Experience

Utah Department of Health

• United States
• Wellness and Fitness Services
• 400 - 500 Employee

• Health Program Specialist III

  • Dec 2015 - Present

  Aging Waiver Liaison between the Division of Aging and Adult Services and Medicaid.Maintain and update the State Implementation Plan for the Aging Waiver program.Coordinate, communicate and educate providers and staff on CMS and Medicaid rules and policies relating to the Aging Waiver program.Perform quality assurance waiver audits.Resolve complicated policy issues.Handle difficult providers and work toward quick resolutions.Participate on the PRISM project testing the new system, attending solution meetings and creating change requests as needed.Train providers, internal staff, other state agencies and area agencies on aging on the new PRISM system.Assist providers with the PRISM enrollment process to become a Utah Medicaid waiver provider.Research and resolve provider's denied claim issues.

• MMIS Supervisor

  • Mar 2013 - Dec 2015

  Establish and implement State and Federal rules relating to the Affordable Care Act and ProviderEnrollment.Participate on the PRISM project designing the new Provider Enrollment System. Participate in State and Federal audits.Interview, hire and train new employees.Manage staff, work schedules, workload, and assign specific duties. Train Medicaid providers on new policies or procedures relating to Provider Enrollment.Handle difficult providers and work toward quick resolutions.Process Data Warehouse queries.

• Health Program Specialist I

  • Oct 1998 - Feb 2013

  Coordinate, communicate, and educate health care providers, and staff on Medicaid rules andpolicies relating to Provider Enrollment.Process provider enrollment applications.Provide Provider Enrollment File training to new employees.Assist the supervisor in their absence.Process Data Warehouse queries.Process sanctions and denials.

• MMIS Technician, Provider Enrollment

  • Apr 1996 - Sep 1998

  Customer Service.Process provider enrollment applications.