Missy Downs, Pmp Email and Phone Number

Serves as Project Manager and the Quality Assurance Specialist for the Expert Witness Acquisition Contract (EWAC) with the Centers for Medicare & Medicaid in: a) determining the most appropriate types of medical expert witness to be offered in disposition of cases, b) confirmation and verification of credentialing components, and c) negotiating and executing Memorandum of Agreements with expert witnesses.

Serves as Project Manager with the Office of Medicare Hearings & Appeals (OMHA) in: a) determining the most appropriate types of medical expert witnesses to be offered in disposition of cases, b) confirmation and verification of credentialing components, and c) negotiating and executing independent contractor agreements with expert witnesses.

Served as the Coordinator for the records portion of the Risk Adjustment Validation and Payment (RADV) project. Responsible for:-Communicated and requested medical records from Medicare Advantage Organizations (MAOs)-Provided Technical Assistance to MAOs as needed-Initial intake of all medical records and assigned to primary coders-Maintained an up-to-date correspondence log with all communication between plans (MAOs)-Collaborated with Coders on medical record issues-Communicated regularly with IT department to improve Abstraction tool-Recorded and distributed minutes from weekly status meetings with CMS-Communicated directly with CMS when issues rose

Served as Project Coordinator for the Expert Witness Procurement (EWP) Project through the Office of Medicare Hearings and Appeals (OMHA). Responsible for:-Directed and managed operational aspects of all outreach and clinical evaluation as related to expert witness service programs-Assisted with developed and implementation of EWP software for OMHA program-Provided direct customer service to requestors and providers for OMHA-Implemented process improvements for expert witness invoice processing-Worked closely with the HMS Program Manager on program issues-Determined the most appropriate types of medical expert witnesses to be offered in disposition of cases-Confirmation and verification of credentialing components