Natalie Sirois

Natalie Sirois has over sixteen years of experience in strategy and management consulting with the Federal government. She has experience in the areas of Federal healthcare delivery, policy and procedure development, information systems, and communications. She has worked with the CDC for fourteen years, and currently serves as the Medical Management Manager on the World Trade Center (WTC) Health Program. Ms. Sirois provides functional support and leadership in the following areas: project management, medical billing and coding, medical review and utilization, Federal health information technology, and education and training. Prior to her experience with the CDC, Ms. Sirois served as the Customer Relationship Management team lead and Strategic Workforce Planning analyst at the Defense Threat Reduction Agency (DTRA).

• World Trade Center (WTC) Health Program, Health Program Support (HPS)
• Centers for Disease Control and Prevention (CDC), National Institute of Occupational Safety and Health (NIOSH), World Trade Center (WTC) Health Program
• Karna became WTC HPS TPA prime contractor in December 2016. Karna provides program, data, systems and labor support for member enrollment, certification of WTC related conditions, member transfers, provider network, provider education/outreach, benefits policy administration, utilization review, claims adjudication, appeals, Coordination of Benefits (COB), FWA (fraud, waste and abuse), data analytics, business intelligence, Health Program integration, quality management, data/systems architecture, applications development/hosting/maintenance, data warehousing, reporting, call center, mail room, written/oral translations, and communications support. In total, Karna has processed more than 2,139,900 medical claims, enrolled more than 193,998 providers, supported enrollment of more than 60,557 program members, processed more than 117,432 certifications, and handled more than 487,201 help desk calls. In December 2021, Karna started executing the WTC HPS Bridge contract to prepare for a potential transition following the re-compete.
• Ms. Sirois manages eight employees on the Medical Management Team, including a medical advisor, five claims review nurses, a medical coding expert, and a business analyst. She is responsible for working with the client to develop medical policy; providing training to the client and clinical centers on program initiatives; conducting medical quality assurance audits to search for potential fraud, waste and abuse; creating and managing the medical codebook; overseeing the review of pended claims for further medical evaluation; and conducting ad hoc research on client initiatives.
• Other Project Experience
• CSC/CSRA, Falls Church, VA
• CSC/CSRA (the company became CSRA in 2015 after CSC merged with SRA) was the original prime contractor on the WTC Health Program. Ms. Sirois managed seven employees on the CSRA Medical Management Team, including two medical advisors, a policy and pricing expert, two claims review nurses, a medical coding expert, and a business analyst. She was responsible for working with the client to develop medical policy; providing training to the client and clinical centers on program initiatives; conducting medical quality assurance audits to search for potential fraud, waste and abuse; creating and managing the medical codebook; overseeing the review of pended claims for further medical evaluation; and conducting ad hoc research on client initiatives. She led the Medical Management Team’s implementation of the International Classification of Disease, Tenth Revision (ICD-10). For the ICD-10 transition, Ms. Sirois conducted quality assurance on the ICD-9 to ICD-10 code crosswalk; developed a Microsoft Access database for the ICD-10 codes with queries to produce two codebook formats that meet different end user needs; created ICD-10 training materials; and provided training to the client and clinical centers. She has also served as a business analyst for the Medical Management and Member Services Teams on the WTC Health Program. She was responsible for creating and managing the medical codebook; supporting the member health condition certifications process; and developing communications for the client, program members, clinical centers and healthcare providers. Ms. Sirois led the member number transition and member card distribution effort. As part of this effort, she supported member card design and coordinated two mass mailings to over 60,000 program members. In addition, Ms. Sirois redesigned the program’s medical codebook. She built a Microsoft Access database to house all the codebook information and developed quality assurance queries to resolve data errors. She created different codebook formats from the Access database to meet all end user needs.
• Customer Relationship Management, Strategic Workforce Planning and Lean Six Sigma
• Department of Defense (DoD), Defense Threat Reduction Agency (DTRA)
• DTRA is a combat support agency with a mission to reduce the threat posed by weapons of mass destruction (WMDs). Natalie Sirois supported the Business Excellence Campaign, which works to streamline business processes and lead continuous process improvement initiatives across the agency. Ms. Sirois served as the Customer Relationship Management team lead and Strategic Workforce Planning analyst. She was responsible for facilitating weekly working sessions for seven different services undergoing Customer Relationship Management assessments. In addition, she supported two Strategic Workforce Action Teams for the Strategic Workforce Planning initiative—Recruiting, Outreach and Retention Programs and Functional Community Management. Ms. Sirois also served as a Lean Six Sigma analyst and was responsible for providing training support and promoting employee engagement. During her time at DTRA, she supported the development of the Customer Relationship Management and
• CSC was an international IT company that provided professional and consulting services. Ms. Sirois worked for the North American Public Sector (NPS), Federal Consulting Practice. This sector was one of the biggest IT service providers for US Federal government. As a consultant, Ms. Sirois conducted research, created a 49 page brief, and gave a presentation on global public sector strategy to CSC’s NPS President of Strategy and Development. She also researched global organizational models and presented her findings to the President of Strategy and Development. In addition, Ms. Sirois assisted the CSC team at Customs and Border Protection by researching and building a 22 page presentation on enterprise information architectures. Further, she worked on an internal project for CSC’s Strategy Group in the Federal Consulting Practice by conducting research and creating a 27 page brief on the Obama administration’s key priorities.
• Government Accountability Office (GAO), Washington, DC
• GAO is a legislative branch government agency that provides auditing, evaluation, and investigative services for Congress. Ms. Sirois was an analyst intern on the International Affairs and Trade (IAT) team. She was a staff member on a Congressional request by the House Committee on Foreign Affairs to evaluate Radio and TV Martí, U.S.-funded broadcasting programs in Cuba. She was responsible for scheduling and participating in 13 interviews with experts in Cuba, journalism and broadcasting, including the head of National Public Radio. She prepared written summaries of all interviews conducted. In addition, she evaluated the content and objectivity of U.S. TV Martí broadcasts in Spanish using a sophisticated content analysis. Further, Ms. Sirois drafted a segment of the GAO report published in January 2009 on the programs’ audience reach and broadcast objectivity. The project resulted in a high-profile GAO hearing before the House Committee on Foreign Affairs.
• Congress, House Committee on Education and Labor, Washington, DC
• The House Committee on Education and Labor has legislative jurisdiction over matters related to higher and lower education, workforce development and protections, and health, employment, labor, and pensions. As an intern, Ms. Sirois participated in committee investigations on allegations of: (1) fraud in federal student loan programs and (2) neglect and abuse of youth attending residential treatment facilities. She was responsible for conducting research and creating written materials for congressional investigative hearings on both subjects. Ms. Sirois also helped identify potential witnesses for both hearings.
• Embassy of Australia, Washington, DC
• As an intern, Ms. Sirois was responsible for conducting focus groups and administering telephone surveys to Australian military families regarding their experience living in North America. In addition, she wrote and edited guides for Australian officials and their families residing in the U.S. and Canada. She also drafted summaries of congressional hearings and seminars on defense and international affairs issues. Lastly, she helped organize embassy receptions, including a cultural program for over 400 guests.