Michelle Duncan
Antelope,CA
Summary
Coordinated Associate Governmental Program Analyst versed in communicating and collaborating across all organizational levels. Successful at updating workflow processes and procedures to improve efficiency across the division and collaborating with teams to initiate, create, and analyze program efficiency.
Overview
20
20
years of professional experience
Work History
Associate Governmental Program Analyst
State of California, Department of Managed Health Care (DMHC)
03.2023 - Current
- Plans, organizes and conducts medical surveys of health care service plans.
- Directs clinical consultants and department analysts to determine compliance with the Knox-Keene Health Care Service Plan Act (Act) and Title 28 under managements direction.
- Prepares, edits and issues reports using division policies, procedures and templates that are then issued to the appropriate health care service plan and the public.
- Works with division’s legal staff to review health care service plan license applications, policies and procedures and other information to determine compliance.
- Documents and tracks milestones in the survey process to ensure timelines are met.
- Analyzes and evaluates health plan documents related to applications, amendments and material modifications to determine compliance with the Act and Title 28.
- Participated in a workgroup to update and streamline policies and procedures to ensure productivity and efficient use of resources.
- Assisted manager with production of training tools for new and current staff.
- Trained new hires, facilitating shadowing during onboarding.
Staff Services Analyst
State of California, Department of Managed Health Care (DMHC)
05.2019 - 04.2023
- Assisted attorneys on various Office of Legal Services (OLS) legal projects assigned by Department counsel including Title 28 regulations development, preparation of legal advice memos, and responses to internal and external legal interpretation requests by analyzing data, information, and records, taking notes for the attorney, preparing response documents, attending meetings, and making suggestions where appropriate.
- Managed production of large volume of documents required when submitting Timely Access regulation to Office of Administrative Law.
- Responded to requests from the public related to the Public Records Act; identifies and gathers responsive records from the DMHC database, and/or coordinates with other offices and divisions.
- Reviewed documents for accessibility, converts documents when necessary to provide accommodations when necessary.
- Maintained data in OLS databases and spreadsheets for incoming correspondence and workload, using Excel as well as internal programs.
- Reviewed all responsive documents to preserve confidentiality and protect personal information; composes letters and correspondence and securely transmits responsive records.
- Performed various administrative functions, including the submission of service requests, new employee onboarding, and phone coverage, managing time and schedule to ensure availability while completing other tasks.
- Served on the COVID Vaccine Task Force with the Department of Public Health, received the Gold Superior Accomplishment Award for this service.
Analyst
State of California, Department of Managed Health Care (DMHC)
07.2020 - 12.2020
- Provided analytical support on the review of applications for licensure, notices of material modifications and amendments filed by health plans to determine whether a health plan complies with the Act and Regulations, as it relates to provider network adequacy.
- Assisted lead staff, counsel and attorneys with the initial analysis of network filings, drafting, compiling and formatting comment letters to health plans on findings.
- Evaluated network adequacy using DMHC analytical tools.
- Analyzed and identified provider network issues and evaluate the availability of facility-based providers as required under AB 72.
- Ensured plan compliance with timely access requirements, Federal Health Care Reform, and new regulations under the Act.
- Performed varied and complex projects that support the Division of Provider Networks including, but not limited to, review and analysis of annual network adequacy data submissions, timely access data and block transfer filings.
Eligibility Specialist
Sacramento County Department of Human Assistance
01.2014 - 05.2019
- Used the CalWIN database, MEDS, SMART, as well as Excel, Word, and Access to process and manage cases, modifying employment plan and eligibility files as necessary, monitored customer compliance and budgets for all programs received while ensuring that their private information was protected per HIPAA requirements.
- Analyzed, interpreted and implemented federal, state, and local laws, regulations, policies and procedures for each program, to determine eligibility and maintain case status.
- Provided excellent customer service by phone and in person in both intake and case maintenance in Medi-Cal, General Assistance, and CalFresh, communicated eligibility information with compassion, respect and tact.
Booth Manager
TNT Fireworks
01.2014 - 12.2018
- Attended trainings on fireworks safety, fire safety, booth management, and advertising.
- Recruited, scheduled and managed 50 volunteers using Excel.
- Received and managed inventory, budgeting, and acquisition and profit and loss management.
- Created marketing tools using Microsoft Publisher, distributing them through social media and in person.
- Reported profits and areas for improvement to the benefiting agency.
Customer Service Representative
California Housing Finance Agency
09.2014 - 01.2015
- Maintained a database to determine customers loan amounts, the type of loan and other information requested.
- Provided customer service to loan recipients via phone and in person, assisted with basic home loan questions, transferred calls to appropriate agents, processed mail, and performed administrative duties including processing of reports.
Eligibility Specialist
Monterey County Department of Social Services
01.2005 - 11.2007
- Kept up to date on changing policies and procedures, ensuring that benefits issued in caseload were accurate and customers’ information was correct and secure, and communicated information to customers.
- Reviewed applications and interviewed applicants for different aid programs and determined qualification criteria for individuals.
- Assisted customers with job search, program and policy requirements for CalFresh, Medi-Cal and CalWorks.
- Managed caseload of beneficiaries and applicants, worked with families applying for and receiving services.
Education
Bachelor of Science - Business with a Marketing Emphasis
University of Phoenix
Sacramento05.2012
Skills
- Microsoft Office
- Time Management
- Attention to Detail
- Team Collaboration
- Effective Communication
- Budget Management
- Volunteer Management
- Interagency coordination
- Legislative research
- Data analytics
- Policy analysis
- Process improvement techniques
Accomplishments
- Received the Gold Superior Accomplishment Award from the Department of Managed Health Care
Timeline
Associate Governmental Program Analyst
State of California, Department of Managed Health Care (DMHC)
03.2023 - Current
Analyst
State of California, Department of Managed Health Care (DMHC)
07.2020 - 12.2020
Staff Services Analyst
State of California, Department of Managed Health Care (DMHC)
05.2019 - 04.2023
Customer Service Representative
California Housing Finance Agency
09.2014 - 01.2015
Eligibility Specialist
Sacramento County Department of Human Assistance
01.2014 - 05.2019
Booth Manager
TNT Fireworks
01.2014 - 12.2018
Eligibility Specialist
Monterey County Department of Social Services
01.2005 - 11.2007
Bachelor of Science - Business with a Marketing Emphasis
University of Phoenix
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