I am a highly skilled professional, with experience in finance, human services and administration. My history also includes customer service management. I am highly motivated and detail oriented.
• Create, plan and maintain new and existing entrepreneurial ventures
• Create and maintain processes for new and existing businesses
• Identify processes needed for the quality management system, their application and
• Continual improvement of their effectiveness
• Develop and maintain forms and databases for new and existing businesses
• Develop and implement strategic management opportunities for new and existing
entrepreneurs
• Ensure the availability of resources and information to support operation and
monitoring of all processes
• Implement all actions needed to achieve planned results and continual improvement of
all processes
• Determine criteria and methods needed to ensure effectiveness of processes
• Complete, develop and present Financial Ratio Analysis
• Teach/Train – communicating with students, as well as parents or guardians regarding student progress and development, grading tests, quizzes, and assignments, and developing educational lesson plans.
• Teaching and monitoring students including those with IEP’s
• Create and maintain departmental processes and procedures.
• Utilize data analytics to prepare compliance audit data from internal and external
resources.
• Provides support for operations by authoring reports of summarized data.
• Research federal and state law and its applicability to environmental regulations.
• Implementation of policies and procedures.
• Create and maintain audit tools to minimize risk.
• Analyze data to avoid risk and identify issues that may arise during project management.
• Work within all company portals to support program development and continued process improvement.
• Liaison to programs to assist with project completion.
• Facilitated the implementation and compliance of the Home and Community Based
Service Rule (HCBS) for Adult Mentally Impaired Persons
• Acted as liaison to MDHHS for ongoing surveys, assessments, and remediation of
• Noncompliance and to lead in completion of projects
• Ensured individuals with disabilities have the same access to the community as
individuals who do not have disabilities
• Monitored Provider Sites for Oakland County to ensure that Home and Community
Based Rule is followed
• Developed and lead strategies with Network Providers to ensure compliance with
MDHHS Home and Community Based Services
• Managed MDHHS Waiver Support Application related to HCBS
• Utilized MS Office Suite daily
• Responsible for the Improvement Program
• Provided education to leadership, staff, and providers on HCBS
• Lead OCHN in efforts to maintain National Committee for Quality Assurance
(NCQA) accreditation
• Directed and educated contracted provider staff on preparation efforts required to meet
accreditation requirements
• Lead Quality Improvement (QI) efforts for providers
• Measured, analyzed, and prepared reports on consumer satisfaction of HCBS via state provided surveys
• Developed and maintained relationship with Providers
• Ensured HIPPA compliance for all clients
• Prepared and submitted claims and reports to MI Department of Human Service
(Medicaid, MI Health Link Managed Care) and various Integrated Care Organizations for reimbursement/payment
• Reviewed rejections and pending reports and followed up on correction and resubmission of claims
• Responsible for Database development and management
• Liaison to Care Management Department to assist in completion of projects
• Liaison to Center for Information Management to assist in completion of projects
• Liaison to MDHHS to assist in completion of projects
• Liaison to the MI Health Link Department to assist in completion of projects
• Investigated errors, variances, omissions and necessary adjustments and reclassifications as required contractually
• Responsible for the creation and production of various reports to assure integrity of data from multiple sources
• Used MS Office Suite daily
• Researched incorrect billing request for Vendor Agencies and processing of disallowances
• Performed Data Analysis of invoices, statuses and account reconciliation to general ledger and system reporting
• Responsible for the development and maintenance of relationships with Vendors
• Database management for performance monitoring
• Examined reports to prevent and determine fraud, waste and abuse
• Reviewed contracts verification and analysis on contractual fees and obligations
• Presented project completion data to leadership
• Reviewed and corrected total costs invoices for correct coding and fund sources
• Analyzed claims and reports for cases of fraud, waste and abuse and compliance with federal regulations and standards
• Proficiency in Vendor Billing, MICIS (MI Information System Database) and Vendor View
• Authored and Review of internal procedures
• Reviewed Requests for proposal
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