Latham Folse, Pmp Email & Phone Number

Baton Rouge, Louisiana, United States

Program Manager over the MCO Oversight Unit within the Program Integrity Section of the Louisiana Department of Health.

Baton Rouge, Louisiana Area

Responsible for providing direct supervision of Medicaid related programs including, but not limited to: Operating Budget, Strategic and Operations Plans, Advanced Planning Documents, Leases, Reporting and management of Contracts. Work on special assignments as required by the Medicaid Deputy Director and Eligibility Program Operations (EPO) Section Chief. Supervise four (4) Medicaid Program Monitors with significant roles within the Bureau of Health Services Financing (BHSF). • Hold direct oversight of the department’s annual $92.6M budget, with funds allocated across four (4) different sections. These activities include expenditure tracking, fund reallocation and the forecasting of future budget needs • Ensure efficient use of state and federal funding in obtaining or retaining lease space to have a physical presence in communities throughout the state. Oversee the leases for 12 different locations, housing 813 state workers and totaling $1.9M annually • Act as liaison between the Centers for Medicare and Medicaid Services (CMS) on reporting and Annual & Operational Advance Planning Documents for Louisiana Medicaid Eligibility programs totaling $209M annually. On an on-going basis, a total of 64 different reports are produced• Assist in the on-going management of the state’s Outstation program that further supports Medicaid Expansion enrollment efforts. At last count, there were 55 Medicaid Analysts located in the offices of 46 different medical providers throughout the state, accounting for an average quarterly savings to the state of $178k• Serve as the lead for LDH’s participation in the launch of a Statewide Consolidated Call Center to provide Customer Service Management (CSM) for multiple state departments. LDH projects to spend $12.5M annually once a contract is signed • Analyze federal, state, and local legislation and advise department officials of anticipated impacts

Greater Pittsburgh Area

Accountable for leading the implementation of projects in the clinical services business unit including utilization management, case and disease management, and other related clinical programs. Responsibilities included definition, planning and delivery of complex programs that require cross-functional collaboration and management of interdependencies between a group of projects and/or related activities within the constraint of scope, quality, time and budget. Coordinated with a group of internal exempt and/or matrixed employees and contractors that served on the program(s) to deliver solutions for the business.• Worked with business and technical organizations to drive out program strategy and approach. Organized, planned, and maintained Program roadmaps consisting of cross-functional activities/projects• Coordinated with business and technical organizations to assemble project teams. Lead Project Managers and Program team in the development and maintenance of comprehensive plans for a defined program• Partnered with Executive Sponsor and Business Owner of a Program, and other management as required, to achieve the Program objectives. Acquired understanding of the business objectives for an assigned area• Monitored, evaluated and reported on Program status inclusive of scope, schedule, budget and alignment to Program and strategic goals. Directed corrective action as needed to maintain the viability of the Program• Developed and maintained positive customer relationships. Delivered presentations of project statuses to effectively communicate throughout the project lifecycle• Adhered to Highmark project management methods, project lifecycle methodologies, and audit requirements. Supported and contributed to the improvement of project management methods and practices

Baton Rouge, Louisiana Area

Responsible for providing direct supervision of Medicaid related programs including, but not limited to: Budget, Outstation Invoicing, Strategic and Operations Plans, Advanced Planning Documents, Leases, Reporting and Management of Contracts. Work on special assignments as required by the Medicaid Deputy Director and Eligibility Program Operations (EPO) Section Chief. Supervise four (4) Medicaid Program Monitors with significant roles within the Bureau of Health Services Financing (BHSF). • Hold direct oversight of the department’s annual $90.6M budget, with funds allocated across four (4) different sections. These activities include expenditure tracking, fund reallocation and the forecasting of future budget needs • Ensure efficient use of state and federal funding in obtaining or retaining lease space to have a physical presence in communities throughout the region. Currently oversee the leases for 12 different locations, housing 718 state workers and totaling $2.0M annually • Act as liaison between the Centers for Medicare and Medicaid Services (CMS) on reporting and Annual & Operational Advance Planning Documents for Louisiana Medicaid Eligibility programs totally $124M annually. A total of 76 different reports are produced on an on-going basis• Serve as a representative for EPO in continuing to determine system and reporting changes needed for Medicaid expansion, which launched in Louisiana on July 1, 2016, with 186,799 members gaining immediate access to full health care benefits, a number that has since grown to over 400,000• Assisted in the launch and on-going management of the state’s Outstation program that further supports Medicaid Expansion enrollment efforts. Currently there are 68 Medicaid Analysts located in the offices of 57 different medical providers throughout the state, accounting for an average quarterly savings to the state of $185k • Analyze federal and state legislation and advise department officials of anticipated impacts

Baton Rouge, Louisiana Area

Serve as the central point of contact for the Medicaid Member Services Contact Center. Supervise and assist four Program Monitors who are responsible for responding to telephone and e-mail inquiries regarding Medicaid benefits, plans, regulations and specific questions concerning members’ accounts. Responsible for the overall contact center productivity, quality and development.• Administer statewide Medicaid program• Supervise the auditing of eligibility enrollment for Medicaid programs statewide• Review work of customer service staff for quality assurance• Plan, develop, implement and monitor comprehensive Medicaid program policies• Conduct and direct studies/special projects pertaining to the programs assigned• Analyze the impact of federal, state, and local legislation and advise department officials of anticipated impacts• Review and analyze complex data and system reports to ensure compliance with program regulations• Administer the day-to-day operational functions of the Medicaid prepaid and fee-for-service programs. Ensure that program policies and procedures are properly applied in accordance with federal and state laws and regulations• Implement Medicaid regulations including provider participation standards and recipient benefits

Baton Rouge, Louisiana Area

Served as the senior client point of contact for the performance of a 364-seat contact center in Baton Rouge, LA. Addressed client requests, questions and needs in a timely fashion and to complete resolution. Managed a team of 8 employees located in Louisiana and Florida with responsibilities in the areas of reporting and analysis along with floor coordination. • Selected as the Project Manager for changes implemented by client in the areas of Quality, Training and Information Technology, working with cross-functional teams and insuring on time completion within budget• Coached team and operations staff members on balancing client metrics with internal profit metrics leading to bottom-line P&L improvements• Built and maintained strong client relationships, resulting in confidence in site performance ability and increased business • Organized presentations and led formal client review sessions highlighting improved performance and outlining sound strategies for improvement where needed• Analyzed Operational performance by reviewing agent-level data, center data and other appropriate information to assess trends and recommended solutions for improvement to Operations• Supported Program Delivery team who worked with the client, analyzed daily results and made recommendations on client program enhancements and changes in strategy

Baton Rouge, Louisiana Area

Focal point for client contact and directly responsible for internal coordination of formal client review sessions, site visits and focus groups. • Analyzed daily performance results and made recommendations to client and internal operations on program enhancements, changes in direction and service offerings to increase performance and drive down costs• Wrote formal weekly performance reports based on data analysis and including center strategic plans to drive improvements• Initiated action plans for the client in order for the center to attain agreed-upon metrics • Approved weekly and monthly billable hours reports before presentation to the client to stay within budget projections

Baton Rouge, Louisiana Area

Managed performance of 18 direct reports located in Louisiana; Tennessee; Utah and Manitoba, Canada. Responsible for trend and performance reporting for direct reports and agents.• Worked with Directors and Senior Managers across multiple sites to increase center performance • Presented, trained, and implemented quality initiatives across multiple centers leading to a minimum of 16% increases in quality results• Oversaw quality specific projects, including the evaluation processes for new centers

Baton Rouge, Louisiana Area

Responsible for communicating key activities, marketing programs and new advertising campaigns to 120 branch offices nationwide. Managed direct response lead generation programs along with supervising two direct reports whose focus was on daily branch communication and support. Managed the department's annual budget of $10 million, including processing and tracking invoices• Negotiated contracts and managed relationships of three lead generating call centers along with yellow pages, specialty items, and advertising companies leading to over $500,000 in yearly savings • Partnered with advertising agency to design new sales collateral pieces used by all branch offices• Developed a marketing campaign manual used by branch offices to source new business• Oversaw specialty items program, including design, ordering and inventory management

Baton Rouge, Louisiana Area

• Prepared and managed branch lead plans of up to 40 qualified sales leads per day• Performed market feasibility studies to determine area marketability• Monitored telemarketing calls to insure script adherence and customer service • Developed brochures and program matrices • Produced RFP (Request for Proposal) for redesign of company web site

Baton Rouge, Louisiana Area

Hired on full-time after completing a 6-month internship with the company and graduating from LSU. Continued with Intern job duties while taking on increased level of responsibility. Projects included managing yellow page vendor, lead quality issues, developing and implementing trade show strategies.