Shirley Bonney
Fort Worth,TX
Summary
Seeking a position in which I maintain and enhance the company's culture of compliance thru collaboration with both internal and external business partners.
Overview
23
23
years of professional experience
Work History
Director of Government Contracts
Molina Healthcare
08.2019 - Current
- Manage relationships with key regulators to identify priorities and position of Molina Healthcare as preferred partners
- Maintain and manage day-to-day state contracts with state Medicaid and Marketplace contract managers, including interactions with senior Medicaid and Marketplace regulators
- Oversee timely implementation of all new legislation, regulations, contract amendments
- Disseminate new requirements to all impacted business units
- Identify a health plan business leader to produce a detailed implementation plan that incorporates regulatory impacts
- Primary resource/SME for inquiries from business units regarding all state-based program requirement (contract, statutes, regulations) for Medicaid, Marketplace and MMP
- Coordinate and submit comments on proposed regulations and contract amendments
- Attend various meetings with state agencies, work groups and trade associations
- Oversight and direction of SB 1264 Arbitration and Mediation.
- Enhanced team collaboration through regular communication, goal setting, and performance evaluations.
- Strengthened internal controls by reviewing existing policies and procedures, ensuring compliance with regulatory requirements.
- Evaluated company documentation to verify alignment with regulatory requirements.
Senior Regulatory & Contracts Analyst
Kaiser Permanente Insurance Company
05.2011 - 08.2019
- Develop KPIC group accident and health insurance contracts and secure necessary regulatory approvals
- Drafting of new contract language and amendments to existing documents
- Legal research and interpret regulations relevant to insurance and financial products
- Provide consulting to KFHP-MAS, KPIC management, as well as the KP organization as a whole on laws and regulations pertaining to fully insured and self funded business
- Correspondence with state departments of insurance to resolve objections and comments to product language in form filings
- Review and approve advertising, marketing and sales materials for compliance with laws/regulations and KPIC benefits
- Provide on-going contract and compliance support to National and Regional Sales and Account management
- State reporting and license renewals
- Responsible for the coordination of the Department of Insurance Market Conduct Exams, Agency Exams and compliance audits.
- Implemented continuous improvement initiatives within the Contracts Analyst role, streamlining processes for greater efficiency.
Director of Regulatory Compliance
Group Dental Service, Inc
01.2006 - 01.2011
- Designed, developed and implemented products/projects utilizing project teams
- Ensured compliance with applicable state DOI, and federal regulations pertaining to group, individual, discount and Medicare products
- Delegated and assigned product filing tasks and compliance research tasks and appeal response to the team of Compliance and Appeal Analysts (4 direct reports)
- Corresponded with state departments of insurance to resolve issues and defend product language
- Managed legislative tracking function within the compliance department
- Reviewed and approved advertising, marketing and sales materials for compliance with laws/regulations
- Directed all departments with the development, implementation and maintenance of policies and procedures to ensure compliance with the requirements of the state and federal regulations
- Responded to compliance questions from other departments quickly and accurately
- Compiled all materials required for state reports, license renewals and annual registrations
- Responsible for the coordination of the Department of Insurance Market Conduct Exams, Agency Exams and compliance audits
- Oversight of the Complaints & Grievances, Appeals and Correspondence staff
- Administered and implemented the company's HIPAA, Fraud and Abuse Program.
Senior Compliance Analyst
ULLICO, Inc
01.2001 - 01.2006
- Reviewed legislation as it affected group, individual and direct marketing products
- Developed appropriate forms and/or language to comply with regulatory requirements, state and federal laws
- Filed subject forms with state insurance departments, responded to objections; tracked follow ups and resubmission of forms to obtain approval on a timely basis
- Utilization review license filing
- Coordinated dissemination of information to sales, marketing, underwriting, claims, managed care and other operational areas
- Informed senior management and department heads on legislative activity
- Reviewed policy forms, advertising material and contracts; performed legal research and worked on special projects.
Education
Juris Doctorate - Law
Texas Southern University
Houston, TX05.2000
Master of Arts - Marketing
Webster University
St. Louis, Missouri08.1993
Master of Business Administration - Finance
Webster University
St. Louis, Missouri08.1992
Bachelor of Arts - Sociology
Boston University
Boston, Massachusetts05.1981
Skills
- Strategic Planning
- Verbal and written communication
- Operations Management
- Legal and Regulatory Compliance
Professional
FLMI, PCS, AIRC, HIA, Licensed - District of Columbia, Westlaw, Lexis, NILS, SERFF, Microsoft Office, Arbitrator, Mediator
Timeline
Director of Government Contracts
Molina Healthcare
08.2019 - Current
Senior Regulatory & Contracts Analyst
Kaiser Permanente Insurance Company
05.2011 - 08.2019
Director of Regulatory Compliance
Group Dental Service, Inc
01.2006 - 01.2011
Senior Compliance Analyst
ULLICO, Inc
01.2001 - 01.2006
Juris Doctorate - Law
Texas Southern University
Master of Arts - Marketing
Webster University
Master of Business Administration - Finance
Webster University
Bachelor of Arts - Sociology
Boston University
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