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Experienced professional in healthcare behavioral health program operations with extensive knowledge in program management, quality assurance processes, profit and loss, customer service, scheduling and call center management. Subject matter expertise in contract implementation and administration, ensuring contract compliance with federal and state law requirements. Possess a master’s degree in business administration (MBA). Performance driven, results oriented leader, with proven success in program implementation and operations.
Leidos Qtc Healthcare Services
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Associate Director Of OperationsLeidos Qtc Healthcare Services Apr 2022 - PresentNashville, Tennessee, United StatesManage medical quality team, which consists of 170-190 Medical Quality Analysts, 9 Operations Managers, 18 Operations Supervisors, 22 Operations Support Analyst, and one Administrative Coordinator. Responsibilities included managing departmental contract compliance and ensuring department meets internal and contractual service level agreements. Daily responsibilities include working directly with the Director of Operations to implement strategies and plan to meet the organization’s goal and objectives. Also, working closely with other departments and providers to ensure end product meets contractual quality and timeliness standards.
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Operations ManagerQtc Management, Inc. Aug 2020 - Sep 2024Nashville, Tennessee, United StatesResponsible for the obtaining specific team performance in order to achieve the operational goals of timeliness, quality, and customer service.Recruit, manage, and maintain appropriate staffing levels.Monitor post training performance for new employees, provide ongoing mentoring and coaching for employees to reach identified goals.Manage processes and procedures to ensure timely and quality completion of work according to clients’ contractual obligations.Responsible for the daily operational workflow, to include communication with external and internal customers, resolution of customer issues, and identify workflow concerns for specific cases and employees.Assist in developing best practice workflows, ensuring operational compliance and timeliness, ensuring high quality standards, and exceeding customer satisfaction.Analyze and report on a monthly and quarterly basis. Administer and monitor cost effective fiscal controls and services. -
Program ManagerAscend, A Maximus Company Jul 2017 - Aug 2020Franklin, TnResponsible for ensuring Federal PASRR compliance for residents or applicants in Medicaid certified nursing facilities.Recruit, manage, and maintain a network of independent contractor clinicians and physicians across statesConduct training for employees, provide ongoing mentoring and coaching for employees to reach identified goals.Partnering with Finance to develop revenue projections, monitor profit and loss, and maintaining a profitable budget. Ensure program complies with contractual requirements, including quality benchmarks, timeliness, HIPAA privacy and security requirements, as well as maintaining state specific policies and procedures, providing weekly, monthly, quarterly, and annual reports to providers and executive staff. -
Contract Support Division ManagerAscend, A Maximus Company Nov 2011 - Jul 2017Franklin, TnManage the contract support call center consisting of 4 team leads, and 23+ customer service staff. Responsibilities included managing contract compliance and ensuring contractual turnaround times and deliverables.Work directly with the Business Analyst and IT to create automated systems and ensure that systems accommodate changes in business lines or scope. Provide reports to the Chief Operating Officer, monitoring day-to-day process, assisting with new projects (implementation), and developing streamlined and effective processes.Recruit, maintain, and provide quality resources to a large network of Independent Contractors.
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Operations ManagerAscend Management Innovations (A Maximus Company) Oct 2009 - Nov 2011Franklin, TnResponsibilities included managing contract compliance and ensuring contractual turnaround times and deliverables. Working directly with Business Analyst and IT to create automated systems and ensure that systems accommodate changes in business lines or scope. Additional duties included providing reports to the Chief Operating Officer, monitoring day-to-day project performance, assisted with new projects (implementation), and developing streamline and effective processes.
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Clinical ReviewerAscend Management Mar 2004 - Oct 2009Nashville, TnResponsibilities included completing a quality review of specialized assessments for individuals who have mental health or intellectual disabilities in nursing facilities or community settings. Also, provided initial and ongoing independent contractor training, providing quality feedback, monitoring compliance, and assisting the in-house medical director with locating and assigning assessments that required medical approval.
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Customer Service AssociateAim Healthcare Mar 2002 - Mar 2004Franklin, TnResponsible resolving post-payment claims issues on behalf of the member or the insurance company. This included daily contact with insurance companies to identify possible over payments and assisted with resolving overpayments. -
Contract Analyst/Contract Underwriting AssistantCigna Jan 1998 - Mar 2002Chattanooga And Franklin, TnMaintained an active caseload of over 90 accounts, processing client benefit information, preparing certificate documents for policyholders. Also, reviewed and applied Federal and State legislation on accounts. Prepared contractual information such as policies benefit booklets and riders. Managed and monitored benefit and eligibility changes for assigned accounts. Additional responsibilities assisted underwriters with completion of client benefits, editing documents, proofreading materials, revising booklets and researching contracts. -
Assistant Claims RepresentativeUnum 1998 - 1999Chattanooga, Tennessee AreaResponsible for adjudicating and processing total disability claims and providing excellent customer service to members. Managed numerous complex contracts and policies owned by Provident. Daily interactions with members, physicians, attorneys, and private investigators. Participated in preparing for appeals and offering settlements agreements to attorneys and members. -
Intake SpecialistHealthsource 1996 - 1997Chattanooga, Tennessee AreaProvided customer service and pre-certification for in-patient Behavioral Health Services for 1.2 million individuals based on the account and specific guidelines. Also, worked in the Total Disability Claims Department (Cardiac Unit) to adjudicate initial claims for disability benefits. This role required monitoring state policies, and individual policies and medical information to determine if the insured was eligible for disability benefits or worked with the medical directors and litigation team for appeals.
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Case ManagerFortwood Mental Health Ctr 1991 - 1996Chattanooga, Tennessee AreaResponsible for helping individuals with mental illness and intellectual disabilities to transition to community settings. Provided daily community support and monitored treatment compliance. Also provided support for individuals with substance abuse issues. Attended weekly team meetings at state psychiatric facilities and community agencies.
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Frequently Asked Questions about Wendy Johnson
What company does Wendy Johnson work for?
Wendy Johnson works for Leidos Qtc Healthcare Services
What is Wendy Johnson's role at the current company?
Wendy Johnson's current role is Associate Director of Operations at Leidos QTC Health Services Manager.
What is Wendy Johnson's email address?
Wendy Johnson's email address is wj****@****ami.com
What is Wendy Johnson's direct phone number?
Wendy Johnson's direct phone number is +161531*****
What schools did Wendy Johnson attend?
Wendy Johnson attended University Of Phoenix, Western Carolina University.
What are some of Wendy Johnson's interests?
Wendy Johnson has interest in Social Services, Civil Rights And Social Action, Education, Human Rights, Arts And Culture, Health.
What skills is Wendy Johnson known for?
Wendy Johnson has skills like Training, Leadership, Healthcare, Public Speaking, Nonprofits, Healthcare Information Technology, Healthcare Management, Process Improvement, Team Building, Policy, Program Management, Budgets.
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Wendy Johnson
Denver Metropolitan Area4alum.mit.edu, digitalglobe.com, maxar.com, ghx.com1 (303) 6XXXXXXX
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Wendy Johnson
Santa Fe, Nm3igc.org, lfmctr.org, uw.edu -
Wendy Wilson
Hr Leader | Director Of Client Experiences & Consulting | Expert In Hr Program Development, Talent Acquisition, And Culture Transformation | Proven Success In Finance, Biotech, It & Medical SectorsLancaster, Sc -
Wendy Johnson
San Diego, Ca5airespharma.com, airespharma.com, geminiwest.net, proquestvc.com, reneopharma.com1 +185836XXXXX
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