Jay Scott Email & Phone Number

New Orleans, La, Us

New Orleans, La, Us

London, Gb

− Direct engagement with the Louisiana Department of Health (LDH) to modernize the state’s Medicaid Management Information Systems (MMIS).− Oversee budget forecasting, invoicing, and financial reconciliation to ensure fiscal accountability.− Lead a team of 23 associates, managing hiring, onboarding, training and performance coaching.− Build relationships with state leaders and stakeholders to collaborate on Medicaid initiatives and drive successful program implementation− Standardize engagement processes and practices creating a structured framework that promotes consistent practices and operational efficiency.− Monitor adherence to contractual obligations, maintaining alignment with regulatory and quality benchmarks.

London, Gb

Project Manager – Cell & Gene Therapy (CGT) Access Model | August 2024 – Present− Design CMS-funded program to expand access to cell and gene therapies for Medicaid beneficiaries with Sickle Cell Disease (SCD).− Partner with Community-Based Organizations and healthcare providers to develop targeted program implementation plans that align with community needs and resources, including behavioral health and childcare support initiatives.− Collaborate with LDH’s Chief Medical Officer to align program objectives with clinical outcomes, ensuring support for SCD beneficiaries undergoing CGT. − Engage behavioral health providers to explore and propose mental health interventions tailored to beneficiaries navigating CGT. Program Manager – Provider Management Module | August 2024 – Present− Provide program oversight and strategic leadership for the procurement and implementation of the Provider Management Module.− Develop strategic goals and deliver programmatic oversight for the Provider Management Project team, ensuring alignment with Medicaid objectives.− Coach and mentor project manager, product owner, and technical lead to enhance team performance and deliver project milestones.− Demonstrate expertise in Medicaid provider enrollment processes by developing a data migration approach to mitigate data quality risks and ensure seamless system integration.Project Manager – Claims, Encounters and Financial Management Module | January 2023 – Present− Lead the procurement of a Medicaid management system, LDH’s largest technology procurement in 40 years, to modernize Medicaid’s claims processing, encounter management, and financial reporting system. − Engage stakeholders to define requirements and evaluate vendor qualifications.− Manage a team of nine associates, providing training and coaching to enhance performance and ensure successful project delivery.

London, Gb

− Led the implementation of API functionality to enable claims data access for over 100,000 fee-for-service Medicaid beneficiaries via third-party applications. Ensured compliance with CMS regulations and seamless integration with existing Medicaid systems.− Developed and implemented a marketing strategy, including drafting and publishing web content, to engage stakeholders and educate beneficiaries.− Directed quality assurance for vendor deliverables, identifying critical issues and preventing delays.− Developed workflows and procedures to operationalize the API, ensuring seamless integration with existing Medicaid systems and processes (e.g. call center routing workflows, data load procedures, third-party application reviews, etc.).

Indianapolis, Indiana, Us

− Led the deployment and configuration of IT systems to support care management operations for new health plans, which included the development of system logic to identify eligible members for outreach, implementation of call routing infrastructure, and integration of health risk assessments into care management systems.− Implemented project management workflows, policies, and procedures to ensure thorough execution of all steps needed to operationalize care management programs.− Designed and implemented enterprise-wide care coordination initiatives to address social determinants of health, improving member access to community resources.− Managed the department budget, including assessing costs for IT enhancements, staffing, subcontractor expenses, and member-facing collateral materials.− Collaborated with communications SMEs to create member-facing materials (flyers, enrollment letters, health education, etc.) and implemented marketing campaigns with targeted outreach strategies to increase program engagement. − Partnered with third-party organizations to facilitate in-home visits for high-risk Medicaid members. Led efforts to integrate data systems to allow care managers to complete health risk assessments via tablet devices. − Oversaw contract review team and allocated resources to align team capacity with project timelines and deliverables.− Facilitated governance meetings with 300+ attendees, driving consistency across Health Plans and aligning to enterprise goals.− Developed and implemented marketing campaigns, including targeted outreach strategies, to increase member engagement and drive health outcomes.

Indianapolis, Indiana, Us

− Led implementation of a Medicaid contract compliance assessment software program across eight Medicaid markets. Streamlined rollout by establishing repeatable processes that maintained quality and reduced implementation timelines by 50%.− Reviewed state Medicaid contracts, operationalizing over 7,500 regulatory requirements.− Monitored and reported on open compliance risks across the Medicaid business, delivering monthly compliance risk reports to senior leadership to enable proactive issue resolution.− Conducted program compliance audits, including "Secret Shopper" findings and recommended corrective actions to ensure adherence with regulatory requirements.

Indianapolis, Indiana, Us

Rotation 2-Office of Business Ethics • Created a comprehensive Plan Compliance Officer on-boarding playbook• Stream lined PCO on-boarding process• Reviewed compliance audit reports• Created project plan and timeline• Collaborated with Plan Compliance Officers, Department VPs, systems administrators & various business owners Rotation 1- Reimbursement Policy Management: Business Support Team• Analyzed the financial impact of more than 40 projects• Coordinated the training of more than 300 associates on the Claims Inquiry Tool• Reviewed and updated more than 120 projects to ensure compliance with federal regulations• Conducted thorough analysis of claims editing policies

I assisted peers with political science or history related course work, clarified complex concepts, taught and encouraged positive study habits

Hampton, Va, Us

I Resolved student and faculty complaints, systematized files, prepared and edited university documents, and organized university events.

• Researched the social, political, and economic impact of Micro-Finance in Jaiper, India• Led a group of graduate and undergraduate researches • Oversaw the planning, execution and closing of research project

• Managed the revision of the company’s vender database• Improved process for updating database• Completed project ahead of schedule• Attended strategic meetings

• Planned, prepared and presented lesson plans to young students • Guided students through the process of identifying a community problem, brainstorming possible solutions, translating the chosen solution into a project plan and implementing the plan

• Directed classes of 10 to 35 young students• Implemented innovative activities • Managed staff of teaching assistants • Effectively communicated complex scientific concepts