To obtain a professional level position, utilizing accumulated education, expertise and experience.
Overview
48
48
years of professional experience
Work History
Appeals Coordinator I and II
University of New Orleans
06.2013 - Current
Utilize the LaMEDS System to conduct reviews of Medicaid eligibility decisions for correctness as it relates to policy and procedural applications.
Prepare Summaries of Evidence and defend eligibility decisions in Administrative Appeal hearings.
Prepare Agency Rescinds, Reversals and Dismissed Requests for pending appeals.
Identify errors in case processing and return cases to the local Medicaid offices for correction as appropriate.
Director
Louisiana Department of Health - Bureau of Appeals
09.1997 - 12.2010
Administered, managed and directed the operations of the Bureau of Appeals.
Supervised the Administrative Law Judges who were responsible for conducting hearings and the adjudication of administrative appeals filed within Department of Health and Hospitals within all offices except Public Health.
Section Chief - Medicaid Field Operations
Louisiana Department of Health
09.1996 - 09.1997
Responsible for the administration and management of Medicaid Field Operations statewide.
Supervised 700+ staff statewide whose duties were to make Medicaid eligibility determinations in the 9 state regions.
Medicaid Regional Manager
Louisiana Department of Health
10.1992 - 09.1996
Managed and directed Medicaid Eligibility Operations for the Baton Rouge Region initially consisting of 12 parishes later reduced to 7 parishes when Mandeville Region established. Duties included staffing, budget preparation and oversight, staff development / training.
Parish Assistant Administrator
East Baton Rouge Parish Office of Eligibility Determinations
06.1989 - 10.1992
Assisted Class V Parish administrator in the administration and management of the office with primary responsibility for program administration and oversight.
Additionally, was responsible for direct supervision of the third level supervision of Eligibility staff whose duties were to make eligibility determination decisions for the AFDC, Food Stamps and Medicaid programs.
Eligibility Determinations Supervisor II
East Baton Rouge Parish Office Of Eligibility Determination
01.1985 - 06.1989
Responsible for the second level supervision of Eligibility staff whose duty was to make eligibility determination decisions in the AFDC, Food Stamps and Medicaid programs.
Eligibility Determinations Supervisor I
East Baton Rouge Parish Office of Family Security
05.1981 - 01.1985
Responsible for direct line supervision of eligibility staff whose duty was to make eligibility decisions in the AFDC, Food Stamps and Medicaid programs
Eligibility Worker
Ascension Parish Office of Family Services
09.1977 - 05.1981
Responsible for interviewing applicants / recipients to determine their eligibility for participation in the Food Stamp program
Education
Bachelor of Arts - Psychology
Louisiana State University
Baton Rouge, LA
01.1975
Further Studies -
Southern University A & M
Baton Rouge, LA
Skills
Microsoft Office
SOLQ
Medicaid Management Information Systems (MMIS)
LaMEDs
ACCESS
Timeline
Appeals Coordinator I and II
University of New Orleans
06.2013 - Current
Director
Louisiana Department of Health - Bureau of Appeals
09.1997 - 12.2010
Section Chief - Medicaid Field Operations
Louisiana Department of Health
09.1996 - 09.1997
Medicaid Regional Manager
Louisiana Department of Health
10.1992 - 09.1996
Parish Assistant Administrator
East Baton Rouge Parish Office of Eligibility Determinations
06.1989 - 10.1992
Eligibility Determinations Supervisor II
East Baton Rouge Parish Office Of Eligibility Determination