Project Manager
Current- Project Manager responsible for managing project activities related to provider data, reporting, reimbursement, new client implementations along with other projects related to the department.
- Oversee the Medicare and Medicaid network adequacy reporting process, this includes keeping appraised of regulatory changes to ensuring compliance and timely filing submission. This requires close working relationship.
- Create and manage end-to-end claim system modification requests; this includes researching and analyzing data requirements, writing work orders, UAT testing, and implementing the modifications once installed into the.
- Responsible for keeping appraised of government regulatory requirements as it relates provider data management and reimbursement, this includes monitoring both state and federal websites for reimbursement updates.
- Subject Matter Expert (SME) on all provider reimbursement methodologies, this includes both professional and institutional pricing models for both Medicare and Medicaid.