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Click here or scroll down to respond to this candidateCandidate's Name
Home: PHONE NUMBER AVAILABLE Email: EMAIL AVAILABLEClearance: NAIC/Public TrustPROFESSIONAL SUMMARYExperienced Healthcare Analyst that accepts the responsibility to support both external clients and internal management. Broad understanding of healthcare data like claims, clinical data, quality metrics, and health outcomes. Capable of analyzing problems and designing recommendations, including workflows, processes, and procedures. Able to present even the most complex of data sets in a comprehensive and engaging way. Extensive and diverse customer service and administrative background including 25+ years experience within the healthcare industry. Knowledgeable in healthcare insurance including HMO/PPO and Electronic Health Records (EHR), medical insurance billing, medical terminology and medical coding.EDUCATIONCurrently attending Capella University studying Doctor of Human Services with specialization in Leadership and Organizational ManagementMaster of Science in Human Services, Specialization in Multidisciplinary Human Services, Capella University December 2017Bachelors Degree, Healthcare Administration, Ashford University May 2015Associate degree, Healthcare Administration, University of Phoenix, October 2011TECHNICAL SKILLSMHS GENESIS, AHLTA, HAIMS, CHCS, CIS, EHR, Meditech, MS Office, Adobe Connect, SharePointEXPERIENCEJanuary 2020-March 2023 Senior Healthcare Analyst - Healthcare Operations Defense Health Headquarters, Defense Health/Koniag Government Services Agency (contractor) Falls Church, VACoordinates integration of day-to-day activities in support of HCO Directorates operating programsOrganizes and prioritizes critical issues and required information for HCO Director and senior leadership to facilitate efficient decision making.Assists in the development, coordination, review, and execution of Operational Orders (OPORDs) and tasks related to the management and administration of Medical Treatment Facilities (MTFs).Coordinates all requests for support inherent to MTF healthcare operations. Requests for support should be reviewed through the lens of the Market construct; provides recommendations to the Chief, Market Execution Office.Ensures close coordination with other Defense Health Agency (DHA) offices, such as the Combat Support Directorate and the Operations, Plans and Requirements Branch, to ensure orders and taskings are properly managed via the designated Task Management System.Provides focused, accurate and timely correspondence, workflow and publication management support to the DHA, Assistant Director, Healthcare Administration, Deputy Assistant Director, Healthcare Operations (DAD HCO) and external agencies as required.July 2017-January 2020Patient Administration Program ManagerDefense Health Headquarters, Defense Health/Fidelity Partners(contractor) Falls Church, VAServed as subject matter expert for the Air Force Integrated Disability Evaluation System (IDES). Collaborated with the Office of Wounded Care Policy, Veterans Benefits Administration, and Military Services to re-engineer IDES program from 295 days to 230 days.Drafted business cases, project charters, and project management plans from initiation through closure. Utilized project management principles to lead high-visibility institutional change management initiative; re-engineered Air Force-wide DES notification process impacting Air Force readiness and warfighting capability, and warrior retention.Provided consulting services to the AF/SGs office with respect to issues relating to DoD, Office of the Assistant Secretary of Defense (Health Affairs), Defense Health Agency (DHA), Program Executive Office Programs, Joint Staff, U.S. Army Medical Department, U.S. Navy Bureau of Medicine and Surgery, AF MAJCOMs, Air Force Inspection Agency, and Air Staff counterparts on patient administration and medical records management functions and issues. Served as functional advisor to the AF Chief of Patient Administration on patient administration functions, such as but not limited to medical records management, medical evaluation boards, information systems and initiatives.Ensured that the organization's strategic plan, mission, vision and values were communicated to the team and integrated into the team's strategies, goals, objectives, work plans and work product and services. Responsible for overarching identification of training needs for field personnel at Military treatment facilities, stations, and embassies worldwide; utilized data from training participants and identified by the Quality Assurance staff through technical reviews and issues uncovered during training and site visits. Also ensured training needs were identified from TMA leadership, TRICARE Regional Office leadership and non-leadership regional office employees were addressed.Trained military and Veterans on how to use the electronic health record (EHR)system.Coordinated and performed administrative functions necessary to deliver and document workflow level coaching programs, led implementation guidance, integration, and change management support tasks operating as a Subject Matter Expert for EHR application and organizational workflows.May 2015-July2017Deployment Health Assessment Program AnalystDefense Health Headquarters, Defense Health/AFSC (contractor) Falls Church, VAResearched, analyzed and presented draft program related issues and initiatives which impact the Active Component and provides recommendations to the ACOR.Verified PDHRA Compliance for all Army Compos on the Strategic Management System (SMS) and provide monthly comments as necessary.Collected data from RMC DHAP Coordinators and independently collect any suggested improvements to MMEPROS, develop slide decks outlining recommendations and present the information at the Quarterly MEDPROS Enhancement Control Board (ECB).Created and assisted in the completion of the G-37 Medical Readiness Monthly Readiness Status Brief.December 2014-May2015Physical Evaluation Board Liaison Officer (PEBLO)Joint Andrews AFB/Signature Performance (contractor) Camp Springs MarylandCounseled military personnel from all branches of the uniformed services, retirees, and the Families of those being processed through the Physical Disability Evaluation System (APDES) on their rights, benefits, privileges, or obligations.Advised Soldier of the necessity of obtaining sufficient documentation (medical and non-medical) concerning the Soldier's ability to perform military duties and the severity of the Soldier's disease or injury.Helped service members who are dissatisfied with the PEB's decision to appeal to the Formal Physical Evaluation Board (FPEB).January 2012 - April 2014Financial Accounts TechnicianDepartment of Veterans Affairs (NECPAC) Lebanon, PennsylvaniaResponsible for the billing and insurance verification functions as they pertain to the e-Pharmacy program for all medical centers serviced by the NECPAC.Updated and ensured the accuracy of patient health records by adding new information about diagnoses, procedures, medications, and other relevant data.Reviewed medical records to ensure they were complete and accurate.Provide expertise on claim submission actions, ensures claims are submitted in various formats in compliance with specific requirements of the appropriate insurance carrier in order to improve collections. Reviews returned/rejected claims for reason for rejection or denial, taking appropriate corrective action and resubmits claims for payment.Interpreted and analyzed claim and provided data in support of risk and quality initiatives.Entered insurance, demographic and health information in the VA system and confirmed records. |
