SHARMEKA THOMPSON
Compliance
Wilmington,DE
Summary
Detail-oriented Compliance Manager offering 20 years of expertise in risk management, policy development and strategic planning. Advanced knowledge of regulatory compliance with proven track record of partnering with executives and business leaders to identify vulnerabilities and create corrective actions. Collaborative and team-oriented with excellent communication and interpersonal skills to foster strategic partnerships and promote company reputation.
Overview
19
19
years of professional experience
Work History
Compliance Analyst
Centene, Delaware First Health
11.2022 - Current
- Collaborated with cross-functional teams for the successful implementation of new compliance initiatives.
- Monitored adherence to industry regulations, ensuring timely reporting of any discrepancies or violations.
- Served as a subject matter expert on compliance matters, providing guidance and support to colleagues across various departments.
- Prepared documentation and records for upcoming audits and inspections.
- Responded promptly to inquiries from regulators or other stakeholders regarding company practices, demonstrating transparency and commitment to ethical conduct at all times.
- Improved company''s risk management strategy by identifying, assessing, and mitigating potential risks related to noncompliance.
- Developed improvement and corrective action plans to bring operations in line with requirements.
- Assisted in the development of a comprehensive risk assessment framework for evaluating potential threats to organizational compliance systems.
- Conducted regular reviews of company policies and procedures for alignment with regulatory requirements and industry best practices.
- Contributed to the development of a strong compliance culture within the organization by promoting awareness of relevant rules and guidelines through training sessions and communications campaigns.
- Conducted comprehensive contract reviews to ensure compliance with applicable laws and regulations.
- Provided expert guidance to senior management on navigating complex regulatory landscapes.
Compliance Operations Analyst
Amerihealth Caritas Delaware
03.2018 - Current
- Assist in overseeing/ monitoring the compliance of the State of Delaware Medicaid Managed Care Organization (MCO) contract .
- Partners with business areas within ACDE and corporate committees to ensure compliance with state and federal regulations. Investigate , resolve and document findings regarding all compliance issues pertaining to ACDE .
- Investigates , monitors and reports on privacy and security incidences and applicable remediation.
- Collaborate with Corporate Audit, Regulatory Affairs,Corporate Compliance and ACDE on responses to audits .
- Provide guidance and oversight in the review and/or development of ACDE Policies and Procedures in response to audit findings or changes in contractual requirements or regulations
- Develop compliance training and education sessions, as needed, in response to audit findings or changes in contractual requirements .
- Assist in the development and monitoring of corrective action plans.
- Assist in the implementation of corporate member consent forms for ACDE including education on the use of the new forms.
Social Service Administrator
Division Of Medicaid And Medical Assistance
04.2016 - 02.2018
- Provide project management and quality oversight of the Health Benefit Manager and the Non-Emergent transportation broker contracts.
- Consistently comply with applicable laws and regulations and ensure Managed Care Organizations adhered to Medicaid regulations.
- Review and interpret applicable Federal and State directives, instructions and guidelines to recommend operational changes for contract compliance
- Represent and interpret the agency's functions and services to other institutions, the public, government agencies and other organizations
- Monitors, evaluates, collects and analyzes program data
- Provide technical assistance and recommends course of action
- Acts as liaison with operations staff, state and federal agencies and community organizations.
Senior Medical Social Work Consultant
Division Of Medicaid And Medical Assistance
12.2012 - 04.2016
- Provided direct casework services which included emotional and social assessments, problem identification and developed service plan to assist client and family in dealing with medical conditions,
- Allowing medical recommendations and achieving maximum social and health adjustment
- Effectively served as primary liaison and subject matter expert providing information and consultation to the Managed Care Organization (MCO), other state agencies, Centers for Medicaid and Medicare, political and community stakeholders in adherence to the MCO contract and federal and state regulations
- Assisted in resolving and satisfying client requests and internal issues
- Collaborated with health specialists and civic groups to determine community health needs and the availability of services and to develop goals for meeting needs
Senior Social Worker/ Case Manager
State of Delaware
08.2005 - 12.2012
- Conducted intake interviews to assess financial eligibility of families seeking financial, medical or related services from the Division of Health and Human Services
- Provided referral and follow up services to alternative sources to ineligible applicants
- Provided individual and family counseling to clients; obtains and coordinates public, private or community medical, social and therapy services to meet client’s needs
- Maintained comprehensive case records, summaries, statistical, narrative reports and completed required forms
- Conducted on-going monitoring and assessment of service delivery for optimum quality and efficiency.
Education
Bachelor of Science - Human Services / Criminal Justice
Springfield College of Human Services
Wilmington, DeSkills
- Good working knowledge of the managed care industry
- Exercise Professional Judgment in all interactions
- Ability to manage multiple priorities simultaneously and consistently meet deadlines
- Strong interpersonal skills
- Compliance Monitoring
- Regulatory knowledge
- Corrective action plans
- Auditing experience
- Project Management
- Operations Support
- Training delivery
- Critical Thinking
- Process Implementation
- Compliance Reporting
Timeline
Compliance Analyst
Centene, Delaware First Health
11.2022 - Current
Compliance Operations Analyst
Amerihealth Caritas Delaware
03.2018 - Current
Social Service Administrator
Division Of Medicaid And Medical Assistance
04.2016 - 02.2018
Senior Medical Social Work Consultant
Division Of Medicaid And Medical Assistance
12.2012 - 04.2016
Senior Social Worker/ Case Manager
State of Delaware
08.2005 - 12.2012
Bachelor of Science - Human Services / Criminal Justice
Springfield College of Human Services
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