Brigid Stone
Halethorpe,MD
Summary
Results driven Analyst and Leader with over 10 years of experience in managing staff, large projects, and analyzing large data sets to solution for complex problems. In-depth knowledge of Microsoft systems, leveraging platforms such as Access and Salesforce to support efficient and accurate health care provider data to members. Outstanding analytical, interpersonal, and organizational skills. Dedicated to expediently resolving issues and exceeding client expectations.
Overview
9
9
years of professional experience
Work History
Lead Analyst – Configuration Information Management
Molina Health Care
01.2021 - Current
- Triage and monitor all Provider Data Management Corrective Action Plans (CAPs) working with stakeholders to ensure both interim fixes as well as long term process changes
- Identified opportunities and implemented both criteria and operational changes to enhance provider outreach efforts, with focus on the enterprise-wide Secret Shopper (data cleansing) Program
- Developed an enterprise-wide compliance library for all Provider Data Management regulatory and contractual obligations, analyzed all findings to identify any gaps in compliance, and worked interdepartmentally to close all gaps
- Supported foundational analysis on the enterprise-wide PCP Assignment end to end processes to identify opportunities to improve the member’s experience and streamline internal workflows
- Successfully launched the new enterprise-wide Provider Online Directory (POD) as part of the core POD team, supported post go live activities, and continue to support in maintenance mode
- Partnered with the Implementations and Provider Data Management (PDM) teams to provide subject matter expertise on the Magellan Complete Care (MCC) data for all MCC states to support the data migration from MCC to Molina.
Director – Magellan Complete Care Provider Data Management
Magellan Complete Care
02.2018 - 12.2020
- Led the MCC Provider Data Management staff for the FL, VA, and AZ Medicaid business
- Successfully implemented OnBase as the physical health provider data source for the AZ line of business
- Managed multiple provider data systems across markets as a subject matter expert across both legacy systems (Magellan proprietary Integrated Provider Database (IPD) and OnBase) and external systems (Facets and QNXT)
- Guided the VA DSNP (Medicare) implementation including data scrubbing, data migration from legacy Facets system to new system QNXT, and contract research
- Supported the review of dataflow between 4 different provider data systems (IPD Proper Database, OnBase, IPD Segregated Database, and QNXT) for AZ line of business
- Developed reports combining data from multiple provider data systems to both feed a single claims system as well as complete deliverables to the state for AZ and VA lines of business
- Significantly reduced errors in both the FL Provider Network Verification (PNV) state-facing and internal reports through successful work with internal IT partners and data scrubbing
- Worked with internal IT partners to identify efficiencies around data load by automating roster loads.
Senior Manager – Magellan Complete Care Provider Data Management
Magellan Complete Care
12.2017 - 02.2018
- Managed the Provider Data Management (PDM) staff for all FL, VA, NY, TX, and AZ lines of business
- Worked with the Network Business Analyst team towards a new fully functional provider data system in OnBase for pre-award physical health provider data that ensured data accuracy for all pre-award state facing reports
- Managed the PDM staff through the acquisition of Senior Whole Health (SWH)
- This included transfer of data, training on systems and processes, and claims runoff
- Managed the PDM staff through a leadership transition with Executive Leadership to ensure that we are appropriately positioned for all new lines of business within current markets and new markets.
Manager – Magellan Complete Care Provider Data Management
Magellan Complete Care
04.2016 - 12.2017
- Managed MCC Provider Data Management (PDM) staff for our Florida business including working closely with the Network Field team to build out the network for the Florida ITN (invitation to negotiate) bid
- Managed MCC PDM staff for our VA business from the RFP (request for proposal) build phase through award for all regions statewide
- Managed MCC PDM staff for building out a new provider data system to hold pre-award data for both the Texas and Arizona bids
- Managed MCC PDM staff for our AlphaCare business including completing both programming and data cleanup to get to a compliant and adequate state file.
Senior Business Analyst – Magellan Complete Care Provider Data Management
Magellan Complete Care
02.2015 - 04.2016
- Responsible for supporting and driving efficiencies in both strategy and technology for Magellan Complete Care provider data
- Worked closely with developers and requestors identifying data and functional requirements in the design of new/enhanced systems for each respective business owner and functional area.
Education
Bachelor of Science in Business Administration -
American University
Washington, D.C.12.2008
Skills
- Project Management
- Gap analysis
- Time Management
- Organizational Skills
- Analytical Skills
- Team Collaboration
- Advanced Excel
- Multitasking Abilities
Awards
2021 Molina Valor Award Runner-Up, As a key contributor to the success of implementing a brand-new Provider Online Directory platform, I was recognized for advancing Molina's goals by achieving extraordinary results, positively affecting Molina’s business goals, and reaffirming the company’s Mission, Vision, and Values.
Timeline
Lead Analyst – Configuration Information Management
Molina Health Care
01.2021 - Current
Director – Magellan Complete Care Provider Data Management
Magellan Complete Care
02.2018 - 12.2020
Senior Manager – Magellan Complete Care Provider Data Management
Magellan Complete Care
12.2017 - 02.2018
Manager – Magellan Complete Care Provider Data Management
Magellan Complete Care
04.2016 - 12.2017
Senior Business Analyst – Magellan Complete Care Provider Data Management
Magellan Complete Care
02.2015 - 04.2016
Bachelor of Science in Business Administration -
American University
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