Cindy M. White
Summary
Experienced leader with strong background in guiding teams, managing complex projects, and achieving strategic objectives. Excels in developing efficient processes, ensuring high standards, and aligning efforts with organizational goals.
Known for collaborative approach and commitment to excellence.
Equipped with strong problem-solving abilities, willingness to learn, and excellent communication skills. Poised to contribute to team success and achieve positive results. Ready to tackle new challenges and advance organizational objectives with dedication and enthusiasm.
Overview
39
39
years of professional experience
Work History
Project Manager, National Provider Enrollment Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Enrollment Task Order
Novitas Solutions, Inc.
08.2021 - Current
- Overseeing all activities and requirements for a multi-million-dollar indefinite delivery indefinite quantity (IDIQ) firm fixed-price task order/contract for the Centers for Medicare and Medicaid Services (CMS). Key functions include:
- Managing a team of over sixty remote exempt and non-exempt level staff accountable for critical Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) enrollment activities, including subcontractors and a dedicated toll free customer service line
- Establishing and supporting positive relationships with the CMS Contracting Officer (CO), Contracting Officer's Representative (COR), and Business Function Leads (BFLs) as well as external associations and suppliers
- Preparing proposals and basis of estimates (BOE) in response to requests for proposal (RFP) for modification of the Statement of Work (SOW) for this task order
- Establishing operational teams, procedures and processes that are compliant with CMS Change Requests (CRs), Technical Direction Letters (TDLs), and the Program Integrity Manual (PIM) through an effective change management protocol
- Establishing and maintaining Joint Operating Agreements (JOAs) with various external stakeholders
- Coordinating with the Unified Program Integrity Contractors (UPICs) for issues related to beneficiary complaints of fraudulent activities and supporting the UPIC investigations
- Recommending and facilitating process and quality improvement activities to enhance operational results and customer satisfaction
- Compiling information for audit and control activities (e.g., QASP, ISO, OIG, GAO, internal controls, internal audits) and responding to audit findings including development of corrective action plans
- Attending and actively participating in CMS-sponsored workgroups and meetings
- Reporting workload status to CMS on a regular basis (weekly and monthly)
Manager, Provider Enrollment Operations Support
Novitas Solutions, Inc.
08.2014 - 08.2021
- Managed a team of exempt and non-exempt level staff in two locations (FL and PA) accountable for critical Part A and Part B provider enrollment support functions for the Jurisdiction H (JH) and Jurisdiction L (JL) contracts. Key team accountabilities:
- Established and supported operational procedures and processes to ensure compliance with the Centers for Medicare & Medicaid Services' (CMS) Change Requests (CRs), Technical Direction Letters (TDLs), Program Integrity Manual (PIM) through an effective change management protocol
- Established and conducted effective employee training programs (new hire and ongoing) for all provider enrollment staff
- Ensured provider enrollment processing issues were promptly addressed and changes implemented effectively
- Resolved critical inquiries including root cause analysis and development of corrective action plans, as appropriate
- Processed CMS and Medicare Administrative Contractor (MAC)-initiated revocations to terminate Medicare billing privileges
- Monitored activities (license continuous monitoring reports, deceased provider report, monthly license reviews)
- Reviewed adverse legal actions to determine appropriate actions
- Processed provider enrollment appeals (corrective action plans, reconsiderations, rebuttals)
- Supported provider outreach and education activities
- Recommended and facilitated process and quality improvement activities to improve operational results and customer satisfaction
- Compiled information for audit and control activities (e.g., QASP, ISO, OIG, GAO, internal controls, internal audits) and responded to audit findings including development of corrective action plans
- Evaluated and provided support for key systems including the Provider Enrollment, Chain and Ownership System (PECOS) and workflow management
- Attended and actively participated in CMS-sponsored workgroups and meetings
- Ensured the accuracy and timeliness of CMS CR/TDL deliverables
- Supported the provider enrollment operational managers
- Participated in RFP/proposal writing activities
- Resolved staff member conflicts, actively listening to concerns and finding appropriate middle ground.
- Maximized performance by monitoring daily activities and mentoring team members.
Business Analyst 4, Core Services Department Support
Guidewell Source
03.2003 - 08.2014
- Liaised with the federal government, the Medicare Shared System Maintainers, internal IT staff and other internal and external partners regarding change management and system releases for the Novitas JH and JL provider enrollment departments. Provider enrollment is responsible for properly enrolling Part A and Part B providers/suppliers in the Medicare Program in accordance with the Statement of Work (SOW), the Centers for Medicare and Medicaid Services' (CMS) security and privacy requirements as well as Chapter 10 of the Program Integrity Manual (PIM). Support of provider enrollment in this role required daily interaction with the Director, Managers, PE Business Operations Specialists, and processing staff as well as routine interaction with senior leadership.
- Served as the subject matter expert and project lead, or high-level contributor, for moderate to complex high-visibility projects and system transitions/implementations:
- Transitioning to/implementation of the Provider Enrollment, Chain and Ownership System (PECOS)
- Implementation of the National Provider Identifier (NPI)
- Designing, evaluating, and implementing a new provider enrollment paperless workflow management system
- Creating a real-time online provider enrollment status tool
- Implementing the Jurisdiction 12 (J12)/Jurisdiction L (JL) and Jurisdiction H (JH) Medicare Administrative Contractor (MAC) awards
- Effectuating provider enrollment appeals for providers whose billing privileges were revoked or denied
- Implementing the revalidation initiative
- Creating technical narratives for Requests for Proposal (RFP)
- Job responsibilities required project management expertise, impact analysis for complex processes, interpreting system documentation and utilization of project management techniques. Lead the timely, accurate and compliant implementation of hundreds of change requests (CRs) and Technical Direction Letters (TDLs) issued by the CMS.
- Interacted with internal customers to understand business needs and translate into requirements and project scope.
Project Analyst, Provider Enrollment Services
Novitas Solutions, Inc.
12.1997 - 03.2003
- Managed various aspects of the provider enrollment process to include:
- Administered and maintained the integrity of the provider enrollment files
- Routinely interacted with the internal and external customers
- Analyzed and interpreted rules and regulations set forth by the Centers for Medicare & Medicaid Services (CMS) to ensure compliance
- Reviewed accuracy of activities performed by department staff
- Created procedures and trained staff for Change Requests (CRs) issued by the CMS
- Participated in external provider educational sessions and attending yearly seminars
Medical Review Auditor - Utilization Review
Novitas Solutions, Inc.
12.1994 - 12.1997
- Conducted comprehensive medical reviews of Medicare Part B providers to identify intentional and unintentional fraud and/or abuse
- Conducted extensive analysis of statistical data
- Reviewed and addressed utilization issues by verifying compliance with medical policies and regulations set forth by the Centers for Medicare & Medicaid Services (CMS)
- Composed comprehensive written reports and required documentation detailing all aspects of the medical reviews aimed at curbing incidents of fraud and abuse for future claims submissions which resulted in the recoupment of overpayments
- Referred cases for further investigation to the Fraud Investigations Unit
- Performed regular interaction with internal and external customers concerning medical reviews
- Facilitated the Focused Medical Review (FMR) workgroup for abusive physical therapy issues
Utilization Case Support Specialist & Utilization Review Specialist
Novitas Solutions, Inc.
10.1988 - 12.1994
Section Supervisor
Rite Aid Corporation
08.1986 - 10.1988
Education
High School -
West Perry Senior High School
Elliottsburg, PA06.1986
Skills
- Systems implementation
- Project tracking
- Project development
- Customer relations specialist
- Workforce training
- Staff management
- Verbal and written communication
- Requirements gathering
- Inventory control
- Coaching and mentoring
- Root-cause analysis
- Procedure development
Timeline
Project Manager, National Provider Enrollment Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Enrollment Task Order
Novitas Solutions, Inc.
08.2021 - Current
Manager, Provider Enrollment Operations Support
Novitas Solutions, Inc.
08.2014 - 08.2021
Business Analyst 4, Core Services Department Support
Guidewell Source
03.2003 - 08.2014
Project Analyst, Provider Enrollment Services
Novitas Solutions, Inc.
12.1997 - 03.2003
Medical Review Auditor - Utilization Review
Novitas Solutions, Inc.
12.1994 - 12.1997
Utilization Case Support Specialist & Utilization Review Specialist
Novitas Solutions, Inc.
10.1988 - 12.1994
Section Supervisor
Rite Aid Corporation
08.1986 - 10.1988
High School -
West Perry Senior High School
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