Work History

Work History
Feb 2015 - Feb 2016

Deputy Project Manager

Iowa Health Quality Healthcare Initiative
  • Train business functional areas in the CMS Medicaid Managed Care Toolkit for system and policy oversight
  • Formulate State and Federal regulatory documentation for Readiness Review, Ombudsman Liaison, and Corrective Action Plan. Create and maintain the project management plan including multiple dashboards for systems and business process transitions
Sep 2014 - Dec 2015

Project Manager

Griffin Enterprise Solutions
  • Lead twelve-member team through external testing and implementation of ICD-10 remediation on legacy MMIS system
  • Update all Advance Planning Documentation(APD) CMS Manage $7. 5 million remediation budget Prepare CMS approved project schedule, contingency plan and test criteria that adheres to the mandated ICD-10 Critical Success Factors
Sep 2014 - Dec 2015


Enterprise Development
  • Deliver of high-value, innovative technology solutions in a dynamic, high-pressure, and geographically dispersed environment.
  • Write, print and submit proposal responses to states for MMIS systems redesign, commercial-off-the shelf products, integrated eligibility system enhancements, and project oversight. Estimated potential new corporate revenue $1. 4 million as preferred contractor for South Dakota
Jan 2014 - Sep 2014

Senior Healthcare Subject Matter Expert

Enterprise Development
  • Provide deep expertise in Health Insurance Exchange, Medicaid Integrated Eligibility and MMIS State and Federal rules and regulations
  • Delivery specialized advice on CCIIO system certification, service-oriented architecture and eligibility, health care enrollment broker and Medicaid claims processing
  • Liaison with Product Management and Development, Sales, Marketing, Participant Support teams and external partners as the Subject Matter Expert(SME) on healthcare modernization including Medicaid and ACA SME for Admin Suite product development ensuring that all COTS products meet MITA 3.0 standards for modularity and reuse
  • Moderator at 2014 MES Conference Write Business Requirements Documents and Functional Specifications and create high-level process flows, as needed. Coordinate with client teams and distributed development teams
Jan 2011 - May 2013

Certification Manager

CSG Government Solutions
  • Iowa Medicaid Information and Data Administration Solutions(MIDAS) Project
  • Pioneered agile-based MMIS certification methodology and adoption by CMS Member of MIDAS Management Team, Oversight Management Team, Change Control Board and State Management Team
  • Oversaw understanding of all MITA business areas and processes including provider management, operations, financial management and member management
Oct 2010 - May 2011

Lead Technical Manager, CMS

  • Managed six member technical writing team Maintain quality assurance and technical writing standards Proposed and write Seven Conditions and Standards maturity model, Technical Architecture documentation and summary documentation
  • Presented MITA Framework 3.0 to Medicaid Enterprise System(MES) Conference 2011 attendees Corporate Senior Medicaid Expert, CSG Center for Excellence
  • Compose basic Medicaid staff training and reference modules for Medicaid legacy claims and eligibility systems, electronic health information technology, pharmacy point-of-sale systems, strategic planning, and deliverable quality management
Feb 2010 - Oct 2010

Senior Project Manager

Cognosante Systems
  • Indiana State Medicaid Health Information Technology Plan(SMHP) and Implementation Advance Planning Document(IAPD) Technical Assistance and support project
  • Conducted SMHP stakeholder visioning meetings, developed SMHP MITA SS-A components and IAPD, and prepared gap analysis for selected solution and made recommendations on how gaps should be filled
  • Acted as team lead for Oklahoma Medicaid Enterprise(HIPAA X12 5010, NCPDP, and ICD-10 Technical Assistance) Facilitated implementation of an MMIS solution utilizing Agile and Iterative development methodologies.
  • Formulated new IAPD component for to roadmap all state Medicaid projects that was adopted and published by CMS
May 2008 - Sep 2010

Deputy Functional Manager/system

  • South Dakota SD MEDx Project
  • Supervised twelve member functional team(SMEs), daily operations, and completion of project deliverables
  • Delivered industry expertise and best practices during the DDI phase of South Dakota's disease episodic grouper
  • Oversight for MITA certification system including data modeling, automated upload, and user screen design Prepared cost-benefit and return on investment analysis of change order requests
  • Provided subject matter expertise to States of Washington and South Dakota for Medicaid Enterprise systems Redesigned the Federal and State Management and Administrative Reporting System(MARS) reporting system to utilize dashboards, summary and drill-through functionality
Oct 2006 - May 2008

Senior Systems Development Specialist

Xerox Medicaid Enterprise Division
  • Oversight for enterprise online transaction processing(OLTP) and online analytical processing(OLAP) reporting to ensure compliance with Medicaid, MITA, CMS, and client standards and methodologies
  • Supervised a team of three to five business analysts on various large scale MMIS projects
  • Developed ad hoc, long term care acuity rate setting, third party liability(TPL), claims, provider, and EPSDTOLAP reporting models
  • Facilitated JAD sessions to clarify and validate the requirements for the New Hampshire replacement MMIS, North Dakota replacement MMIS, and Arkansas replacement MMIS for the DSS component
  • Designed, developed, and implemented all MARS, dash boarding, and strategic business reports using Cognos software Identified critical changes to acuity rate setting, EPSDT and TPL model that ensured compliance with CMS standards and elaborated a solution that was approved by the client Identified 41 obsolete reporting requirements and streamlined these reports into 10 new
Jan 2006 - Sep 2006

Senior Systems Development Specialist

Renown Health Systems
  • Recruited to proactively identify issues/risks associated with reimbursement, benefit plan solutions, and electronic health records for health system with four hospitals and eight medical groups
  • Oversaw contracting and payment standardization project which utilized resource based relative-value system(RBRVS), ambulatory payment classification(APC), diagnostic related grouper(DRG), long term care hospital prospective payment system(LTCH PPS), ambulatory patient groups(APG) fee-for-service(FFS), and capitated-rate structures for Medicare, PPO, and HMO plans
  • Collaborated with senior management, auditors, contract officers, clinical nurse managers, credentialing specialist, and claims manager in support of several information systems including InterQual Decision Support, McKesson claim and medical management BI operations, and reporting
  • Acted as SME for reimbursement services, contracting, and clinical services
  • Spearheaded creation of provider/vendor contract monitoring system with an auditing tool.
Jan 2005 - Jan 2006

Data Warehouse Manager

  • Provided remote and on-site technical support and subject matter expertise to state Medicaid staff and legislature on four systems QueryPath, HEDIS Systems, OmniAlert, and SAS
  • Conducted JAD and Design Specifications Document(DSD) sessions; developed use case, business rule, and extraction, transformation, and load(ETL) requirements; identified and gathered requirements; and trained state policy officers, quality assurance, and financial analysts
  • Resolved major client issues with DSS implementation including establishing a QueryPath report resulting in a higher project report card mark and contract renewal from client.
  • Created, wrote, and deployed RoboHelp training and help component for QueryPath Developed 10 of 17 Healthcare Effectiveness Data and Information Set(HEDIS) measures
May 2004 - Jan 2005

Senior Policy Analyst

  • Acted as team lead hospital, clinics, and Indian Health Services section provided expenditure and fiscal oversight
  • Provided technology support for the Facilities and Clinical Quality section, providing management of technology initiatives utilizing the Medicaid Decision Support System and other components of Montana MMIS
  • Developed and implemented IT strategic plans for family planning waiver, hospital provider tax, cost-to-charge, and cost settlement reports, and budget versus actual expenditures Provided analysis of MMIS system implementation requirements for change order requests of the facilities payment process and all new payment models
  • Presented Medicaid 1115 and 1915 waiver analyses for Family Planning and Home and Community Based(HCBS) Behavioral Health waivers to state legislature Implemented automated cost reporting audit exception reporting models to safeguard facility over-payments 




Montana State University


University of Arizona

Public Health Administration and Accounting

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