Rena Brown Email & Phone Number

Kansas City, Missouri, United States

• Provided management and support of contracts team with full oversight of on and off exchange applications and project implementation with emphasis on federal and state specific ACA compliance. Interpreted federal and.
• Regulatory oversight for all Affordable Care Act (ACA) applications and submission activities for individual and small group Qualified Health Plan and Stand-Alone Dental Plans for 14 states, including weekly meetings.
• Set strategic direction for project management and maintained oversight of all state and federal deadlines.
• Worked in tandem with government affairs and all interested functional groups across the organization to influence stakeholders to support key projects/programs to ensure positive outcomes and deliver results.
• Solution driven working directly with CMS and the NAIC to help identify efficiencies in system programming and capacity.
• Analyze and make recommendations for efficiencies in developing the ACA applications and submissions.

Overland Park, Kansas, United States

• Developed and maintained effective and efficient processes for determining the appropriate admission status based on the regulatory and reimbursement requirements. Identified and analyzed appropriate metrics, evaluated.
• Led two clinical supervisors and 50 associates to confirm eligibility, process initial requests and process additional requests for home health care.
• Ensured compliance with performance standards by monitoring turnaround time and telephone statistics.

Kansas City, Kansas, United States

• Designed and implemented various policies and procedures for claims. Provided services to all business requirements and ensured optimal handling of all claims and investigated all issues. Evaluated all new claims and.
• Managed 40+ employees and served as the lead in the development of the new business administration system (Vitech – V3).
• Developed positive relationships with outside service partners, including CIGNA and CIGNA Behavioral Health

Overland Park, Kansas, United States

• Claims Manager, Medical Review Division, 2007 – 2009 Monitored billing activities, performance management, and production standards and quality of results. Provided technical assistance to clinical staff in order to.
• Improved relationships with outside vendors in the areas of utilization and case management, transplants, and subrogation. Senior Project Manager, 2006 – 2007 Coordinated internal resources and vendors for the flowless.
• Led a successful implementation of a correspondence project, involving collection, review, revision, and team approval of approximately 150 online forms and letters.

Kansas City, Missouri, United States

Reviewed contacts to prevent potential disputes and financial risks. Analyzed contract clauses, stipulations, obligations, and liabilities. Recommended and drafted contract provisions and amendments. Negotiated contract terms, payment structures, and reimbursement. Researched industry compliance regulations and policies. Evaluated internal operational and.

Seeking Certificate, Regulatory Compliance Specialization

Bachelor Of Science - Bs, Journalism

Activities and Societies: Writer and photojournalist for the Lincoln Clarion Afternoon and weekend DJ for KLUM Radio