JERRIE RICE
Harvest,AL
Summary
Dedicated Multi-Dimensional Healthcare professional with over 18 years hands-on management and business experience in the healthcare field and medical office environments. Extensive knowledge in developing, managing, and training staff, with a successful track record of managing personnel, finances and facility operations while ensuring patients are provided with the highest quality care. Results-driven and committed to reengineering and delivering consistent and strategic end-to-end business process solutions. Analytical professional well-versed in coordinating and prioritizing project tasks, managing timelines and maintaining project plans to communicate status to clients and senior management.
Overview
24
24
years of professional experience
Work History
Implementation Project Manager
Optum - 340B
05.2021 - 05.2024
- Managed over 50 pharmacies implementations per quarter with inventory of high dollar specialty medications.
- Collaborated with cross-functional teams such as sales, marketing, finance, IT support services ensuring smooth execution of multiple concurrent projects.
- Managed stakeholder expectations through clear communication of goals, objectives, and timelines.
- Documented specialized data and requirements to address business demands.
- Maintained detailed records of all projects completed within scope, budgetary constraints, and specified deadlines.
- Established and enforced project timelines and deadlines.
Sr Resolution Recovery Analyst
Optum
01.2018 - 04.2021
- Responsible for investigating, recovering and resolving all types of claims as well as recovery and resolution for health plans.
- Investigate and pursue recoveries and payable on subrogation claims and file management.
- Process recovery on claims.
- Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance.
- Verified data integrity and accuracy.
- Developed comprehensive reports to track progress, identify challenges, and provide actionable insights for management review.
Clinic Operations Manager
Choice Medicine -
05.2009 - 01.2018
- Manage all aspects of multi-physician medical practice and office logistics from physician- employee-patient scheduling, network connectivity e.g., office, laboratory billing, insurance, physician contracting with insurance companies-independent physician associations-hospitals, purchasing, marketing, payroll, reconciling practice financial for accountants and financial advisor's.
- Act as liaison between physician, employee, and patients in clinical and business setting.
- Ensure Quality Measures and Health metrics are meet for providers.
- Responsible for renewing and maintaining records for physician's federal and state licensees. (e.g., DEA, Alabama controlled substance, state medical license, malpractice insurance, long term/disability insurance).
- Optimize patient/physician /employee scheduling and time to best increase profits and accounts receivables.
- Actively participated in community outreach events promoting clinic services, enhancing public awareness about available resources, and fostering strong relationships with community members.
- Managed budgetary planning to maintain financial stability within clinic while providing high-quality services.
Medical Training Supervisor
Zaide Medical Management
06.2004 - 05.2010
- Develop plans and coach for medical practices and professionals in problematic issues that may contribute to missed or loss revenue with proper billing and coding, training and ensuring compliance with federal and state laws, regulations correlating coding principles.
- Assist medical offices in implementing state and corporate regulatory policies and procedures into daily office practices, informing and training staff members. (e.g., HIPPA, OSHA, CLIA)
- Monitor health information procedures ensuring high quality standards of documentation, ethical practice, confidentiality, information security, information retention and retrieval.
- Train office staff on Meaningful use and other health quality measures,
Medical Billing Manager
Specialized Medical
08.2000 - 06.2004
- Oversee and streamline billing and collection process.
- Plan and implement quality assurance for all processes.
- Train or instruct employees in job duties and company policies.
- Verified data integrity and accuracy.
Education
MBA - Business Management
Alabama Agricultural And Mechanical University
Norma, AlBachelor of Arts - Business Management
Faulkner University
Montgomery, AlMay 2008
Skills
- 340B Certified
- Strong knowledge of multiple EHR systems, Clinical Standards of Care, Managed Care Plans, Gap Closures, Quality Measures, MIPS and MACRA
- Excellent written, verbal and internal-personal communication skills
- Analytical and problem solving skills
- Ability to manage multiple projects concurrently
- Proven track record for improving process efficiencies and effectively implementing quality assurance for all processes
- Strong positive long-term relationships with physicians, medical groups in community
- Project Management and Implementation
Timeline
Implementation Project Manager
Optum - 340B
05.2021 - 05.2024
Sr Resolution Recovery Analyst
Optum
01.2018 - 04.2021
Clinic Operations Manager
Choice Medicine -
05.2009 - 01.2018
Medical Training Supervisor
Zaide Medical Management
06.2004 - 05.2010
Medical Billing Manager
Specialized Medical
08.2000 - 06.2004
MBA - Business Management
Alabama Agricultural And Mechanical University
Bachelor of Arts - Business Management
Faulkner University