8 year experienced, results-driven and passionate leader with a demonstrated history of working in an academic medical center. Lean Six Sigma Certified (Yellow belt). Expert in payer policy analysis & regulations [Medicare, Medicaid, Managed Care and Commercial] and Healthcare Management. Certified Epic IT professional with a Master of Business Administration.
Self-Employed
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Creator Of Eye C USelf-EmployedUnited States
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Gso Housing Assignments ManagerUs Embassy Mexico City Nov 2018 - Mar 2021Mexico City, MexicoTasked with managing a complex portfolio of housing assignments with prompt and professional service to diverse range of clients through the 52 different agencies.Spearheaded a team of 3 employees and work with colleagues in various offices to manage a complex housing make-ready process.Prepared a running list of 20-60 properties for departure, arrival or termination that helped managed over 400 residents in the make-ready process.Updated the leasing team monthly about expected arrivals and requests for properties.Collaborated with the GSO Inspectors to manage the make-ready process for residences to be completed within a reasonable period, coordinated the safety/security installations and cleaned before tenants receive new keys.Accountable for the receipt of the housing questionnaires and handling any customer service issues.Availed presence by email and phone calls as well as with monthly webinars to ensure optimum customer service provision.Managed pressure with professional communication which features fairness and equity to a diverse range of clientele.Assisted in reviewing potential new properties for the pool providing valuable feedback on the long-term feasibility of such properties.Identified spaces relevant to a range of families and displayed solid understanding of the locations where housing is approved and where residents prefer to live resulting into happier clientele and improved mission morale.Served as the Administrator for the housing board while facilitating meetings monthly.Scheduled meetings, recommended assignments for board approval, and prepared and distributed minutes.Coordinated all petitions or appeals received and worked to address the concerns of residents by partnering with GSO, FAC, RSO, the landlord, etc. before it goes to the IAHB.Leveraged technology and migrated meetings from in-person to teleconferences and then video conferences with cyber votes for written documentation of housing assignments and approvals.
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AnalystUnc Health Nov 2018 - Mar 2021 -
AnalystUnc Health Nov 2018 - Mar 2021 -
Hcs – Applications AnalystUniversity Of North Carolina At Chapel Hill Sep 2015 - Jun 2018Chapel Hill, North Carolina, United StatesTasked with providing high level of technical support (development, testing, integration and implementation) of applications and interfaces which deliver IT tools and support business functions across the health system.Performed project management functions, requirements definitions, systems design, analysis, code development, problem resolution and vendor coordination.Evaluated requests and consulted in design for new or modified computer programs, solutions, reports and interfaces to determine feasibility and compatibility with the current system.Identified and recommended solution development for larger and complex projects and ensures best practice development.Assigned to formulate and develop plans at a high level and documents required steps to achieve stated requirements. Reviews plans with management/peers as appropriate.Developed and maintained clear, understandable documentation to describe program development and modification, as well as troubleshooting. Updated system and support documentation as necessary to reflect changes to programs, solutions, reports and interfaces. Informed management, customers and others as appropriate promptly about the progress on assigned tasks, projects and issues, via written or oral reports.Proffered support to other IT teams with selection and provides technical evaluation of products/tools to ensure that the proposed solution adheres to enterprise-wide requirements.Adapted to new requirements and changing technologies to meet business standardization protocols and objectives.Provided guidance to Applications System Analysts to ensure best practices, standard methodologies and processes are executed.Recognized as a technical consultant to the health system and maintained high service level while participating in system-wide initiatives to improve efficiency and reach institutional goals and objectives. -
Policy AnalystUniversity Of North Carolina At Chapel Hill May 2013 - Sep 2015Chapel Hill, North Carolina, United StatesDirected research policy matters including denials, rejections, insurance coverage, patient’s rights, payers responsibilities, LCD's, NCD's, compliance issues, policy changes and/or updates, etc. and crafted solutions and implement corrective action plans as neededDeveloped findings and recommendations reports based on policy changes released by the payers and alert and provide guidance to the different areas that could potentially be affected by those changes.Submitted formal inquires to Palmetto GBA and the Centers for Medicare and Medicaid Services (CMS)of policy issues affecting reimbursement and causing denials and/or rejections of claims for codes that were previously paid.Attended meetings where policy issues may arise to address them and/or research them llater.Provided guidance as well as a findings report instructing steps to be taken for resolution of policy and/or regulations related matters. CCG Meeting, BCBS Payer Specific Meeting, SOAR meeting, etc.Contacted and obtained consent from all medical schools within Palmetto’s Jurisdiction to participate in an All Schools Meeting for purposes of discussing any sensitive and pressing issues affecting the medical schools within J11 Part B.Developed Training materials for training and development of new UNC Physicians employees as it relates to the EPIC System and the Revenue Cycle.Read through all Palmetto/Medicare alerts, determine the importance, summarize and send the information to the specific areas as needed as well as through agency alerts: DOL, VA, HHA, Hospice. summarize and send the information to the specific areas. -
Compliance SpecialistMcs Puerto Rico Jul 2006 - Dec 2007San Juan, Puerto Rico• Played an instrumental role in organizing and executing internal and external audits.• Provided strategic advice and recommendation to management and senior executives concerning business policies, rules, and regulations.• Assisted other departments to ensure their compliance with the quality standards of the company.• Guaranteed that the policies and procedures are continuously monitored and evaluated—specificallyactivities associated with marketing and execution processes as they relate to the products beingmonitored.• Detected and responded to fraud and other misconduct by third parties that may affect the government programs.• Designed and implemented policies and procedures for the compliance department.• Oversaw junior and entry-level professionals within the department and developed comprehensivetraining plans while supervising periodic compliance training and education for the company’s personnel.• Provided Compliance, Medicare Advantage, Grievances and Appeals, Sales practices, Enrollment, andDisenrollment procedures training according to the Centers for Medicare and Medicaid Services (CMS)federal regulations.• Worked in the investigation process of the Appeals & Grievances for Medicare Advantage.• Completed knowledge of the MA and Part D appeals and grievances process.• Reviewed and translated CMS-approved documents, legal documents, and marketing materials.• Provided strategic advice and recommendation to management and senior executives concerning business policies, rules, and regulations.• Assisted other departments to ensure their compliance with the quality standards of the company.• Guaranteed that the policies and procedures are continuously monitored and evaluated.• Detected and responded to fraud and other misconduct by third parties.• Designed and implemented policies and procedures for the compliance department.• Oversaw junior and entry-level professionals within the department and developed comprehensivetraining plans. -
Enrollment SupervisorFirst Medical Plus Jul 2005 - Feb 2006Puerto Rico -
Compliance Special Project CoordinatorMmm Healthcare, Llc Apr 2003 - Feb 2005Puerto Rico
Frequently Asked Questions about Jessica S.
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Jessica S.'s current role is Creator of Eye c u.
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Dynamic And Experienced Financial Services Leader | Trust Operations | Strategic Planning | Process Improvement |Marketing & Communications -Rockford Area Shrm, Phr, Shrm-CpGreater Rockford Area2plansmith.com, gatewaycb.com1 +181562XXXXX
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