Tamara Sands Email & Phone Number

Mulvane, Ks, Us

Remote

Partnered with IT Scrum teams and internal Medicaid Health Plan partners to construct assessments and portable document formats (pdf) within database to be utilized by LTSS Case Management team via universal HIP system. Assessed system requirements, including capturing member data, and ensuring contractual, reporting, and regulatory requirements were confronted. System allowed Anthem LTSS to deliver optimal care to members by determining appropriate services. Managed 12 subcontracted consultants.

Established positive provider relations and administered training in claims methodology and reimbursement, appeals, credentialing, contracts, grievances, various healthcare benefits, regulatory requirements, ethics, incentive programs tied to quality measures, and best practices. Consult architects in systems and interface development

Established positive provider relations and administered training in claims methodology and reimbursement, appeals, credentialing, contracts, grievances, various healthcare benefits, regulatory requirements, ethics, incentive programs tied to quality measures, and best practices. Consult architects in systems development.