Sarah Walker, Mba Email & Phone Number

Oklahoma City, Ok, Us

Oklahoma City, Oklahoma Area

Lead and mentor a team of 4 senior research analysts that interpret, analyze and visualize complex data and associated state or federal rules and policies. Collaborate with internal and external stakeholders to facilitate the implementation and evaluation of coordinated initiatives requiring data specific to the Oklahoma Medicaid program. Perform extensive analysis of MMIS program data using SAP Business Objects , SPSS and Tableau.Current contact person responsible for entering CMS Core Set (HEDIS) Quality Measures into the CMS reporting system (formerly MACPro) and organizing responses to CMS “Seek More Information” requests.

Analyzed administrative claims data and developed visualizations that allowed for actionable conclusions and recommendations.Performed complex analysis using SAP Business Objects, SPSS and Tableau on Oklahoma Medicaid data. Developed queries and dashboards to accurately track and report Prior Authorization totals and trends.Contact person responsible for entering CMS Core Set (HEDIS) Quality Measures into the CMS reporting system (formerly MACPro) and organizing responses to CMS “Seek More Information” requests. Designed reporting for several of the Core Set Quality measures.

Plan and conduct audits of pharmacy records and other information to verify that products billed to the Medicaid program were the same products purchased; that the products were delivered to the specified Medicaid client; and that a valid prescription order exists for each claim billed. Prepare reports and other information concerning inspections, investigations and audits; develop exhibits and other evidence concerning violations. Assist in compiling and reviewing statistical data, in compiling and editing data for accuracy and completeness through Business Objects and Access.

Serve as a lead worker to Contract Specialist I and II in researching, reviewing and replying to a large range of complex telephone inquiries from providers, billing agencies, law offices, recipients and others relating to agency and federal rules for Medicaid contracts.Provide assistance to Provider Contract Specialist I and II involved in reviewing, renewing and disseminating general professional provider contracts.Analysis, research and/or action to correct, reverse or otherwise recover provider payment discrepancies or erroneous Electronic Fund Transfers.

Enter all incoming contracts on the MMIS Application Tracking file.Review provider file on MMIS for appropriate resolutions to providers for accurate and complete information.Independent decisions on how to resolve any problem provider is experiencing through individual research and interpretation of federal rules and procedures and agency rules in relation to Medicaid Provider Programs.

Receive and date stamp in all incoming mail.Log in contracts on Access database and assign to appropriate personnel.Research, review and reply to entry level correspondence and written inquiries regarding Medicaid rules and agency procedures relative to Medicaid provider programs.

Masters Of Business Administration, Business

Bachelor, Business Administration; Finance