Chadaye Sharp-McMillon, LPN
Miami,FL
Summary
Dedicated and compassionate Licensed Practical Nurse with experience in accurate documentation, compassionate care, and infection control. Maintains composure and makes accurate decisions in fast-paced, unpredictable and stressful environments. History of interfacing seamlessly with health care providers, specialized support services, patients and visiting families.
Overview
10
10
years of professional experience
1
1
Certification
Work History
SNF License Practical Nurse
East Ridge Retirement Village
Miami, Florida
01.2026 - Current
- Administer medications according to prescribed schedules and protocols.
- Assist residents with daily living activities, ensuring comfort and safety.
- Provide comfort measures such as bathing, grooming, feeding, ambulation assistance, repositioning patients in bed and chair, and wheelchair assistance; also, empty drainage bags.
- Communicate concerns regarding patients' status, care, and environment to nursing supervisors, clinical care supervisors, and case managers.
- Maintain accurate records of patient care, conditions, progress, and concerns.
Supervisor, Health Plan Operations
Molina Healthcare Inc
Remote
09.2023 - Current
- Oversee team of coordinators who are responsible for the accurate and timely validation and maintenance of critical provider information on claims and provider databases; Ensuring adherence to business and system requirements of internal business partners as it pertains to other provider network management areas, such as provider contracts.
- Monitor provider directories for accuracy and compliance with regulatory requirements; Assign and monitor workloads, ensuring timely completion of tasks such as provider credentialing, contract loading, and demographic updates.
Hospice License Practical Nurse
AccentCare, Inc
Miami, USA
10.2025 - 01.2026
- Provided continuous care to hospice patients experiencing acute or crisis-level symptoms requiring intensive monitoring and intervention which included administering medications as prescribed.
- Performed ongoing assessments of physical, emotional, and psychosocial status, reported changes promptly to the RN Case Manager and interdisciplinary team along with collaborating with physicians, RNs, social workers, chaplains, and home health aides to ensure coordinated, holistic care.
- Maintained accurate and timely electronic health documentation per agency and Medicare hospice regulations.
- Delivered compassionate patient and family education regarding disease progression, medication management, and comfort measures.
- Supported family members through emotional presence, communication, and bereavement preparation.
Investigator, SIU
Molina Healthcare Inc
Remote
07.2021 - 09.2023
- Initiated audits by conducting detailed claims analysis. Conducted proactive data mining to identify cases of potential fraud, waste, or abuse committed by members, providers, and vendors via the FWA Shield platform.
- Performed preliminary investigations, including interviews with witnesses of alleged/suspected fraud, waste, or abuse when corroborated by evidence; Reviewed medical records against claims to validate accurate billing practice.
- Prepared detailed referrals for extensive investigation to state, federal, and law enforcement agencies such as DEA, FBI, OIG, and MFCU when fraud, waste, or abuse is identified as required by contractual and/or regulatory requirements.
Supervisor, Appeals & Grievances and Quality Assurance
Molina Healthcare Inc
Remote
02.2019 - 06.2021
- Completed state reports and KPI reporting on a daily, weekly, and monthly basis within the organizations and regulators due date; Created Policy & Procedures, SOPs, Job Aids, and QRGs as needed to close any identified gaps that may incur liquidated damages.
- Quality & assurance auditing included tracking, trending, and reporting issues recognized during the audit process. Identified and escalated patterns of non-compliance to correct the issue(s) and implement a correction action plan.
- Reviewed escalated appeals, disputes, and grievances to identify the issue of concern and review resolve by reviewing billing guidelines, contractual payment information, etc.
Lead, Provider Inquiry Research & Resolution
Molina Healthcare Inc
Remote
11.2015 - 02.2019
- Ensured providers were loaded and configured correctly according to the signed Provider Services Agreement (PSA) for proper reimbursement. Coordinated with internal departments as needed to resolve provider complaints, disputes, and appeals.
- Reviewed high dollar claim disputes for accuracy of proper payment.
- Validated prior authorizations, billing guidelines, and contractual compensation. Conducted root cause analysis of claims processing errors identified during provider reconciliation process.
Education
Licensed Practical Nurse (Multistate License) - Miami, FL
Robert Morgan Technical College
Miami, FL07.2025
Medical Billing & Coding Certification - Miami, FL
MedVance Institute
Miami, FL06.2006
Skills
- Compassionate care
- Clinical documentation
- Pain management
- Clinical judgment
- EMR / EHR
- Infection control
- Vital signs
- Patient safety protocols
- Medication reconciliation
- Staff direction and task delegation
Certification
- CPR certified by the American Heart Association (BLS provider), 05/31/26
- Licensed Practical Nurse - Compact License, Florida Board of Nursing (LPN5268511), 07/31/27
- Certified Professional Medical Biller, 04/13/18
Timeline
SNF License Practical Nurse
East Ridge Retirement Village
01.2026 - Current
Hospice License Practical Nurse
AccentCare, Inc
10.2025 - 01.2026
Supervisor, Health Plan Operations
Molina Healthcare Inc
09.2023 - Current
Investigator, SIU
Molina Healthcare Inc
07.2021 - 09.2023
Supervisor, Appeals & Grievances and Quality Assurance
Molina Healthcare Inc
02.2019 - 06.2021
Lead, Provider Inquiry Research & Resolution
Molina Healthcare Inc
11.2015 - 02.2019
Licensed Practical Nurse (Multistate License) - Miami, FL
Robert Morgan Technical College
Medical Billing & Coding Certification - Miami, FL
MedVance Institute