Currently developing Youthful Journeys LLC, a consulting business focused on assisting educational and daycare providers with compliance and operational efficiency within the Children and Adult Care Food Program (CACFP). Although early in its launch phase, I aim to offer expert guidance in program compliance, document organization, and resource management to help providers optimize their services. I am committed to establishing a strong foundation to bring impactful, structured support to educational facilities. Services are provided at clients’ locations or virtually, as needed.

I administered the annual budget for the Child and Adult Care Food Program (CACFP), improving resource allocation and ensuring compliance with federal regulations through detailed financial reporting; I streamlined reimbursement processes by enhancing documentation accuracy, which resulted in faster claim approvals and reduced delays in funding; Maintained compliance with USDA guidelines by staying updated on program regulations, ensuring accurate meal pattern documentation and adherence to standards; Identified and implemented process improvements in meal tracking and financial recordkeeping, enhancing program efficiency and reducing administrative errors.

Provided timely resolution to complaints; Knowledge of childcare development which consists of program planning; Managed 4 staff; Provided community outreach support and acted as a liaison between staff, families, monthly newsletters, and webinars; Ensured compliance with all licensing regulations; Assisted in the preparation and operation to the annual budget; Processed student enrollment, maintained attendance, health, and safety records; Met with current and prospective parents to answer questions and give tours of the facility; Created and plan monthly menus; Ordered and purchased monthly supplies and equipment for the facility.

Handled insurance verification and prior authorizations for over 50 patients daily, ensuring timely access to medications such as Keytruda; Optimized data tracking systems, improving accuracy in documenting insurance details and expediting approvals by efficiently communicating findings to other departments.Streamlined workflows to reduce processing times for prior authorizations, resulting in improved patient outcomes and faster claim resolutions; Collaborated with cross-functional teams to refine the approval process, ensuring compliance with timelines and minimizing delays in patient care.

Managed 5 key program areas (Expanded EPSDT, CHIP, Telehealth, Therapy Services, Ambulatory Services), ensuring regulatory compliance and optimizing service delivery across programs; Improved the efficiency of claims resolution by serving as a liaison between healthcare providers and managed care plans (Molina, United Healthcare, Magnolia), reducing delays and ensuring quicker responses to claim issues; Developed monthly ad-hoc reports to identify cost-saving trends, enhancing program efficiency and achieving measurable reductions in expenditures for therapy services; Improved fee schedule update processes, ensuring accurate rate uploads to the Medicaid web portal and timely provider access to updated rates; Coordinated provider re-credentialing, maintaining compliance with Medicaid standards and facilitating smooth program operations.

Verified accuracy of claims to identify denials in the Point of Sales System (POS) within MMIS; Participated in health fairs to educate customers about Medicaid and Medicare Part D prescription drugs plan; Assisted with pharmacy prior authorization request and reimbursement rate for adjustment of claims; Updated approved Medicaid pharmacy providers for purpose of compliance with Medicaid's policy; Communicated and assisted beneficiaries with a question regarding complaints with available drugs; Attended quarterly Pharmacy and Therapeutic meetings with advisory panel to discuss updates and recommendation on appropriate drugs for the Preferred Drug List and new upcoming drugs that needed prior authorization.

Managed caseload daily ranging from 150 to 200 cases per month to determine eligibility; Compiled case file with appropriate documentation; Provided outreach to the general public in applying for Health benefits; Acted as a liaison for Medicaid and third party insurance; Provided assistance to beneficiaries concerns; Maintained effective public relations to community agencies, outside professionals and the general public; Interviewed beneficiaries; Investigated collected data for eligibility purposes; Accepted a minimum of 50 applications per week, using Medsx database to input, file sorted data; Implemented any recommendations received by management for needed regulations, policies, and procedures for the proper administration of programs; Prepared reports summaries for approval and denial of health benefits; Performed related duties as required or assigned.

Served as the liaison to the University Medical Center billing office, health-related facilities, and other entities for purpose of collecting a debt; Inputted and uploaded files from agencies for collection; Collected money for payments on bad accounts; Exercised extreme discretion in confidentiality while maintaining effective public relations; Managed voluminous amounts of paperwork; assisted with projects and activities as assigned; Prepared and ran monthly reports on outstanding collections and payment received from customers.

Developed spreadsheets to reduce the number of bad addresses by 12%; Worked closely with upper management to ensure overall project coordination and completion; Assisted with the managing and monitoring of the Robert Wood Johnson and Bower Foundation Grant budget for tracking expenditures; Prepared correspondences and various reports using word processing and excel applications; Served as the liaison for CHIP and Blue Cross Blue Shield of MS for the purpose of investigating, researching and tracking third party insurance inquires; Assisted with the enrollment of Medicare Part D prescription drug coverages; Planned and delivered presentations to faith-based organizations, hospitals, non-profit agencies and public schools on the importance of having health insurance and how to apply for Medicaid; Attended monthly Statewide Coalition meetings with supervisor; performed other duties as assigned