Maintains office services by organizing office operations and procedures, preparing payroll, controlling correspondence, coordination of EMR systems, reviewing and approving supply requisitions, conduct quality improvement measures and monitor weekly, monthly, and quarterly, created community resource documents, track and monitor daily reports from MCOs via several external systems. assigning and monitoring clinical/administrative functions. Responsible for planning, organizing, controlling for processing the patient centered medical home NCQA certification. Develop, implemented policies and procedures and maintained NCAQ as well as all organizational certifications to ensure staff compliance for Patient Centered Medical Home certification. Provided staff training and education for operational policies and procedures for PCMH.

Ensures compliance with contractual provisions and local MOUs, as applicable. Manages HSA/PSA operations, negotiates priorities, and allocates available resources based on customer needs and contractual requirements.Schedules, monitors and performs all necessary briefings in order to meet contract requirements. When local resources are exhausted the consultant coordinates with leaders to ensure complianceParticipates in and meets all contingency operations requirements whether exercise or real world. c. Accurately maintains required documents not limited to but include the MOU Supplement, Contingency Plan, Resource Guides, encounter information, issues log, etc.Services as the primary point of contact for Military Treatment Facilities, Commanders and their staffs within assigned HSA, as applicable. Maintains positive, collaborative relationships with all internal and external customers.Maintains relationships by actively participating in ACMs, PWGs and other necessary meetings. Develops and presents presentations as required for meetings.Provides accurate and timely interpretation of TRICARE policies upon requestAssists in operating and maintaining a stable, cost efficient network within the HSA.Maintains provider data quality, supports Network Development and Management in cost of care initiatives by developing, implementing, monitoring and analyzing strategies to ensure maximum network utilization in multiple plan areas.Determines the strengths and weaknesses of the network system and develops options and recommendations for change to better serve MTFs and beneficiaries.Participates in success of meeting established goals and objectives of Network Development and other network activities and reporting requirements.Participates in the development and implementation of network development and steerage strategies.Interacts with Network Providers to develop and foster relationships and proactively support the needs of the network.

Managing all administrative and operational functions associated with the office including inventory control, personnel management, patient relations, and patient flow. Strengthening the daily operations of the provider offices including staff, scheduling, cash reconciliation, charge entry, and operational checks and balances. Works directly with the CBO to ensure A/R is optimally liquidated, collections increased, denials are minimized, refunds are issued, and customer service is conducted. Interviews, hires, orients, trains, supervise, evaluates, and builds office staff. Responsible for increasing staffing resources, scheduling staff, assigning work, promoting and disciplining staff. Ensures that the site is in compliance with OSHA, CLIA, (and in some cases JCAHO), FSLA, patient confidentiality standards, and payor regulations.

Oversaw health center operations both nursing and administrative by ensuring staff members follow established guidelines in arrears of patient care, scheduling, registration, data entry, medical records, referrals, billing, and clinical operations. Directed daily support/mentoring/training to staff. Researched and resolved patient complaints and operational problems. Solicited feedback from physicians, dentists, and other providers to determine ways to improve their effectiveness and satisfaction with clinic or dental operations and programs. Performed required pre-certification, authorizations, referral, surgery, and increased daily deposit collection. Input data into computer system and documents all requirements of the registration process. Improved design skills enhancement programs and refresher courses for staff. Scheduled and participated in all required on site surveys and third party inspections; maintained records, statistics for administrative and regulatory purposes. Built compliance with OSHA, fire safety, and other applicable regulations. Selected, oriented, and set goals for all clerical and clinical support staff.

Conceptualized on problem solving, recruiting, disciplining, orientating, and training of staff. Improved growth and development of the clinical staff by forecasting with planned participation in new technology. Projected upcoming changes and promoted and coordinated continuing education. Assessed and maintained staff productivity to budgeted standards by presenting and formulating daily objectives, managing policy and procedures. Focused on strong and positive customer service skills at all times. Planned in advance to prevent any insurance issues by notifying patients concerning network insurance coverage information. Solved confusion at the front office by adapting a calling ahead program to give patients insurance co-payments, deductibles or any type of patient responsibility prior to visit.