Provide legal research and analysis for contract procurement.Prepare and draft vendor contracts, renewals, amendments, data use agreements, etc.

Provide advanced legal support to in-house counsel and internal clients with responsibility for insurance and provider operations, regulatory filings, transactional matters, corporate record keeping, contract review and general litigation.Prepare and evaluate legal documentation to resolve problems, close transactions, and/or maintain good corporate governance.Conduct legal research and analysis, and recommend appropriate course of action and next steps.Act as liaison and internal… Show more Provide advanced legal support to in-house counsel and internal clients with responsibility for insurance and provider operations, regulatory filings, transactional matters, corporate record keeping, contract review and general litigation.Prepare and evaluate legal documentation to resolve problems, close transactions, and/or maintain good corporate governance.Conduct legal research and analysis, and recommend appropriate course of action and next steps.Act as liaison and internal client point of contact regarding various legal issues, regulatory compliance reporting requirements, corporate structure, entity information and other matters.Perform fact checking, gather documents, research and respond to subpoenas, record requests, and various inquiries from internal and external sources, coordinate investigative and discovery activities.Serve as a lead in the investigation and resolution of complex cases.Monitor state and federal legislation affecting the corporation, and develop and/or implement recommendations relative to changes in regulations and laws.Apply business knowledge and technical expertise to optimize solutions and improve practices.Participate in projects and negotiations and strategize with business and staff.Enter information into appropriate databases and other document management systems.Assist in resolution of member and provider disputes.Advise on interpretation of requirements of the Medicare Advantage and multiple state Medicaid programs. Show less

Responsible for providing oversight and guidance in support of policy and procedure management for Anthem’s Medicare Revenue programs and ensuring that Centers for Medicare & Medicaid Services guidelines and regulations are followed.Consulted w/ key internal Medicare Revenue business partners to ensure that processes and procedures were appropriately documented and compliant with CMS regulations.• Coordinate and partner with other areas of Anthem, such as Medicare Compliance, to… Show more Responsible for providing oversight and guidance in support of policy and procedure management for Anthem’s Medicare Revenue programs and ensuring that Centers for Medicare & Medicaid Services guidelines and regulations are followed.Consulted w/ key internal Medicare Revenue business partners to ensure that processes and procedures were appropriately documented and compliant with CMS regulations.• Coordinate and partner with other areas of Anthem, such as Medicare Compliance, to guarantee that CMS regulations were met and that proper policies and procedures were met.• Served as a subject matter expert for process analysis, policy interpretation and education to internal business partners.• Served as a subject matter expert on CMS regulatory guidance that may impact Medicare Revenue policies and procedures and provided policy and procedure training.• Performed independent and ongoing analysis on Medicare Revenue processes and made recommendations for necessary training, policy development and/or revisions and process enhancement.• Developed reporting structure and tools to monitor policy and procedures and reported to Medicare Revenue management. Show less

Perform a variety of MRI scans including the use of IV contrast. Communicate with patients, staff and physicians.Research and report on suspected contra-indications and outdated policy terms. Compile data and remit for ACR accreditation.

Perform estate audits looking for inconsistencies and fraud. Website Web site creation and modification. Contribute to the re-writing of the Local Rules of the Court. Offer opinions and legal arguments to Magistrate and Judge. Familiar with Court systems and procedures.

Contingent MRI Tech

Implemented and supervised internal compliance and QA programs. Submitted plans for reorganization allowing for increased patient throughput while avoiding Stark violations. Reviewed, analyzed and interpreted regulatory requirements. Maintained policy manual. Created screening forms and procedures to limit company malpractice liability. Reviewed vendor and service contracts.Helped establish additional imaging centers. Analyzed patient and equipment usage data… Show more Implemented and supervised internal compliance and QA programs. Submitted plans for reorganization allowing for increased patient throughput while avoiding Stark violations. Reviewed, analyzed and interpreted regulatory requirements. Maintained policy manual. Created screening forms and procedures to limit company malpractice liability. Reviewed vendor and service contracts.Helped establish additional imaging centers. Analyzed patient and equipment usage data. Identified business problems and worked to create solutions. Interacted with patients providing customer service while efficiently performing MRI exams. Directed the daily clinical and administrative operations of the MRI facility, ensured efficient process and a high degree of patient and physician satisfaction. Investigated and reported on suspected non-compliance. Supervised staff and department administration, payroll, scheduling, and marketing. Show less

Contingent MRI Tech

Staff supervision/department administration, payroll, scheduling, marketing, and QA *Transformed a struggling organization into a stable, efficient operation *Retrained and motivated employees to achieve improved productivity *Solidified service contracts, increased staff and output of x-ray exams resulting in a consistent revenue stream