Randy H.

Assistant Director, Medicaid Operations at Utah Department of Health
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Contact Information
us****@****om
(386) 825-5501
Location
Syracuse, Utah, United States, US

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Experience

    • United States
    • Wellness and Fitness Services
    • 400 - 500 Employee
    • Assistant Director, Medicaid Operations
      • Apr 2014 - Present

    • Finance Manager
      • Jan 2014 - Apr 2014

      Supervise Division purchasing staff and IT and contracting. Supervise pharmacy financial systems. Supervise contracts for the Division of Medicaid.Manage and oversee Medicaid fiscal activities for the Division, including budgets, forecasts, federal reporting and legislative process.Generates, analyzes and presents custom reports and fiscal interpretations.Manage staff in the Bureau of Fiance.

    • Auditor IV (Manager)
      • Feb 2013 - Jan 2014

      Manage the Medicaid cost settlement process. Single point of contact for OIG, OIA, Utah State, and Federal Audits. Management of audits on Nursing Homes, HMO's, Federally Qualified Healthcare Centers, and State Hospital audits and cost settlements. Direct external audit firm in various Medicaid Audits.

    • Auditor IV
      • Feb 2012 - Feb 2013

      Plans, conducts and manages performance and financial audits. Writes audit plan, findings, and recommendations.Ensures compliance with applicable federal and/or state laws, regulations, and/or agency rules, standards and guidelines.Gathers documentation to support negotiated resolution of non-compliance issues.Supervise staff; delegate work assignments, monitor/review quality of work, schedule staff, provide technical assistance or training, and/or provide input on performance appraisal, hiring and discipline.Knowledge of principles, theories and practices of auditing.Assess the operational impact of legislation or audit recommendations on an agency.Uses automated accounting and/or financial computer systems.Provide consultation and/or expert advice or testimony evaluate information against a set of standards review and/or edit documents for accuracy and completeness. Show less

    • Government Administration
    • 700 & Above Employee
    • Senior Business Analyst
      • Jun 2008 - Feb 2012

      Utilization of computer software programs to store, retrieve and analyze data. Coordinate the use of information analysis related hardware, software, and data. Interface with data processing users to automate applications and/or resolve application and operating problems. Estimate project costs; assure deadlines are met; negotiate common standards for data formats; assess needs for data analysis related hardware, software, and data. Make recommendations to management to resolve complex operation and/or data processing issues. Monitor and review system performances to make recommendations for enhancements. Adapts automated system(s) to accommodate special and complex agency needs. Facilitates work groups to design and enhance unique automated systems to interface with existing systems as needed. Anticipates the impact that new or modified software will have on existing standards and systems. Identifies problems or potential problem areas and recommends solutions. Selects testing methods to evaluate the success of both software upgrades and modifications. Creates a positive environment, evaluates group processes, recommends solutions or alternatives, etc. Audits and reviews systems and practices to ensure compliance with procedures, regulations and standards. Reviews and/or inspects work for quality, accuracy, and completeness. Recommends user level computer system enhancements to better meet customer needs. Monitors and evaluates operations, programs, processes and/or practices for quality and effectiveness; makes recommendations for improvement. Monitors system performance to ensure proper operation and identify possible problem areas. Show less

    • Real Estate Appraiser
      • Jul 2007 - Jan 2010

      Perform residential appraisals for single family residences, 2-4 family residences, and condominiums in accordance with federal standards. Perform commercial appraisals on business properties. Perform commercial land appraisals for oil and gas companies for eminent domain acquisition. Perform residential appraisals for city and county government for eminent domain acquisition for school property. Maintain the server for all applications used by the company. Update computer software and hardware for the company. Perform backup of critical data. Show less

    • Government Administration
    • 700 & Above Employee
    • Management Information Analyst II
      • Jan 2006 - Jul 2007

      Adapt automated system(s) to accommodate special and complex agency needs; designs or enhances agency unique automated systems to interface with existing systems as needed.Anticipate the impact that new or modified software will have on existing standards and systems.Identify problems or potential problem areas and recommends solutions.Selects testing methods to evaluate the success of both software upgrades and modifications.Plan and manage projects and/or programs.Facilitates/Chairs work groups, teams, and/or meetings. Evaluates group processes, recommends solutions or alternatives, etc.Audits and reviews systems and practices to ensure compliance with procedures, regulations and standards.Reviews and/or inspects work for quality, accuracy, and completeness.Recommends user level computer system enhancements to better meet customer needs.Monitors and evaluates operations, programs, processes and/or practices for quality and effectiveness; makes recommendations for improvement.Monitors system performance to ensure proper operation and identify possible problem areas.Consult department on necessary software and hardware upgrades for continuously improving information technology improvements. Show less

    • Auditor IV
      • Feb 1998 - Jan 2006

      Supervise, conduct, and plan financial, performance, IT audits.Assist outside auditors and reviewers of the Department.Create controls to help detect and eliminate identity theft with other departments.Perform audits in accordance to the Government Accountability Office’s auditing standards.Review statewide budget of $700 million on multiple levels to ensure that the department is adequately allocating and expending funds.Investigate crimes such as: Fraud, Extortion, Drug Distribution, Pedophilia, and Harassment cases.Determine and establish policies and procedures for the dissemination of department information.Provides mentoring and consulting on implementation of audit recommendations.Investigate computer sabotage and inappropriate use of computers.Conduct and consult on internal affairs personnel investigations.Work with FBI, US Marshal Service, local police departments to pursue fraud cases.Work with State Attorney General Office to pursue legal situations for the department.Conduct audits of contractor's financial information and verify compliance with contractual agreements.Process information disclosure issues for the Department.Work on improvement of computer security for state agency with IT controls. Show less

    • Eligibility Specialist
      • Sep 1997 - Feb 1998

      Extensive knowledge of department Policies and Procedures.Determine eligibility for Financial, Food Stamp, and Medical services.Provide inter/intra agency supportive services from a variety of funding sources.Promote teamwork and participate as a multi service team player.Assess job readiness of clients and help overcome employment barriers.

    • Auditor
      • May 1995 - Sep 1997

      Performed monthly audits of mortgages to ensure compliance with Federal Regulatory measures. Conducted branch audits to review processes in the office with loans in process. These audits covered offices in Nevada, Utah, Idaho, Montana, Oregon, and Washington. Conducted consolidations of accounts in Loan servicing. Made Determinations on foreclosed of properties. Supervised compliance staff for federal and state compliance reviews. Reported directly to the Board of Directors on the state of the bank. Assist with external auditors on fiscal reviews of bank. Show less

    • Sweden
    • Motor Vehicle Parts Manufacturing
    • 700 & Above Employee
    • Research and Development Engineer
      • Jun 1993 - May 1995

      Develop and supervise the creation of new assembly lines. Engineered new inflator devices for safety air bags. Tested new designs of inflators for both driver and passenger side air bags. Researched and designed first designs of smart air bags. Develop and supervise the creation of new assembly lines. Engineered new inflator devices for safety air bags. Tested new designs of inflators for both driver and passenger side air bags. Researched and designed first designs of smart air bags.

Education

  • Weber State University
    Bachelor of Arts (B.A.), Accounting and Computer Science
    1991 - 2002

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