Developed and managed implementation of a care management program with a population health focus for a plan with a predominantly Medicaid and Medicare population. Programs included transitions of care, complex care management and disease/condition management
Developed an administrative query tool to identify children with special health care needs for a health plan's performance improvement project
Conducted readiness review preparations, Medicaid managed care compliance audit preparations, corrective action plan management, reporting and response
Performed Medicaid managed care contract and compliance reporting
Managed project to connect care management tool with alerts from local health information exchange
Managed project to integrate data from electronic health records, health plan claims data, and health information exchange to support proactive panel management, risk stratification, and patient engagement
Supported accountable health communities deployment
Medicaid global payment model: served as an integral partner with health plan from initial proposal development through implementation, including planning, documentation, internal and external communications, and system changes
Facilitated health plan attribution model development and managed internal, external and system implementation
Developed health plan Early and Periodic Screening, Diagnostic and Treatment (EPSDT) communications and training, conducted process improvement and compliance, and updated policies