Experience

University of Maryland Medical System Health Plans

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Medicare Compliance Analyst

  • Feb 2016 - Present

  • Assist the Director of Compliance with planning and managing initiatives to ensure timely completion of Medicare compliance program objectives. • Develop & implement appropriate compliance tracking, monitoring and reporting systems for Riverside Health Medicare Advantage products. • Development and implementation of CMS-required Plan Documents including, but not limited to: ANOC-EOCs, Summary of Benefits, Directories, Formularies and beneficiary forms. • Ensure business units are up to date on Medicare regulations. • The Medicare Compliance Analyst must incorporate at least four main functions: o Maintain, update, and coordinate all required compliance training as defined in the Medicare Compliance Program for existing and new staff and Board of Directors. o Review all documents and communications received from CMS or its designees and communicate to internal business owners and external first tier, downstream and related entities as necessary to ensure compliance. o Monitor operations for compliance with all regulatory requirements and guidelines. o Review all marketing materials for compliance with CMS Marketing Guidelines prior to submission to CMS and work with operations to ensure all materials are compliant. • Maintain knowledge of the business and regulatory environment relative to Medicare managed care, Medicare Advantage Part A&B and Medicare Part D and maintain general knowledge of other plan product lines, business activities, etc. • Work with business units to determine root cause and remediation of compliance issues. • Assist the Director of Compliance with Quality Improvement Committee reporting, Medicare Compliance Committee reporting and reporting requirement submissions for Medicare line of business to the state and federal governments. • Develop and maintain compliance policies & procedures; continually monitor and evaluate the adequacy and efficacy of policy, procedures and company adherence. Show less



Coventry Health Care

• Columbia, Maryland

• Administrative Assistant III

  • Nov 2003 - Oct 2012

  Performed a variety of clerical and administrative duties for the Vice-President of Government Programs and 6 healthcare management directors including but not limited to, creating correspondence, maintaining calendars, compiling complex reports, internet research, creating graphic presentations, filing, managing the administrative functions in the facility, answering telephones and greeting visitors.  Used a variety of software packages to draft routine and non-routine correspondence to consumers, providers, and federal agencies for executive’s review.  Screened all incoming telephone calls for executives and referred to appropriate staff as applicable.  Researched, compiled and formatted complex information into spreadsheets and documents. Verified data for accuracy and completeness. Compiled information for inclusion in complex reports  Organized meeting logistics and events. Prepared meeting materials such as agendas, timelines, reports, and presentations. Transcribed and distributed meeting minutes.  Assisted the executives with preparation of presentation materials including creating, proofreading, editing and printing.  Under the direction of the Vice President and/or Directors, coordinated a variety of ongoing projects such as negotiating work space, procuring data and/or telecommunications equipment, furniture, and supplies.  Ensured that all departmental administrative matters were handled appropriately and timely. Interpreted standard department policies and procedures in response to all incoming inquiries. Communicated information to the executives on a consistent basis.  Maintained Vice President and Directors calendars, arranged meetings and appointments and travel itineraries.  Developed and implemented administrative processes for facilities management to ensure facility equipment, telecommunications, department equipment, and reception area were maintained and operational at all times. Show less



Cintas First Aid & Safety

• Hanover, Maryland

• Administrative Assistant

  • Aug 1999 - Oct 2003

  Provided administrative and clerical support to Branch Manager, 2 Service Managers, Sales Department, Training Department and Warehouse Manager.  Coordinated and maintained all inventory records and standard reporting to management of Cintas products.  Developed standardized tracking reports for management and conducted research to prepare statistical reports.  Used a variety of software packages to draft routine and non-routine correspondence to consumers and internal staff.  Responded to customers by telephone to provide information about products and services, take orders, cancelled accounts, and obtained details of complaints.  Keep records of customer interactions and transactions by recording details of inquiries, complaints, and comments, as well as actions taken.  Maintained electronic and hard copy filing systems  Managed daily calendar of Branch Manager, including scheduling and coordinating meetings and appointments.  Opened, sorted and distributed incoming correspondence.  Maintain office supply inventories for department. Show less



Dart Group Corporation

• Landover, Maryland

• Executive Assistant

  • 1989 - 1999

  Provided full administrative office support to the Vice President of Assets Protection and staff comprised of 5 investigators and 9 security officers.  Managed administrative functions for development and distribution of standard monthly reporting for 260 stores and over 3,000 employees.  Coordinated communication process with cross-functional departments on contracts, security reports, and compliance while maintaining the strictest confidentiality.  Drafted routine and non-routine correspondence.  Processed and handled all incoming and outgoing mail.  Prepared purchase orders and handled invoices to ensure timely and accurate payments.  Responsible for documentation and data entry of payroll schedules for department.  Coordinated all work maintenance requests for department/facility to ensure an organized and safe environment.  Maintained Vice President, Asset Protection Managers, and Locksmith calendars, arranged meetings and appointments and travel itineraries.  Coordinated and managed all travel expenses for department.  Managed the issuance of all security badges to approved personnel and maintained records for compliance.  Managed coordination and distribution of policies and procedures. Show less



Alarm Guard Security/Mack Security

• Catonsville, Maryland

• Alarm Dispatcher

  • 1988 - 1989

  Responsible for monitoring business and home alarm systems and dispatching emergency entities accordingly. Responsible for monitoring business and home alarm systems and dispatching emergency entities accordingly.