If I were a character from “The Office” (US), I would’ve probably been Toby Flenderson. Beneath the bone-dry, monotonous inflection and overall dissatisfaction with his job at Dunder Mifflin’s Scranton branch, Toby was perhaps the most reliable and competent person there, and the sort of meticulous applicator of policies and regulations best aligned to advance compliance strategies and regulatory affairs.As a compliance investigator with 7 years of experience navigating complex, continually changing, and highly regulated healthcare environments, I can absolutely relate to the challenges that entail implementing and monitoring policies. For instance, I was once mistaken on my first day for an auditor from the Office of the Medicaid Inspector General. Coworkers actively avoided me for about 2 weeks, scattering in all different directions whenever and wherever I appeared--I was only trying to brew a cup of Cafe Bustelo with Oreo cookie creamer, I swear.Their initial suspicion was largely due to a pervasive misconception of compliance folks as rigid doctrinaires rather than partners sharing a greater overarching goal. In addition to cultivating a deep passion for policy analysis and leveraging technology to drive innovative, risk-based solutions to complex problems, my experience underscored the critical importance of bridging knowledge gaps and promoting a culture of transparency and visibility.By combining my technical expertise with my interpersonal skills, I’ve been able to successfully advocate for impactful changes. I’ve developed and implemented effective compliance programs to enhance financial controls aimed at combating fraud and abuse; mitigate finance risks through optimized billing documentation protocols, and leverage a fully integrative payment solutions platform to streamline the disbursing of funds, increasing efficiency and reducing fraud risks.Additionally, I've found that a proactive and visible compliance presence is essential. By being present and consistent, we can shift the paradigm from reactive to proactive compliance. This enables us to identify and mitigate risks, anticipate potential issues, and take preventative measures, creating a more resilient and compliant organization.As I seek to leverage my skills, experiences, and passion for finance and innovation into a dynamic career in government affairs and AML/BSA/Sanctions, I look forward to a brighter, more compliant future where compliance isn’t just about checking all the boxes or policing the rules and processes; it’s a driver of innovation and sustainable growth.
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Quality Assurance Specialist Benefits And EntitlementsKelberman Mar 2023 - Sep 2024Utica, New York, United StatesLeveraging my knowledge and experience in governmental affairs, collaborating with multiple levels of government agencies, I implemented and monitored a portfolio of payee accounts from scratch. As a steward to an average of $500k+ annually, I meticulously monitored transactions of 29 accounts to ensure adherence to regulatory standards.Through a strategic partnership with a Fintech payment solutions platform, I transitioned programs to a business-to-individual grant disbursement system. This shift from legacy processes successfully streamlined processes by 30%.Additionally, by deploying technology to optimize processes such as documentation and record storage, the transition to e-ledgers and a payment solutions platform effectively enhanced auditing capacity by 28%. Other key achievements included: • Collaborating closely with a colleague to turn around a struggling compliance program, achieving a 456% increased compliance efficiency within 12 months. • Identifying cost-savings opportunities for the people receiving services through the strategic expansion of Medicaid Irrevocable Burial Trust, from 7% to 86% adoption rate.My experience cultivated a deeper understanding of regulatory affairs and Medicaid/Medicare programs. As Quality Assurance Specialist, I developed, implemented, and monitored bi-annual disbursements of clothing allowance grants from New York State, ensuring individuals receiving services received funds to meet their needs and mitigate fraud risks.Technical Skills: EHR, treasury management system, case management system, proprietary incident management system, and specialized database system for incident reporting. -
Assistant Program DirectorLantern Community Services Sep 2021 - Apr 2022New York City Metropolitan AreaAs Assistant Shelter Director, I played a crucial role in the successful opening of a new adult men's shelter for medically vulnerable, unhoused clients. I leveraged my expertise in government affairs to build strong relationships with local and state agencies, ensuring seamless coordination and securing essential resources.Drawing on my experience with pharmacy benefit managers, I successfully implemented a medication access program, partnering with a full-service pharmacy to provide uninterrupted care for our clients. By conducting a cost-benefit analysis, I identified an opportunity to replace bottled water with filtration systems, resulting in annual savings of $36,300 and benefitted about 120 clients daily.I oversaw the shelter's compliance program, ensuring adherence to regulatory standards and contractual obligations. Additionally, I led a cross-functional team to achieve a perfect audit by a major funder. Through collaboration with internal and external stakeholders, I coordinated efforts to identify and connect clients with essential resources, such as legal services, healthcare services and substance use treatment, housing opportunities, and public assistance programs.Technical Skills: Proprietary case management systems, custom procurement software, negotiation, vendor management, government affairs, contractual obligations, government entitlements, identifying community resources, and multi-level government agencies. -
Investigative And Qa AnalystThe New York Foundling Oct 2020 - Oct 2021New York, New York, United StatesI conducted numerous in-depth abuse investigations in OPWDD-certified settings across all 5 boroughs and Rockland county. I maintained a caseload of up to 6 investigations simultaneously. Through meticulous analysis of evidence, I identified patterns and trends, developing actionable recommendations to mitigate risks and improve quality of care.For example, I identified patterns in medication administration errors and advocated for increased monitoring protocols, including safeguards for controlled substances, to mitigate risks and improve safety for people receiving services. By championing for enhanced financial controls and optimized training protocols, I contributed to a safer and more secure environment for individuals with disabilities.Technical Skills: EHR, incident management software (IMS), and Vulnerable Person Central Register (VPCR) incident reporting process. -
Regional Quality Assurance CoordinatorCommunity Options, Inc. Jul 2019 - Oct 2020Brooklyn, New YorkI transitioned into a mid-management position overseeing the compliance program for Brooklyn, consisting of 5 Supervised Individualized Residential Alternatives (IRAs) and a day program for individuals with intellectual and developmental disabilities. As a regional compliance point person, I assisted with audit management and participated in the corporate compliance committee for New York State.Additionally, I conducted thorough investigations on incidents of abuse, neglect, mistreatment, and financial exploitation. I partnered closely with my colleague in Incident Management to reduce the investigation lifecycle by half, successfully developing a standardized line of questioning and process for the collecting and protecting the integrity of evidences. Our initiative became the benchmark for training all investigators.By leveraging my findings, I developed actionable recommendations to reduce fraud risks, enhance quality of care and service delivery, and increase positive client outcomes.Technical skills - Electronic health records (EHR), billing solutions, pharmacy benefit manager (PBM), OPWDD Regulation 624 & 625, OMIG billing standards, and investigative methodologies. -
Senior Direct Support ProfessionalCommunity Options, Inc. Jan 2019 - Jul 2019Greater New York City AreaAs a Senior DSP, I assisted with weekly planning and implementing meaningful activities for a Day Hab Without Walls. I reviewed billing documents to ensure timely submission and accuracy. I worked closely with individuals receiving services to better understand their unique goals and aspirations, and I tailor my supports to meet their needs.For instance, one of my proudest achievements was helping an individual develop strong social skills and learn to navigate the subway independently. This newfound confidence enabled them to enroll in a culinary training program, where they acquired valuable job skills.
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Unit CounselorIndependent Community Living May 2018 - Dec 2018Greater New York City AreaI assisted with program activities and individual counseling as needed at a 300-bed MICA (Mentally Ill Chemical Addicted) shelter for adult women in the New York City metropolitan area. Interacting directly with extremely vulnerable, unhoused women, I helped clients access critical services and community resources to address their needs.Most importantly, through my daily direct interactions with clients, I worked closely with my team and case management to create a safe, supportive, and nurturing environment for women in need. -
Day Habilitation SpecialistThe Arc, Oneida-Lewis Chapter May 2017 - Dec 2017Utica, NyI played a vital role in enhancing the quality of life for people with intellectual and developmental disabilities. I assisted in the planning and implementation of activities and programs, such as arts and craft, volunteer work, community outings, and exercise to ensure a safe, stimulating, and supportive environment for the people receiving services.By developing a deep understanding of each individual's service plans, I tailored 1:1 activities to their goals to help individuals develop and maintain skills in areas, like social interaction and independent living skills. Additionally, I implemented positive behavioral support strategies to address challenging behaviors and promote positive interactions.Technical Skills: Electronic health records (EHR), Medicaid billing documentation, and case management system.
Regina Sarah R. Education Details
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Sociology -
Study Abroad
Frequently Asked Questions about Regina Sarah R.
What is Regina Sarah R.'s role at the current company?
Regina Sarah R.'s current role is Financial Technology Enthusiast | Data Privacy and Compliance Background | Strong Analytical Skills | Improved Program Compliance Rates by 361% in a 12-Month Timeframe | Creative Problem Solver..
What schools did Regina Sarah R. attend?
Regina Sarah R. attended Baruch College, Herkimer County Community College, Regent's University London.
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