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Aaron Lambert, MPH, MBA — Chief Executive Officer Aaron Lambert brings deep knowledge at both the State and national level building and delivering high-quality operations and program solutions for State Medicaid programs. He is an adept communicator with a hands-on leadership approach who builds a culture of accountability and commitment to operational excellence and results. As the CEO, Aaron embraces and drives Healthy Blue’s mission and goals that support the Triple Aim and helps ensure all areas of the organization deliver to meet these goals and LDH’s objectives. Aaron also serves on the Board of Trustees for the Boys and Girls Club of Greater Baton Rouge, the Board of Directors for the Louisiana Association of Health Plans, and Louisiana’s Health Information Technology Advisory Committee. He holds Masters’ degrees in Business Administration and Public Health, Health Management, and Policy.
Professional Experience HEALTHY BLUE President and Chief Executive Officer June 2017 – Current
Oversees the strategic direction, growth, operations, and performance of Healthy Blue, serving more than258,000 Medicaid members
Works in conjunction with the Healthy Blue Board of Directors and key personnel to develop andimplement the health plan’s strategic vision, as well as establishing and meeting programmatic andfinancial goals
Spearheads the joint venture between Anthem and BCBSLA to deliver best-in-class Medicaid services;grew Healthy Blue’s membership and market share by 11% and 9% respectively over the last two years
Builds strong ties with system stakeholders to foster opportunities to deliver value to Healthy Louisianaand to secure Healthy Blue’s place as part of the fabric of parish communities by launching initiativeswith local schools, community-based and faith-based organizations, State entities, and providers
Nurtures top-level talent across the organization through communication and relationship building; andcontinuously assures that Healthy Blue’s mission, vision, and goals align with LDH
Spearheads new initiatives and develops relationships with key hospitals and large physicianpractices/clinics and key ancillary providers to increase participation in Value-Based Payment models
Analyzes reporting across financials, encounters, quality, and other regulatory reports to identify issuesand work collaboratively with leadership to assure the health plan’s delivery of quality services
AMERIGROUP GEORGIA Director II, Medicaid State Operations September 2011 – May 2017
Led the health plan’s Operations department to meet new growth and expansion by developing a robustprovider network and relationships, plus a strong operational support structure including providercredentialing, provider operations strategy, reporting and analytics, program management, and providernetwork data support
Drove increased provider engagement and improved experiences across a network of 29,000 primary careproviders, specialists, ancillary providers, and hospitals to score 93% provider satisfaction rating onclaims processes and provider reimbursement across the organization’s public sector health plans
Spearheaded project management efforts to implement State Medicaid program changes andenhancements
Implemented operational strategies to help reduce cost of care while maintaining the highest level ofquality
Drove accountability across the health plan’s shared service partners to meet and exceed our State andprovider contractual service level agreements (including claims, member and provider call centers,encounters, enrollment, system pricing and benefits configuration, and regulatory reporting)
Served as the south region’s Community Manager for the Innovation Champions program, which droveengagement and the discussion of ideas to address key business challenges faced across several affiliates
Oversaw Medicaid reimbursement methodologies and provider relations strategies that droveenhancements to training, claims payment processes, and new standards for staff to make sure thatproviders received the support and tools needed to meet contract requirements and to deliver the bestpossible care
Exhibit 1 - Resumes LaGov# 2000441827
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AMERIGROUP CORPORATION Manager, Configuration Root Cause Team - Health Plan Services April 2010 – August 2011
Managed a team to perform research and root cause on provider claim payment errors; facilitated thelaunch of the pricing and benefits quality framework, created error input channels, developed teamcharter and handbook, hired and trained new employees, and developed team performance metrics
Monitored key performance indicators, developed a quality performance dashboard, and publishedquality reports for the department’s senior management team
Supervisor, Claims Processing - Support Operations June 2008 – March 2010 Managed a team of 24 analysts to process claims for Amerigroup’s Georgia and Virginia markets, with
responsibility for analyzing and improving high dollar claims accuracy by designing a monthly claimsquality dashboard, creating action plans, and developing solutions for manual high-dollar processingprotocols
Served as a project team member for Six Sigma Black Belt projects: prospective payment systems andconfiguration accuracy, manual claims payment accuracy, and corrected claim and clean interest date
Management Development Associate - Operations Performance Improvement May 2007 – June 2008 Managed an international consulting team, along with an internal team, to re-engineer quality assurance’s
audit and rebuttal database Analyzed business requirements, aligned external consultants with internal resources, coordinated user
acceptance testing, and led the implementation effort throughout support operations
Education College of William and Mary, Master of Business Administration, 2011 Eastern Virginia Medical School, Master of Public Health, Health Management, and Policy, 2007 Old Dominion University, Bachelor of Science, Environmental Health, 2005
Professional Certifications and Affiliations Member - Board of Directors Louisiana Medicaid Managed Care Organization Association (2018 –
current) Member - Louisiana’s Health Information Technology Advisory Committee (2017 – current) Member - Board of Trustees Boys and Girls Club of Baton Rouge (2017 – current) Member - Board of Directors Louisiana Association of Health Plans (2017 – current) Participant - Winning Leaders, an executive-nominated senior leadership development program for
Anthem’s high-potential associates (2016) The Juran Institute - Six Sigma Green Belt Certified (2013) Member - Board Development Co-Chair - Young Nonprofit Professionals Network, Hampton Roads
(2013) Member - Board of Directors, Boys and Girls Club of Southeast Virginia (2011 – 2013) Member - Delta Omega, National Public Health Honor Society (2011 – present) Past President - Eastern Virginia Medical School’s Health Professions Alumni Association (2011 – 2013) President - Eastern Virginia Medical School’s Health Professions Alumni Association (2009 – 2011) Secretary - The College of William and Mary Mason School of Business Flex MBA Association (2009 –
2010)
Exhibit 1 - Resumes LaGov# 2000441827
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Dexter Trivett, MBA — Chief Operating Officer Dexter Trivett brings a decade of experience in managed care, and has successfully led initiatives around provider relations, network development, and operations that involved redesigning and streamlining processes and turning strategic ideas into fully operational programs. Since 2015, he has overseen day-to-day operations across Healthy Blue’s departments to ensure we continue to meet LDH’s requirements and to drive the best possible outcomes for members. Dexter’s progressive history of leadership positions includes managing provider relations and operational initiatives across Medicaid affiliates in 20 states.
Professional Experience HEALTHY BLUE Chief Operating Officer January 2015 – Present
Oversees the health plan’s operational areas to ensure continued compliance with State, federal, andContract requirements as well as achieve the organizational mission, vision, and goals
Maintains responsibility for overseeing and leading our Member Services, Provider Services, Claims, andInformation Technology (IT) departments
Served as the liaison to various corporate support services and regulators, local network development,provider partnerships, relations, medical, case and quality management programs, performancemanagement/improvement, budgets, complaints and appeals, regulatory and contractual compliance,monthly financials, and reporting
Provided input on overall strategic direction, especially strategies affected by operations, practices, andpolicies
ANTHEM Senior Manager, Corporate National Provider Relations April 2013 – January 2015
Served as the program manager and implementation leader for key national and local market ProviderRelations initiatives across 20 Medicaid affiliates
Directed all aspects of provider relations and contracting, including developing, building, and maintainingrobust networks that deliver culturally and linguistically responsive medical, behavioral health, andancillary services
Orchestrated the design and implementation of a Provider Relations program to support and build lastingprovider relationships and minimize their administrative burden
Project Manager II, Corporate Provider Operations June 2011 – April 2013 Led portfolio of projects within the Provider Lifecycle Program, redesigning processes to reduce provider
contract processing times and improve data quality Assisted in launching multiple cross-functional programs and projects aimed toward building strong
provider collaborations, cultural change, process improvement, and quality to support members Oversaw Patient Care Consultants on activities related to the Provider Access and Quality Care programs,
as well as the Provider Quality Improvement programsAMERIGROUP CORPORATION Associate, Leadership Development Program June 2009 – June 2011
Partnered with senior leadership to identify, evaluate, and execute robust, high-profile processimprovement initiatives. Developed leadership skills at an accelerated pace while designing and rollingout improvements at the department, statewide, and national levels. Transitioned between the followingdepartments during two year program: IT, Healthcare Management, Business Development, and theFlorida health plan
Researched emerging industry trends and built cultural competency initiatives database in support of newRFP requirements, contributing to winning RFP response
Championed development and implementation of statewide process for contracting with new providers inFL, driving efficiencies through defining roles based on function; created standardized processdocumentation and training
Education
Old Dominion University, Master of Business Administration, 2009 James Madison University, Bachelor of Business Management, 2007
Exhibit 1 - Resumes LaGov# 2000441827
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Raymond Poliquit, MD, FAAP — Chief Medical Officer Dr. Raymond Poliquit is a Kenner-based, board-certified pediatrician who brings more than 25 years of experience providing direct patient care. As Healthy Blue’s full-time Medical Director since 2015, Dr. Poliquit has played an integral role in clinical and quality management activities. He is licensed to practice medicine in Louisiana and is a Fellow of the American Academy of Pediatrics. Since 1994, Dr. Poliquit has cared for Louisiana residents, serving the State’s most impoverished communities as former Chief of Staff at Madison Parish Hospital in Tallulah and at one of the state’s largest Federally Qualified Health Centers. He is also a licensed Zumba® instructor and leads Zumba classes for Healthy Blue’s “Making Fitness Fun” program, providing open access to classes across the state.
Professional Experience HEALTHY BLUE Chief Medical Officer July 2013 – Present
Oversees all aspects of clinical operations for Healthy Blue, accountable for providing leadership anddirection on utilization/cost management and clinical quality management functions
Makes timely medical decisions and provides peer-to-peer consultation to providers across the state Works collaboratively across health plan functional areas — provider relations, member services, claims
management, and more to drive strategic short- and long-term planning that will achieve theorganization’s mission, vision, and goals
Develops and enforces clinical policies, assures fully integrated care, and supports, assists, and directsmedical management activities in conjunction with the Behavioral Health Medical Director and other keypersonnel
Collaborates with affiliate health plan Medical Directors on national medical policies and carries outnational medical policies at the health plan in collaboration with the Health Plan President
PRIMARY HEALTH CARE SERVICES CENTER Medical Director/Pediatrician August 2009 – June 2013
Oversaw medical management and supervised physicians, nurse practitioners, nurses, quality nurses, casemanagers, medical records staff and clinical pharmacists for this safety-net provider, serving 12,000patients in Ouachita Parish with 28,000 encounters a year
Managed the Quality Assurance program of the clinic and spearheaded the center’s NCQA Patient-Centered Medical Home Recognition
MADISON PARISH HOSPITAL Emergency Room Physician July 1995 – October 2014
Provides emergency care for the critically ill adult and pediatric patients, including stabilization of traumapatients for transfer to Level 1 Trauma Center
CENTENE CORPORATION Committee Member, Louisiana Healthcare Connections September 2011 – June 2013
The Credentialing Committee reviews and approves all providers of the health plan monthly. The QualityAssessment Performance Improvement Committee meets quarterly to review progress of grievance &appeals
OUTPATIENT MEDICAL CENTER AT TALULLAH Medical Director/Pediatrician September 1994 – August 2009
Maintained responsibility for all aspects of medical management and supervision of physiciansMADISON PARISH HOSPITAL Medical Staff/Courtesy Medical Staff September 1994 – October 2014
Reviewed medical policies and procedures of the hospital; coordinated medical services and reviewedutilization of these services on a monthly basis
Education State University of New York, Health Sciences Center at Brooklyn, Kings County Hospital Center, Pediatrics, 1994 University of the Philippines, Doctor of Medicine, 1989 University of the Philippines, Bachelor of Science, Biology, Cum Laude, 1984
Exhibit 1 - Resumes LaGov# 2000441827
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Professional Certifications and Affiliations Board Certified (Pediatrics) Certificate No. 235115 (1994) Licensed Zumba and Zumba Kids Instructor Zumba Instructor Network (2017 – Present) Louisiana State Board of Medical Examiners Registration No. 046157 License No. 10687 R (1994 –
Present) Federation Licensing Examination (1992) Educational Commission for Foreign Medical Graduates Certificate No. 437-967-3 (1991) Physician Licensure Examination, Philippines Certificate No. 70294 (1990) Clinical Recognition – Patient-Centered Medical Home NCQA (2011 – Present) Rural Health Medical Coding Certification Association of Rural Health Professional Coders (2011 –
Present) Co-founder, Owner, El Doco Loco Dance Studio, Kenner (2018 – Present) Board Member, Crescent Care/NO AIDS Task Force (2016 – Present) Certified Foster/Adoptive Parent (2009 – 2014) Board Member, Philippine-American Association of Northeast Louisiana (2013 – 2014)
Exhibit 1 - Resumes LaGov# 2000441827
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Cheryll Bowers-Stephens, MD, MBA — Behavioral Health Medical Director A 25-year health care industry veteran, Dr. Bowers-Stephens has held a variety of leadership roles, from serving as the Louisiana Department of Health and Hospital’s Assistant Secretary of Mental Health (Government Appointee) to managing Medical Director to Chief Medical Officer for Healthy Blue. Dr. Bowers-Stephens’ two decades of directly managing staff, fiscal budgets, and clinical operations, means that she keenly understands all aspects of clinical, quality, and utilization management as well as population health strategies. She is currently board-certified in both General and Child & Adolescent Psychiatry with an unrestricted medical license to practice in Louisiana, as well as two other states. She has also taught organizational behavior and financial management and accounting, the core curriculum for students working on a Master of Public Health at LSU School of Public Health.
Professional ExperienceHEALTHY BLUE Behavioral Health Medical Director 2015 – Present
Plays a key role in major clinical and quality management initiatives around behavioral health (BH), anddevelops programs and strategies to support the integration of care, including supporting and educatingprimary care physicians on common BH conditions, overseeing and assisting with psychopharmacologyactivities, and providing clinical guidance related to mental health and substance use disorder
Leads all aspects of BH administration and utilization, including assessments, referrals, and processesthat assure members receive the services they need
Builds relationships and engages with Louisiana providers, community-based organizations, and otherstakeholders to drive value-based care and awareness of BH needs in the community, and to createsolutions that address those needs (includes serving on joint operating committees, conducting peer-to-peer reviews and consultations, and chairing and serving on internal committees)
Designs and develops national-level interventions in conjunction with affiliate Medical Directors, leveragingexisting tools that will drive performance and best practices in value-based care across affiliates
Hired and oversees a BH team, participates in readiness reviews and presentations, and assists withdeveloping Medicaid clinical models
Collaborates with providers on parenting skills and behavior modification techniques, and developsstrategies to inform members and their families on available benefits and services
Supports the Medical Management staff, ensuring timely and consistent responses to members andproviders
PERFORMCARE Chief Medical Officer 2013 – 2015
Provided administrative oversight to the Healthcare Management, Quality Management, Behavioral andHealth Informatics teams to assure members receive the most appropriate services and supports,including planning, organizing, and supporting an Integration Health Strategy for Amerihealth Caritas
Helped pioneer innovative health care programs to address the unique needs of members, and directedboth clinical and non-clinical initiatives to positively influence quality and outcomes
OSCHNER MEDICAL FOUNDATION Child and Adolescent Psychiatrist 2007 – 2013
Provided direct care to individuals with severe BH conditions in main campus tertiary care clinic.Specialized in treating people with both developmental disabilities and BH disorders, young adultstransitioning to adulthood with ADHD, and youth with Traumatic Brain Injuries from sports-inflictedinjuries
Education University of New Orleans, Master of Business Administration, 1998 Tulane University Medical Center, Fellowship, Child and Adolescent Psychiatry, 1993 Ochsner Medical Foundation, Internship and Adult Psychiatry, 1991 Louisiana State Medical University Medical School, Doctor of Medicine, 1988 Spelman College, Bachelor of Arts, Psychology, 1982
Exhibit 1 - Resumes LaGov# 2000441827
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Christine Coleman, MBA — Chief Financial Officer Christine Coleman began her career in finance more than 13 years ago and has a progressive track record that includes senior roles at Ochsner Health System and University Medical Center prior to joining Healthy Blue. With strong business and financial acumen, Christine oversees all aspects of financial operations for Healthy Blue, including budget, accounting, financial reporting, and audit activities. Her broad range of skills span business analysis, forecasting, planning, and accounting. Christine holds a Bachelor of Arts in Accounting and a Master of Business Administration.
Professional Experience HEALTHY BLUE Chief Financial Officer June 2019 – Present
Oversees the financial reporting for a $1 billion in revenue health plan Strategically analyzes the plan’s reporting, profitability, financials, and key functional areas and
processes to meet performance targets, goals, and objectivesUNIVERSITY MEDICAL CENTER Senior Decision Support Analyst March 2018 – June 2019
Reported to and directly supported the CFO Created financial pro formas for new services Created and maintained budget template Managed hospital-wide expense reduction initiatives Created customized reports for senior management and conducted ad hoc analyses as needed Prepared monthly volume, revenue, expense and FTE forecast Prepared and analyzed service line financials
OCHSNER HEALTH SYSTEM Service Line Financial Manager, Decision Support May 2016 – March 2018
Managed financial optimization of the service lines Lead a team of financial analysts Oversaw the System’s 14 service lines strategic plan and operating budget across eight hospitals Responsible for the monthly/quarterly reporting packages (dashboards, Monthly/Quarterly Operational
Reviews, etc.) to be presented to executive management Provided valuable financial analyses to assist executives in make operational decisions Identified revenue enhancement and cost reduction opportunities
Senior Financial Analyst, Decision Support January 2015 – May 2016 Financial partner of operation managers Budgeted for 100+ medical specialties cost centers/departments Created pro formas for new physician and/or equipment requisitions Created monthly dashboards for senior management Provided financial data for physician credentialing, grants and hospital ranking surveys
Senior Financial Analyst, Treasury Department June 2007 – January 2015 Performed financial analysis for the System Prepared the System’s quarterly cash forecast Responsible for capital financing analysis/accounting Handled banking administrator duties Acted as liaison for IRS bond examinations Drafted post-bond compliance policy Attended the Board of Directors Investment Committee quarterly meetings Member of the Finance Recognition Committee, which decided Employee and Manager of the Month
Financial Analyst, Treasury Department May 2006 – June 2007 Performed financial analysis for the System Managed the System’s and its pension plan $1B investment portfolios Performed monthly and annual financial close Participated in annual budgeting/forecasting process Served as intricate member of bond issuance and post-issuance compliance team. Experienced in regulatory and compliance reporting: IRS forms 990 and 5500
Exhibit 1 - Resumes LaGov# 2000441827
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Performed daily cash management responsibilities
Education University of Dallas, Master of Business Administration, 2004 Dillard University, Bachelor of Arts, Accounting, 2000
Exhibit 1 - Resumes LaGov# 2000441827
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Mykayla Jones — Pharmacy Director Mykayla Jones brings more than 11 years of pharmacy experience, including roles at Southeast Community Health Systems and Louisiana Healthcare Connections prior to joining Healthy Blue. She has extensive clinical and medication knowledge plus a proven track record of developing and launching strategies to improve outcomes, overseeing pharmacy health plan operations. In her role as Pharmacy Director for Healthy Blue, Mykayla will make sure all aspects of pharmacy operations comply with CMS and State regulations and will act as Healthy Blue’s pharmacy subject matter expert. Mykayla’s expertise lies in employing pharmaceutical and clinical skills to various patient populations, working diligently to ensure patients receive safe, appropriate, and cost-effective drug therapy.
Professional Experience Healthy Blue Medicaid Pharmacy Account Director September 2019 – Current
Will collaborate with Health Plan to develop strategies to achieve positive patient outcomes with cost-effective prescribing
Will support the Health Plan in meeting cost of care goals with implementation of local initiatives Will represent Healthy Blue by driving our initiatives with various state committees
LOUISIANA HEALTHCARE CONNECTIONS Clinical Pharmacist, Medicare December 2017 – September 2019
Provided operational support for the delivery of Medicare clinical information to various business unitswhich included but were not limited to Medical Management and Quality
Developed, implemented, and enforced Medicare Part D operations Developed workflow processes to ensure adequate monitoring of patient outcomes as it relates to Star
Measures Developed pharmacy training manual for Medicare Part D Developed DUR process according to CMS rules and guidelines Participated in the development and execution of initiatives to improve Medicare Star measures Assisted in implementing programs and process improvement to enhance the level of customer service
provided to members from Pharmacy and Medical Management team members Outreached to members and providers to ensure to improved patient care in order to obtain target Star
Measures Monitored and analyzed reports from PBM to gauge plans current position with Stars and Display
Measures Served as an active member of client committees, as requested Severed as primary plan point of contact for vendor relations Served as primary plan contact for Part D claim issues or formulary Participated and assisted in planning P&T Committee quarterly meeting
SOUTHEAST COMMUNITY HEALTH SYSTEMS Director of Pharmacy, 340B Specialist February 2015 – December 2017
Developed and Implemented 340B pharmacy program for clinical and pharmacy departments Developed 340B and pharmacy operations policies and procedure manual Developed and monitored 340B compliance program Educated all stakeholders regarding 340B rules and regulations as well as various processes as pertaining
to HRSA and OPA guidelines Designed and maintained audits to ensure regulatory compliance and revenue maximization Conducted periodic electronic health record audits with Chief Quality Control Manager to ensure
pharmacy records and medical record coincide Established relationships with contract pharmacies in order to build revenue for the organizations’ 340B
program Prepared and monitored key performance indicators to gauge effectiveness of departmental goals as well
as identify opportunities for process and/or policy improvement Consulted with medical director, clinical and pharmacy staff as well as other disciplines to develop and
implement pharmacy programs to reduce cost while maintaining or improving quality of care to thepatients served
Exhibit 1 - Resumes LaGov# 2000441827
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Developed Hepatitis-C program to provide clinical and pharmacy services to under and/or uninsuredpatients
Conducted Fraud Waste and Abuse training for all clinic staff Implemented prior authorization process for clinic staff in order to ensure approval for specialty
medications Performed monthly and quarterly audits to support compliant operations and make custom
recommendations to improve operational efficiencies Analyzed budget and operations reports to identify key opportunities for growth and improvement within
the pharmacy department Led efforts in developing and maintaining current and consistent tools and resources to support member
compliance Provided strategy for development of education plans to support HRSA-audited entities Oversaw day to day operations within the department (i.e., Workflow, inventory management, budget) Responsible for day-to-day pharmacist duties which included: prescription verification, drug monitoring
and patient counselingGULF COAST PHARMACEUTICAL SPECIALTY CO. Pharmacy Manager, Long-Term Care February 2014 – January 2015
Assisted and directed support staff in the production and dispensing of medication order to facilities andresidents
Ensured staff and facilities operated according to Federal and State Regulations as it pertain to LTCpharmacy
Prepared and/or supervised the assembly of IV piggybacks or large volume parental and parentalnutrition solutions
Supervised the pharmacy production staff to ensure proper order entry, work flow, security of thepharmacy area, and adherence to delivery schedules
Checked for completeness and accuracy of all new and refill labels and orders; checked for content andaccuracy of all drug packaging and labeling
Practiced appropriate drug utilization review and follow up Liaised with Supervisor of Client Services on feedback/issues resolution between facility and pharmacy Assisted in the proper ordering, handling, receiving, documentation, and storage of all controlled
substances; assisted in maintaining a perpetual inventory for schedule II drugs.WALGREENS CO. Pharmacy Manager June 2003 – July2012, November 2012 – February 2014
Provided direct supervision to nine pharmacy support staff as well as three pharmacists in a pharmacy,filling more than 2,200 prescriptions weekly
Consulted with physicians and patients on proper medication dosage, drug interactions, diseasemanagement, and probable side effects of prescription and OTC medications
Worked efficiently in dispensing and compounding prescriptions as well as maintaining accurate patientrecords for dosing information and directions of use
With the use of Outcomes-MTM software, actively conducted Comprehensive Medication Review(CMR) sessions with select patient populations to ensure coordination of care and patient understandingof medication therapy
Demonstrated interpersonal skills in collaborating with insurance providers regarding billing andreimbursement issues
Ensured pharmacy was compliant with both state and federal laws Oversaw 340B program for Baton Rouge General Medical Center and maintained proper inventory and
invoice maintenance Thoroughly examined financial reports to evaluate pharmacy sales and other financial reporting while
developing action plan according to findings Served as a certified immunizer trainer for the district, responsible for training and orientation to fellow
pharmacists and pharmacy technicians on proper immunization administration technique and properhandling and storage of vaccinations
Rendered exceptional support to pharmacy supervisor with college recruiting assignments as well ascoordinated various district meetings
Maintained direct involvement with pharmacy acquisitions and pharmacy buy-out opportunities
Exhibit 1 - Resumes LaGov# 2000441827
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Productively boosted pharmacy revenue by implementing immunization clinics that included: Flu,Pneumonia, and Zostivax vaccinations both in-store and in community setting
Successfully established and implemented pharmacy “checklist” that served as a guide for pharmacy stafffor the development of pharmacy operations within the district
CVS PHARMACY Pharmacist-In-Charge July2012 – October 2012
Administered duly assigned tasks in entering, filling, and reviewing prescriptions for drug-drug, drug-allergy, and drug-health condition interactions during clinical review
Consulted physicians on proper drug regimen based on patient disease state in order to increase patientsquality of care
Worked efficiently in dispensing and compounding prescriptions as well as maintaining accurate patientrecords for dosing information and directions of use
Played leadership role in assigning and supervising staff in overall pharmacy operations which include;inventory maintenance, prescription processing, and delivering excellent customer service
Worked with Pharmacy Supervisor to set financial and personal goals for pharmacy, evaluated results,and set up action plans in order to improve department operations.
Responsible for hiring, training and evaluating pharmacy staff including pharmacists Ensured pharmacy department is compliant all federal, state, and local laws and regulations, as well as
CVS’s policies Provided immunization services and set up flu clinics with local schools and business leaders Active Preceptor for Xavier University informed interns and other health care professionals on matters
pertaining to pharmacy
Education Bellevue University, MBA with a concentration in Health Care Administration, 2016 Xavier University of Louisiana, Doctor of Pharmacy, 2007
Professional Certifications and Affiliations Currently licensed in Louisiana and Texas
Exhibit 1 - Resumes LaGov# 2000441827
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Kimberly Chope — Contract Compliance Officer With more than 20 years of managed care experience, specializing in regulatory compliance for Medicaid programs, Kimberly Chope brings a wealth of knowledge to her Contract Compliance Officer role at Healthy Blue. Kim has been a key part of the Anthem family of affiliates, serving in government relations and regulatory positions for the last 16 years. She was instrumental in launching Anthem’s national Regulatory Services department in 1996.
Professional Experience HEALTHY BLUE Contract Compliance Officer June 2014 – Current
Leads the development and implementation of policies, procedures, and standards to make sure allaspects of the organization fully comply with all federal, State, and Contract requirements
Develops and manages the implementation of State Medicaid contractual requirements to ensure all areexecuted per the specifications of the State Contract across the health plan and shared service partners:these partners include health plan operations, quality management, health care management, claims,marketing, and encounters
Maintains oversight and management of all health plan regulatory reports and their timely submission toState agencies through requirements gathering and development
Serves as primary point of contact for State entities, developing strong working relationships to addressissues that arise well before they become cost drivers
Continuously aligns Regulatory Services, health plan, and shared service resources to effectively meetneeds and by honing consistent and positive messaging in all communications
Coordinates and drives accountability of key stakeholders including affiliates and shared service partnersto meet program changes dictated through State Contract amendments and policy directives, as well asadvising senior management relative to impact and risks
Helped orchestrate the implementation of Amerigroup Louisiana rebrand to Healthy Blue with LDH, theEnrollment Broker, and Fiscal Intermediary
Manager, Regulatory Services November 2012 – June 2014 Initiated and conducted activities to support and promote corporate and health plan compliance with
regulatory and contractual obligations of multiple state and federal regulatory bodies Initiated and designed an innovative compliance monitoring system that included the monitoring of
contractual and regulatory compliance level via report review and assessment, resulting in reducedoverhead expenses
Conducted business owner education of new legislation or contractual requirementsAMERIGROUP FLORIDA Consultant, Provider Contracting September 2010 – November 2012
Successfully contracted long-term supports and services networks in 17 Florida counties where managedcare was not prevalent
Demonstrated ability to contract primary care and specialist providers in a challenging rural Florida area Significantly grew market share of dual-eligible programs by contracting, educating, and servicing
Assisted Living Facilities on new public-private programsNATIONAL FLIGHT ACADEMY Consultant, Special Projects and Development August 2009 – May 2011
Led the coordination of all special events and fund-raising events for the National Flight Academy (NFA)from pre-construction to operations, resulting in positive image and overwhelming community support
AMERIGROUP CORPORATION Manager, Regulatory Services April 1996 – September 2002
Developed and directed the start-up of the Amerigroup Regulatory Services department from a one-person position into a fully staffed, multi-functional department (responsibilities included regulatorycompliance operations for five states, coordination of regulatory filings for new market expansions, andmaintenance of policies and procedures companywide)
Directed and coordinated responses with regulatory agencies to include reporting, marketing materials,market and product expansions, and concerns raised by agencies
Exhibit 1 - Resumes LaGov# 2000441827
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Supported daily operations and consistently exceeded service level standards and accomplisheddepartmental objectives within budget
Reengineered and facilitated modifications to numerous processes to meet the demands of increasedmembership and rapid company-wide growth challenges
Managed the regulatory process and submission of regulatory filings for start-up in new markets, as wellas acquisitions in emerging and existing markets (including the identification of regulatory filings,document preparation, submission of each filing, and acting as primary liaison with regulatory agenciesin addressing concerns and follow-up communications)
Researched new market requirements and preformed initial due diligence and pre-implementationactivities
Provided analysis and feedback to stakeholders for issues identified via state member and providercomplaints
Education University of Georgia, Bachelor of Business Administration, Risk Management and Insurance, 1989
Professional Certifications and Affiliations Member - Board of Directors, IMPACT 100 Pensacola Bay Area (2016 – present)
Exhibit 1 - Resumes LaGov# 2000441827
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