Summary
Overview
Work History
Education
Skills
Professional Highlight
Timeline
Generic

Monica Thompson

Chicago,IL

Summary

Mission focused with unique experience in managing the daily operations services and programs in various capacities. Skilled at preparing and submitting regulatory documentation, including report writing, reviewing materials, technical data and accuracy of filings. Articulate personable and methodical with good judgement and sound critical thinking and resolution abilities.

Overview

13
13
years of professional experience

Work History

Medicaid Regulatory Analyst

HCSC BCBS
08.2022 - Current
  • Participate in audits, supporting tracking and submission of Medicaid State Contracts related deliverables, including fulfillment of internal and contractual reporting requirements
  • Coordinate the Utilization Management Committee to ensure effective implementation of the BCBS network plan and to support compliance with requirements for HCSC BCBS.
  • Influenced positive change within the organization by identifying process improvements aimed at increasing efficiency without compromising compliance standards.
  • Collaborated with cross-functional teams to address any identified gaps in compliance or areas requiring improvement.
  • Developed or tracked quality metrics.
  • Interpreted regulatory rules or rule changes and communicated with others through corporate policies and procedures.
  • Provided guidance to business units for maintaining compliance with applicable laws and standards.
  • Prepared timely and accurate reports for submission to regulatory agencies, ensuring proper documentation and recordkeeping.

Tax Consultant/Office Manager

QRTax Service
01.2021 - 05.2022
  • Provide a consultative approach to analyze and decipher financial information to ensure compliance with government regulations
  • Work to ensure clients tax liability is minimized and communicate any tax issues and conduct research tax laws
  • Completed and filed returns with tax departments at local, state, and federal levels.
  • Identified discrepancies in client records that could trigger audits or result in missed deductions or credits.
  • Furnished taxpayers with sufficient information and advice to facilitate correct tax form completion.
  • Implement office systems and layouts, manage timesheets, design filing systems, approve supply requisitions.

Associate Integration Lead

HCSC BCBS
08.2021 - 01.2022
  • Collaborated with business partners to align business solutions, liaison between the business and the key stakeholders
  • Support business needs across delivery cycle and driving communication of changes and any updates needed
  • Ensures integration and serves as a functional business liaison in the development and implementation of project scope
  • Provide project oversight to ensure business value is realized, including approval of scope, execution of scope and conveys impacts to changes to the Business.
  • Facilitated cross-functional collaboration between departments during integration efforts, fostering a unified approach towards achieving business objectives.
  • Established team priorities, maintained schedules and monitored performance.


Clinical/Program Coordinator

AMOPPORTUNITIES
07.2018 - 04.2020
  • Conducted site visits, built, and manage relationships with physicians, administrators, hospitals, and healthcare entities
  • Managed credentialing process, program requests, and ongoing issues i.e., emergency replacement, student no-show and hygiene
  • Assist with the Onboarding of physicians, medical students, administrative staff and negotiating contracts i.e
  • Communicate contract terms and payment structure
  • Maintained tracking system for requesting and receiving background checks and finger printing
  • Made recommendations for audit procedures that impact short and long-term goals and prepared reports
  • Assist with the application and webpage design for end users i.e., smart use of visuals, and displayed information
  • Streamlined the process to apply and enroll for clerkship and or rotations with various healthcare professionals
  • Established quality controls for receiving and processing documents and enrollments into the intended programs
  • Oversaw regulatory compliance for B-1 visas, USMLE, ESTA, passports and sent request for full background/drug screens
  • Spearhead monthly departmental brownbag meetings for diversity and inclusion, best practices, and team building
  • Identified and interpret trends, prepared statement of work and KPI’s for enrollment i.e., number of students, bottlenecks
  • Coordinated with cross-functional departments and entities to ensure preceptors and medical students have a fulfilling experience.
  • Improved interdepartmental communication through the implementation of clear channels and reporting processes, fostering teamwork and collaboration.

Admin Assistant to the CIO and Vice Provost of IT

UNIVERSITY OF ILLINOIS AT CHICAGO
09.2016 - 05.2017
  • Participated in the ongoing management of ACCC operations and provided administrative support to the CIO in the aspect of coordinating and overseeing programs, projects, events, and conferences through completion
  • Represented the Vice Provost in meetings with other leadership members, and stakeholders
  • Assessed program priorities to allocate resources in accordance with goals and the ACCC strategic plan
  • Supervised office support and volunteers, monitored performance, purchasing, inventory and submitted timesheets
  • Communicate effectively across the distinct groups in UIC and worked with the ACCC staff on the management of board committees, Chairs, work groups, task forces, operations, and effective processes
  • Served as project coordinator to help develop project plans that included defining the project scope, goals, deliverables, assembling and coordinating staff resources and providing quality oversight
  • Assist with budget management, forecasting and other financial requirements within ACCC to ensure effectiveness
  • Maintained policies and procedures, ensuring alignment with Governance department, managed the agenda of meetings
  • Oversaw data collection from the board members, chairs, senior management, and directors, maintained the database and analyzed data to produce actionable information for ACCC team and UIC
  • Provided clear, concise, and timely communications detailing all event requirements to facility management, schedulers, and other pertinent entities.
  • Worked closely with management to provide effective assistance for specific aspects of business operations.
  • Reviewed and edited documents for accuracy, grammar and clarity.
  • Increased profitability and productivity by minimizing downtime and streamlining quality control procedures.
  • Assisted manager in all aspects of business operations.
  • Managed data and correspondence to secure information across complex landscapes of organizational departments.
  • Answered incoming phone calls to process requests, transfer calls, or relay messages to appropriate personnel.
  • Collected and input timesheet data into automated accounting system and processed labor corrections.
  • Supported business growth by assisting in marketing campaigns and coordinating events.
  • Planned and coordinated logistics and materials for board meetings, committee meetings, and staff events.
  • Improved accuracy of financial records with diligent tracking of expenses, budgeting, and invoice processing.
  • Managed calendars and coordinated travel arrangements and accommodation for senior-level staff to optimize schedules.
  • Trained and supervised employees on office policies and procedures.
  • Remained solutions-oriented in face of complex problems to assist management and overall business direction.

Executive Admin Assistant/Compliance Officer Assistant

JACKSON PARK HOSPITAL
10.2014 - 09.2016
  • Provided daily support to the VP of Quality i.e., scheduled and attended meetings, calendar and email management
  • Ensure specific department goals align and contribute to institutional goals through effective collaboration and partnerships
  • Influenced the development and implementation of short and long-term strategic plans for the Department
  • Created periodic and year-end statistical reports to track patient census, personnel hours, and agency usage
  • Met regularly with the president, senior vice presidents, and vice presidents to provide updates on all ongoing activities
  • Sent notifications for hospital, environmental health & safety codes, and project coordinator for ICD
  • Reviewed caseloads for case managers regarding utilization reviews and social services regarding patient length of stay
  • Created and managed reports for CMS insurance, LOS, FTE’s, competences, and chart reviews
  • Prepared cost estimates and operating budgets for projects and laborer services needed for scheduled maintenance
  • Compliance/Quality Analyst Conducted audits, and compliance activities such as performing mock surveys, developing compliance plans and facilitating meetings with site managing teams
  • Assisted with identifying controls and gaps in current processes, assemble findings and create reports for senior management
  • Aided in managing projects within compliance operations to ensure all requirements were met and completed on time
  • Inspected and observed all medical facilities equipment, and procedures, assess safety of emergency exits, examine printed labels, checked expiration dates on medications, foods and detached obstructed impediments to equipment or other areas
  • Participated in the regulatory examination and root cause analysis, Uniform Data system to review the hospitals operations, trends and performance and prepared reports
  • Monitored for regulatory updates, including new forms, interpretations, legislation and compliance
  • Serve as a change agent and work closely with hospital, service line, in identifying priority areas, developing goals, planning improvement, and monitoring effectiveness and progress towards goals
  • Monitor and tracked incidents reports and develop summary reports for Jackson Park’s leadership team
  • Identified action plans to improve quality and patient experience and manage competencies e.g., HIPAA, CMS, HEDIS, JACHO, regulatory and hospital surveys for all staff
  • Established quality controls and reporting for E.D
  • Registration, triage wait times, recruiting and on-boarding
  • Ombudsman Assist with medical center-wide education on new or updated requirements and training as well as best practices
  • Measured patient experience by utilizing the PQRS CHAPS survey i.e., access to care, self-management, and hospital staff
  • Examined data to determine how hospital staff, conducts their everyday administrative activities and actions
  • Conducted patient rounding to identify trends in service delivery and opportunities to facilitate service recovery
  • De-escalate and resolve issues professionally by investigating complaints, and service recovery
  • Reporting on safety slip and fall, risk, waste, accidents and accidents to the executive teams and regulatory entities
  • Collected, analyzed, complied, and disseminated data from quality rounds, i.e., Press Ganey and tracers
  • Investigated and managed complaints and use analytical skills to resolve and ensure customer satisfaction and confidentiality
  • Made recommendations in procedures to improve the effectiveness of operations to improve performance, service excellence
  • Recruiter Assisted with the attraction and retention of qualified applicants, wrote job descriptions, reviewed resumes, administered and graded tests
  • Interfaced with prospects, assist with the onboarding process, and ensure HIPAA guidelines were enforced
  • Notified director of physician and resident licensing renewals, to ensure compliance with regulatory entities and with all vendors i.e., Aetna, BCBS, Cigna and Illini Health
  • Provide and disseminated id badges security entry and parking permits to fellows and medical students
  • Managed provider database and reports for the department and consulted with department heads.
  • Processed travel expenses and reimbursements for executive team and senior management group.
  • Offered assistance, collaboration and clerical support to auditors throughout entire review process.
  • Facilitated training and onboarding for incoming office staff.
  • Scheduled appointments promptly, ensuring optimal use of executive time while minimizing conflicts or cancellations.

Compliance Project Coordinator

DICIMI TECH
01.2011 - 03.2014

Education

Certificate -

Johns Hopkins University
03.2022

Bachelor of Science - HEALTH SCIENCE

Kaplan University
Davenport, IA
05.2014

Skills

  • Technical Guidance
  • Data Collection Monitoring
  • Database Maintenance
  • Impact Assessment
  • Project Management
  • Legal Research
  • Policy analysis

Professional Highlight

  • Healthcare Management
  • CHAPS Survey
  • KPI Review
  • Medicaid/Medicare
  • Regulatory Compliance
  • Data Collection
  • Staff Training and Development
  • Investigations
  • Patient Experience
  • Service Recovery
  • Quality Control
  • STARS/HEDIS
  • NCQA
  • Process Improvement
  • Vendor Management
  • Microsoft Word, Excel, PowerPoint, Outlook365, Meditech, Zendesk

Timeline

Medicaid Regulatory Analyst

HCSC BCBS
08.2022 - Current

Associate Integration Lead

HCSC BCBS
08.2021 - 01.2022

Tax Consultant/Office Manager

QRTax Service
01.2021 - 05.2022

Clinical/Program Coordinator

AMOPPORTUNITIES
07.2018 - 04.2020

Admin Assistant to the CIO and Vice Provost of IT

UNIVERSITY OF ILLINOIS AT CHICAGO
09.2016 - 05.2017

Executive Admin Assistant/Compliance Officer Assistant

JACKSON PARK HOSPITAL
10.2014 - 09.2016

Compliance Project Coordinator

DICIMI TECH
01.2011 - 03.2014

Certificate -

Johns Hopkins University

Bachelor of Science - HEALTH SCIENCE

Kaplan University

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Monica Thompson