Brian Dotts Email & Phone Number

Fort Worth, Tx, Us

Fort Worth, Tx, Us

Leads Epic Tapestry Configuration/ Build/ Implementation/ Support - in the areas of:- AP Claims- Vendor Contracts- Benefits Engine- Triplets (Provider, Vendor, Place of Service)- AP Cycle- CRM- Facilitates Epic Tapestry decisions through contractual/ regulatory compliance as a Texas Medicaid Managed Care Organization.- Leads through the administration and monitoring of multiple application areas, performing required maintenance and upgrades as appropriate. Identifies any resulting impacts on other technologies. - Mentors staff with responsibility for their development. - Ensures the transfer of knowledge through on-the-job training, presentations, and ongoing coaching. - Proposes new standards and develops new migration plans to the future application and information technology infrastructure. - Acts as a project lead/ key resource for project team. - Provides ongoing support and troubleshooting for installed solutions.

Fort Worth, Tx, Us

•Works with Microsoft Visual Studio, SSIS, SSRS, TIBCO Spotfire to produce static/ dynamic reporting to drive awareness, decisions and operational leadership through data analysis.•Gathers initial business requirements from clients, making recommendations based on subject matter expertise•Refines business requirements through collaboration with client and data/business process stakeholders•Works from new developed implementation plan or existing documentation, independently or in project team as needed•Collaborates with data architects to bring new data or data transformations into EDW and applications. Performs queries or collaborates with Information Services to acquire other needed data•Designs applications, reports, and processes using formats and standards•Participates in clinical process/quality/business process improvement committees and project teams, providing subject matter expertise to support departmental and initiatives•Develops and maintains systematic understanding of data•Enters and updates all work assignments and tasks in the tracking application

Fort Worth, Tx, Us

Claims Manager for Cook Children's Health Plan:Managed teams, including:- Front End, Claims: (Data Entry)- Claims Call Center- Back End, Claims: Claim Appeals/ Reconsiderations/ Claim Projects- Texas Medicaid Encounter Submission/ Reconciliation- Operational Reporting- Health Plan Operations: SharePoint site Design/ Administration- Performance Management- Leadership Development- SQL Server Data Analysis- Windows PowerShell Report AutomationStaff ModelingQuality Monitoring

Irving, Tx, Us

Irving, Tx, Us

Claims Team ManagerTeam BuildingNew Product ImplementationOperations LeadershipVendor ManagementProject ManagementProcess ImprovementData Management and AnalysisCompliance: DoD, Tricare, CMS, Medicaid, Healthcare ExchangeInterface DevelopmentEDI: 270, 271, 276, 277, 834, 837Encounter Data ProcessingSQL, Sharepoint, Visio, Excel, Access, Power PointFinancial Reporting Call Center ManagementCOB

Hartford, Connecticut, Us

Supervisor, IT - Project Management- Manager of the Analytics Team in the Texas Medicaid Health Plans- Relationship management with various Shared Services Departments- CEO, CMO, COO, CFO, Department Heads and Compliance collaboration to use data analysis to lead change/ process improvement- Adherence with regulatory requirements based on MCO (Managed Care Organization) Agreement- Process Improvement- Process Mapping- Project Management

Hartford, Connecticut, Us

Sr. Business Analyst- Direct association with CEO, COO, CFO, Department Heads and Compliance to ensure adherence to state requirements based on MCO (Managed Care Organization) Agreement.- Involved in Operational Analysis to lead Process Improvement initiatives- Creation, implementation and correction of multi-departmental Process Mapping and Project Planning.- Involvement in implementation of Texas Managed Care (Star and Chip programs) deliverable reporting database and improvement initiative.

Hartford, Connecticut, Us

Provider Relations Supervisor - Management and improvement of Provider Relations Medicaid unit for the Aetna Texas Medicaid plans, including: Parkland Community Health Plan, Aetna Better Health, and Christus Health Plan.- Oversee Network Development, Credentialing, Contracting, Workflow creation, implementation and auditing.- Establish and maintain relations between providers (hospitals, physicians, etc…) and the Aetna Better Health Plans.- Departmental reporting and coordination (IT, Claim Review, Customer Service, Patient Management, etc…)- Direct report hiring, training, scheduling, reporting, monthly/ yearly employee evaluation, termination, etc.- Direct coordination with other department heads to increase network growth and member retention through process improvement and change control.- Managed a team of Network Representatives who navigate through various systems and coordinate with other departments to satisfy providers with issues of varying complexity.- Etablished a reportable department that managed claim correspondence and issues via incoming mail, faxes and an inbound phone queue. We met all service levels based on a subcontracted Managed Care Organization agreement with HHSC (Health and Human Services Commision).

Education record

General Diploma