children, Concord NH
Patient Account Manager Yale University School of Medicine, Faculty Practice Plan, New Haven, CT
Practice Manager Gastroenterology of New Haven, New Haven, CT
Assistant Manager Marianne's, Branford, CT
Education and Credentials
Master of Business Administration
Franklin Pierce University, Rindge, NH
Bachelor of Science in Health Sciences with Public and Community Health Minor
Southern Connecticut State University, New Haven, CT
Professional Training
ICD/CPT Coding and Medical Terminology, Yale University, New Haven, CT; Health and Personal Lines Certification, University of New Haven, New Haven CT
Professional Affiliations
New Hampshire Medical Group Management Association (Honorary Distinction)
Franklin Pierce Graduate Alumni Association
Habitat for Humanity of Saline County-Volunteer and Family Mentor
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