Managed four supervisors responsible for Medicare Policy, Medical Review, Reimbursement Profiles, Edit Resolutions, and Edit Data Managed 75 staff Developed, analyzed, and communicated Medicare coverage, limitations, utilization review, reimbursement rates, and reimbursement policy Implemented these policies and procedures into the Medicare claims processing and reimbursement profile system May 1981 1984 As Supervisor Medicare Policy, Medical Review and –May – Reimbursement Profile Unit, supervised 18 Medicare claims examiners and staff responsible for medical and utilization review and reimbursement. Developed and maintained Medicare fee schedules and reimbursement system. Employment Summary Organization Position Cognosante, LLC Director of MMIS May 2011 – Present State of Wisconsin, Department of Director, Bureau of Operational June 2010 May – Health Services (DHS), Coordination 2011 Division of Health Care Access and Section Chief-Systems and Vendor March 2009 June – Accountability Management Section 2010 (Wisconsin Medicaid Agency) Project Director, MMIS and Fiscal January 2003 – Agent Contract Replacement Project December 2010 Director, Bureau of Health Care January 1999 – Systems and Operations March 2009 Section Chief Operations Section October 1994 – – January 1999 Unit Supervisor, Systems Monitoring July 1988 – Unit October 1994 Program and Planning Analyst 4/5, February 1985 – Policy and Planning Section July 1988 Wisconsin Physicians Service (), Assistant Manager - Medical Review, May 1984 – Medicare Part B Carrier Policy and Reimbursement February 1985 Supervisor Medicare Policy, Medical May 1981 May – – Review and Reimbursement Profile Unit 1984 Education Bachelor of Business Administration, Majors in Personnel Management and Risk/Insurance, University of Wisconsin - Madison 1981
Managed four supervisors responsible for Medicare Policy, Medical Review, Reimbursement Profiles, Edit Resolutions, and Edit Data Managed 75 staff Developed, analyzed, and communicated Medicare coverage, limitations, utilization review, reimbursement rates, and reimbursement policy Implemented these policies and procedures into the Medicare claims processing and reimbursement profile system May 1981 –May 1984 As Supervisor – Medicare Policy, Medical Review and Reimbursement Profile Unit, supervised 18 Medicare claims examiners and staff responsible for medical and utilization review and reimbursement. Developed and maintained Medicare fee schedules and reimbursement system. Employment Summary Organization Position Cognosante, LLC Director of MMIS May 2011 – Present State of Wisconsin, Department of Health Services (DHS), Division of Health Care Access and Accountability (Wisconsin Medicaid Agency) Director, Bureau of Operational Coordination June 2010 – May 2011 Section Chief-Systems and Vendor Management Section March 2009 – June 2010 Project Director, MMIS and Fiscal Agent Contract Replacement Project January 2003 – December 2010 Director, Bureau of Health Care Systems and Operations January 1999 – March 2009 Section Chief – Operations Section October 1994 – January 1999 Unit Supervisor, Systems Monitoring Unit July 1988 – October 1994 Program and Planning Analyst 4/5, Policy and Planning Section February 1985 – July 1988 Wisconsin Physicians Service (), Medicare Part B Carrier Assistant Manager - Medical Review, Policy and Reimbursement May 1984 – February 1985 Supervisor – Medicare Policy, Medical Review and Reimbursement Profile Unit May 1981 – May 1984 Education Bachelor of Business Administration, Majors in Personnel Management and Risk/Insurance, University of Wisconsin - Madison 1981