Child Health Plan Plus (Chp+) Project Manager
Currentaccess to vital healthcare services for 55,000+ children and families annually.• Monitor changes in regulations and fee schedules, ensuring timely communication to guarantee adherence to both state and federal guidelines.• Achieved targeted annual, semi-annual, quarterly, and monthly business retention objectives through the delivery and successful negotiation of renewal contracts with the State of Colorado.• Executed the successful implantation and meticulous monitoring of the Performance Improvement Project (PIP) yielding a 2% increase in dental utilization.• Streamlined administration processes for client programs, ensuring adherence to State of Colorado's expectations and contract terms; enhanced communication accuracy and efficiency, surpassing RFP requirements.• In charge of updating Office Reference Manuals, implementing corrective action plan response and effectively organizing client audits.• Formulated and constructed a quality improvement strategy aligned with organizational objectives and regulatory requirements, resulting in improved HEDIS performance.• Conducted comprehensive audits and assessments to verify compliance with CMS, HCPF, and NCQA regulations; identified and resolved 100% of non-compliance issues, ensuring adherence to industry standards.• Analyzed quality data, prepared detailed reports, and presented program initiatives at committee meetings, resulting in transparent tracking and progress reporting that drove data-informed decision-making and program improvement.