Business Intelligence Behavioral Health

Melbe N. Ponds Johnson

Sacramento, CA 916-***-**** *************@*******.*** / ************@*****.*** /

View Qualifications Portfolio College transcripts, course descriptions, work samples, certificates, licenses

Education

Ph.D. candidate, Social Psychology and Behavioral Health, Northcentral University, (Graduate 2027)

M.S., Business intelligence / Data Analytics, Full Sail University, Winter Park, FL (2014 -2015)

Master of Science, Business Administration- Healthcare Administration, Argosy University, San Francisco (2010 -2013)

Bachelors in Science, Business Administration and E-Commerce, University of Phoenix, San Francisco (2004 - 2008)

Summary of Recent Software Tools, Trends, and Techniques:

Knowledge in medical claims billing in ambulatory, pharmaceutical, outpatient, and ancillary

Knowledge of HMOs, IPOS, FFS, Medicare, Medicaid (Medi-Cal), and Private Insurance carriers

Applied medical terminology, ICD - 9, CPT, DRG, and HCPCS coding knowledge within previous positions.

Provider contract and credentialing business network development for alternative healthcare plans.

Knowledge of HIPAA, Knox-Keene Act, GAAP, Section 508 and ACA compliance and oversight requirements

Develop and recommend Human Resources Succession Plan for Healthcare Insurance Carrier.

Researched, designed, implemented, and maintained complex hospital or professional provider reimbursement programs for traditional and managed care programs.

Application of trending tools, financial analyses, S.W.O.T. analysis, payor contracting, capitation rates, and business process improvements.

●Oracle ERP -PeopleSoft (HCM, ACM), Oracle Cognos Reports, ServiceNow IT Helpdesk, Salesforce CRM

●Microsoft 365 Office Suite and virtual communication platforms.

●Web Design Tools: HTML, CSS, Javascript, VSCode, Notepad++, Github, Figma

●Content Management Systems: Wordpress, Drupal, SiteImprove

●Manual, Automated and Functional Testing & Developer tools: Extension Plugins, SQL, VBScripts, HP QTP

●B.I. Tools: SAP Business Objects 4.0, SAP Crystal Reports, SAP Dashboards & WebiReports Interface/ Tableau

●Data Modeling, graphical visualization, and digital marketing apps and tools for: R programming, Visio, Adobe Illustrator, SPSS, SEO

Certifications

Digital Web Accessibility Certified Professional -(Certification 09/2023) (WCAG) 2.1 / Section 508 Accessibility

Six Sigma Greenbelt Business Process Improvement (Certified 11/2022)

Electronic Healthcare Records Implementation Manager (CHTS-IM 2012)

Software Quality Assurance Tester/Business Analysis (H2K Infosys – 2013)

Employment History

Revenue Officer U.S. Department of Treasury – Internal Revenue Service 08/26/2025 – 02/20/2025

Collects delinquent tax and secures delinquent returns from taxpayers who have not resolved their obligations in response to prior correspondence or other contact.

Conduct interviews with taxpayers (and/or their representatives) in different environments such as the business location, residence or office as part of the investigative process of collecting delinquent taxes and securing delinquent tax returns.

Provides customer service by respecting and explaining the taxpayer's rights, IRS policies and procedures. Provides instructions, and analyzes issues presented by taxpayers, practitioners and IRS employees. Customer service is based upon learning, interpreting, and applying IRM policies and procedures, regulations, court decisions, state and local laws, and various Titles of the United States Code.

Provides instructions, and analyzes issues presented by taxpayers, practitioners and IRS employees to resolve account discrepancies and responds to taxpayer and practitioner requests.

Performs credit and financial analysis of the taxpayer financial records to determine the taxpayer’s financial condition and ability to pay outstanding tax obligations and prevent future delinquencies.

Analyzes financial information and evaluates assets applying expense standards and provides guidance on a wide range of financial alternatives to assist taxpayers in identifying options that could assist in resolving delinquent tax obligations including installment agreements, offers in compromise or suspending collection action.

Evaluates and compares taxpayers' financial information internal and external sources to verify taxpayers' financial condition including analyzing financial statements that include b balance sheets, income statements and profit and loss statements. Develop a clear plan of action to resolve the case.

Performs financial investigations in situations in which taxpayers are unwilling to be forthcoming concerning assets and sources of income.

Searches public records, tax returns, and financial and credit information to locate distrainable assets. Summonses taxpayer records and other financial information from the taxpayer and financial institutions or other third parties. Confers with internal and external advisors, analysts, or attorneys regarding case development, issue determination, case processing and coordination. Recognizes patterns of delay and other indicators that a taxpayer is not cooperating or attempting to defeat assessment or collection of delinquent tax.

Plans and takes appropriate enforcement actions to secure an assessment on past due returns, such as summonsing tax records, referrals to examination or assessing taxes using IRC 6020(b), or prompt, quick and jeopardy assessments.

Takes appropriate enforced collection action, such as levies, redemptions, seizures, nominee liens, judicial actions, or fraud investigation. Prepare affidavits, statements and testimony for court cases, such as summons enforcement, or seizure action. Files and releases Federal tax liens and calculate penalty assessments.

Human Resources Health Records Generalist II (TES) UC Davis Health 08/14/2023 – 02/12/2025

Responsibilities include processing and communicating personnel actions for position appointments, advancements, transfers, separations using UC Davis automated systems in high-volume transactional environment.

Regularly apply complex human resources and the University’s policies, procedures, and practices aligned with federal and state laws and national ethical standards. Referring to collective bargaining units contracts for clarifications specific to negotiated terms for classifications

Excellent computer and technical skills to utilize databases, produce reports, capture, analyze, and manipulate data using word processing, spreadsheet, and presentation software (MS Word, Excel, and PowerPoint) and design screens, reports, and queries in these programs.

Knowledge and experience of UC’s proprietary enterprise information management systems: Peoplesoft, AggieService, Salesforce, Cognos Reports, ServiceNow, and PeopleSoft to create, extract, manipulate, interpret and integrate data from electronic data sources producing correspondence, source documents, reports, forms, and spreadsheets.

Organizational skills to achieve timely progress on multiple simultaneous complex projects, distribute effort appropriately among the projects, meet tight deadlines and maintain a high level of productivity and accuracy effectiveness under a heavy, varied workload.

Analytical, problem solving and decision- making skills to identify and define problems, recommend, and implement solutions.

Digital Accessibility Manager (apprentice/remote) U.C. San Francisco /Helix Opportunity Institute 03/2023 -07/2023

Perform all tasks related to testing for accessibility content using automated and manual testing applications.

Develop skill sets of stewardship as a Disability Accessibility Subject Matter Expert (SME) and I.D.E.A.

Customer Service Lead GOCO Consulting 2022 - present

Support communities affected by natural disasters with temporary shelter w/ supplies for power outages. (as needed).

Software Quality Assurance Analyst Accenture Consulting 2013

Participate in the planning, constructing and execution of test scripts for public welfare eligibility systems.

Apply business and functional knowledge including testing standards, guidelines, and testing methodology to meet the team's overall test objectives.

Query relational databases and retrieve complex datasets from both the Oracle and SQL Server.

Ensure all testing results are easily accessible and understandable. Track defects to closure and keep defect repository up-to-date.

Independent Insurance Broker Just in Case Insurance Solutions 2010 - 2012

●Solicit, negotiate, and perform field contract underwriting of applications applying rules to insurers’ specifications and guidelines.

●Created and developed marketing approaches for target markets of private health insurance plans IPOs, HMOs, and FFS.

●Applied sales techniques, consultation to clients regarding the many insurance products available.

●Research and negotiate sources for lead generation, prospecting and follow-up with client’s needs and contracting requirements with marketing organizations.

●Develop personal relationships through influence and collaboration performing market research to better understand targeted market of local communities applying surveying techniques and tools.

Medicare Sales Insurance E-Health Insurance 2011

●Assisted customers in making Medicare healthcare decisions and carefully matched the customers with the optimal products and services explaining the terms and conditions of providers’ contract. Provided sales over the phone through inbound sales calls.

●Ensured compliance with governmental requirements with the Centers for Medicare and Medicaid Services (CMS) Medicare Marketing Guidelines and company policies and procedures.

Certified Tax Preparer Liberty Tax Services 2011

●Oversaw the day-to-day operations of the kiosk desk. Responsible for training staff, preparing taxes, submitting, and securing required documentation.

●Maintained compliance with government guidelines and allowances.

Staff Services Analyst / Administrative Assistant California Department of Mental Health 2001 – 2010

●Receive, document and resolve problems and complaints brought to Ombudsman services, via the 800 telephone lines, email and controlled correspondences.

●Responsible for explaining all aspects of the state’s Medi-Cal Mental Health Specialty Services delivery system to beneficiaries and external callers regarding services provided within the state.

●Investigate insurance coverage and provider contracts to assess patient eligibility for state-funded programs using MMIS systems.

●Review and resolved reimbursement issues with beneficiary accounts through Third party payors using EOBs and plans’ guidelines and county – provider network contracts.

●Elicit and identify necessary courses of action for best resolutions for constituents according to existing contracts.

●Receive, document, track and resolve problems and complaints as the state oversight Medi-Cal Managed Care representative.

●Participate on division taskforce for provider contract analysis and/or reimbursement program implementation.

●Act as web liaison designing layout, content, and web conferencing using approved resources and programs.

●Research and draft source documents and data reports using Excel pivot tables, macros, creating templates, reports, style sheets, and mail merges for internal and external partners.

●Create, maintain, and complete business requirements documentation and reference library as resource information.

●Provided administrative support to two divisions, Licensing & Certification and Medi-Cal Managed Care & Policy.

●Maintained detailed knowledge of the program, policy and activities of the unit to assist with public inquiries.

Key Data Processor California Employment Development Department 1997- 2001

Data input of employers’ and employees quarterly California tax contributions.

Ensure data quality and quality assurance were applied and maintained with every batch by following policy and procedures.

Perform regularly scheduled batch uploads nightly or weekly as determined by internal and legal processes.

Word Processor/Project Coordinator Foundation Health (HealthNet) 1998 - 1999

Created, formatted and produced word processing documents for governmental affairs publications department; integration of styles, formats, and structures into a standard master document, frequent changes in project priorities and often critical timeframes.

Create and edit charts, tables, organizational or statistical data from drafted/pre-printed work for an array of projects from designing simple covers and spines for " to 5" binders, formatting and proofing up to 10,000 pp. documents. Drafting source documents and data reports using Excel pivot tables, macros, creating templates, reports, style sheets, and mail merges.

Adhere to all regulatory compliance areas for federal contracting RFPs and BCPs, corporate policies and procedures, and standards.

Medical Health Records/Billing Claims Review Turning Point, Community MH Services 1998 - 1996

●Supported two professional teams of counselors and members in a social services environment. Managing daily operational paperwork (provider contracts, patient agreements, and procurement), applied strict procedural application for handling member charting.

●Monitor and process billable minutes, treatment codes, and progress documentation according to governmental regulations. Assisted as team member in support of reception and internal quality improvement projects.

●Assisted in performing research, establishing administrative processes, planning team events and organization of internal communications.

Provider Network Credentialing Landmark Healthcare 1995-1996

Completed and verified provider credentials for onboarding of alternative medicine provider network for healthcare plan.

Worked as a general business development liaison negotiating allowable payer negotiated rates within the healthplan’s guidelines.

Assisted with marketing campaigns and mailouts to specialty associations, special interests conventions and conferences for alternative medicine in chiropractic, acupuncture, and massage therapy to recruit providers.

Performed general office duties to maintain records, verify license and certification completions internationally.

References Available Upon Request

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