Dawn H. Email & Phone Number

Melbourne, Fl, Us

- Drive the success of customer implementation and production support to ensure expectations are met and ensures continued customer satisfaction.- Serve as the Product group’s interface to operations which includes Implementation, Production Support, Development, Configuration, Quality Assurance, Compliance, and other internal departments.- Provides product direction throughout the customer lifecycle to ensure a consistent customer experience and to maintain the integrity of the broader… Show more - Drive the success of customer implementation and production support to ensure expectations are met and ensures continued customer satisfaction.- Serve as the Product group’s interface to operations which includes Implementation, Production Support, Development, Configuration, Quality Assurance, Compliance, and other internal departments.- Provides product direction throughout the customer lifecycle to ensure a consistent customer experience and to maintain the integrity of the broader MHK platform.- Create highly satisfied customers, analyze, and improve the CAG product suite, advance my own knowledge, and help remove impediments so the team can consistently move forward.- Work with internal MHK clients as the operations interface for Appeal & Grievance supporting implementation and production support for new and existing customer environments.- Serves as the Product SME for CAG during meetings, including participating in customer meetings and understanding detailed customer requirements.- Responsible for leading business requirement gathering sessions with clients in conjunction with other MHK teams and managing customer-specific configuration workbook versioning and storage.- Troubleshoot application issues in MHK and client environments using knowledge of MHK applications and Appeals & Grievances business processes and regulations.- Maintain accurate module configuration workbooks for “out of the box” product and ensure they accurately reflect MHK template environment.- Testing application configuration and product functionality to ensure accuracy with specifications and/or product specifications with each release.- Perform User Acceptance Testing, Quality review for production environments and following established release management processes.- Assists in developing future Product Roadmap items with the rest of the CAG team.- Collaborate within a multi-disciplinary team to provide support for new and installed systems and to resolve issues. Show less

Melbourne, Florida Area

- Responsible for reviewing contract solicitation terms, interpreting agreement terms and conditions and identifying potential issues, reviewing agreement amendments / modifications and incorporating changes.- Reviews contractual documents to ensure adherence to company policy, government specifications and requirements, identifies risks and areas of concern on contract terms and conditions and provides contractual advice, guidance and support to the contract lead / program and operations… Show more - Responsible for reviewing contract solicitation terms, interpreting agreement terms and conditions and identifying potential issues, reviewing agreement amendments / modifications and incorporating changes.- Reviews contractual documents to ensure adherence to company policy, government specifications and requirements, identifies risks and areas of concern on contract terms and conditions and provides contractual advice, guidance and support to the contract lead / program and operations managers.- Responds to inquiries regarding requests for proposal and other types of sources sought. Proposal preparation for customer requirements. Prepares and analyzes moderately complex price proposals.- Negotiates standard terms and conditions. Participates in Truth In Negotiation Act (TINA) implementation/sweeps.- Prepares teaming agreements, Memorandum of Understanding (MOU), Memorandum of Agreement (MOA), and domestic and international consultant/sales representative agreements as well as other contractual agreements.- Assist in the administration and closure of contracts. Participates in management review of proposals/contracts and in the conduct of program reviews. Show less

Melbourne, Florida Area

- Documenting corrective action requests as identified by Compliance, Internal Audit from the Health plans or the business.- Work closely with business and shared service partners on correction measures identified internally and externally, specific to the Community and State, Medicaid operation.- Work with delegated entities; internal and external, as well as oversight teams to develop recommendations for remediation to ensure consistent problem resolution occurs across… Show more - Documenting corrective action requests as identified by Compliance, Internal Audit from the Health plans or the business.- Work closely with business and shared service partners on correction measures identified internally and externally, specific to the Community and State, Medicaid operation.- Work with delegated entities; internal and external, as well as oversight teams to develop recommendations for remediation to ensure consistent problem resolution occurs across organizations.- Tracking associated remediation activities and validating the implementation of corrective measures to ensure compliance is met in accordance to each State’s requirements. Show less

Melbourne, Florida Area

- End to end holistic issue resolution; including incident identification, deep dive analysis to identify root cause failures and remediation activities for escalated provider issues; including Department of Insurance and State complaints.- Collaborate with internal and external business partners to identify innovative solutions for resolving incidental, and large scope issues to reduce the overall number of failures in the Community and State, Medicaid operations market.- Engage in… Show more - End to end holistic issue resolution; including incident identification, deep dive analysis to identify root cause failures and remediation activities for escalated provider issues; including Department of Insurance and State complaints.- Collaborate with internal and external business partners to identify innovative solutions for resolving incidental, and large scope issues to reduce the overall number of failures in the Community and State, Medicaid operations market.- Engage in predictive analytics to prevent system and claim related issues from impacting providers across multiple markets as well as quality auditing to ensure compliance and quality expectations are met.- Analyze and interpret data to identify trends, patterns and opportunities for the business to meet and exceed compliance and quality expectations.- Produce, publish and distribute scheduled and ad-hoc client and operational reports relating to the development and performance of products, processes and technologies. Show less

Melbourne, Florida Area

See Sr. Business Analyst Job Description

Cambridge, Il Area / Melbourne Fl Area

- Provide expertise and general support to teams in reviewing, researching, investigating and resolution.- Train employees on the systems used, policies and procedures, understanding standard operating processes and compliance requirements.- Coaching employees to improve quality, increase efficiency, and broaden their skillsets.- Generate standardized reports for team metrics, current inventory, inventory metrics and state reports for monitoring successes and identifying… Show more - Provide expertise and general support to teams in reviewing, researching, investigating and resolution.- Train employees on the systems used, policies and procedures, understanding standard operating processes and compliance requirements.- Coaching employees to improve quality, increase efficiency, and broaden their skillsets.- Generate standardized reports for team metrics, current inventory, inventory metrics and state reports for monitoring successes and identifying opportunities for improvement.- Workflow management of multiple queues to ensure quality and compliance metrics are met for processing workload.- Research and resolve written Department of Insurance complaints and complex or multi-issue provider and State complaints.- Proactive and reactive trend analysis, deep dive root cause and issue resolution. Show less

Cambridge, Il

See Subject Matter Expert Job Description

Greater Chicago Area

Project ~ Account Management | Documentation Specialist | Training and Development | Team LeadBusiness Management | Quality Assurance | Performance and Process Improvement

Greater Chicago Area

Project ~ Account Management | Training and Development | Business Management | Business OperationsQuality Assurance | Performance Management | Human Resources

Certificate, Child Daycare And Development

High School Diploma, General Studies