Stephani Keyser
Sweet Home,OR
Summary
Results-driven professional with over sixteen years of experience in the Medicare and Medicaid lines of business, encompassing operations, enrollment, systems, compliance and Government Programs. Recognized for exceptional problem-solving skills and the ability to interpret complex regulations while implementing proactive procedures to mitigate potential issues. Demonstrates strong critical thinking abilities and proficiency in a range of software applications, including Excel, Word, Publisher, PowerPoint, Facets, and SharePoint. Proven leader in project management with a successful track record in facilitating audits and fostering team collaboration to achieve organizational goals in fast-paced environments.
Overview
18
18
years of professional experience
Work History
Government Programs Program Manager
Samaritan Health Plans
Corvallis, OR
09.2020 - 10.2024
- Led cross-functional teams for purposes of timely and compliant deliverables and audits for State and Federal Oversight Agencies.
- Developed and executed project plans aligned with organizational goals, ensuring timely delivery of services.
- Established key performance indicators to assess program effectiveness and drive operational improvements.
- Established strong relationships with key stakeholders, ensuring support for program initiatives.
- Managed cross-functional teams for successful project completion within deadlines and in Compliance with State and Federal Oversight Agencies
- Identified program obstacles and communicated possible impacts to team.
- Met with project stakeholders on regular basis to assess progress and make adjustments.
- Improved program efficiency by streamlining processes and implementing time-saving solutions.
- Created, implemented and maintained oversight and management of Part C and D Reporting and the annual Data Validation Audit processes
- Oversaw enrollment operations for Samaritan Health Plans, ensuring efficient processing during annual enrollment period.
Compliance Analyst III
Samaritan Health Plans
04.2015 - 09.2020
- Coordinated and executed CMS program audits to enhance program integrity and adherence to regulations.
- Coordinated annual CMS readiness assessment to evaluate organizational preparedness and identify improvement areas.
- Engaged in comprehensive evaluation processes during annual Samaritan Health Plans risk assessment to identify potential vulnerabilities.
- Conducted comprehensive review and oversight of Samaritan Health Plans' Special Investigations Unit (SIU).
- Managed preparation and timely submission of annual Part C and Part D reports to meet regulatory requirements.
- Coordinated annual Part C and Part D reporting data validation audit to ensure compliance and accuracy.
- Daily completion of the memo notification process for impacted departments and staff
- Facilitated submission of all Medicare Advantage communications and marketing materials to ensure compliance and accuracy.
- Analyzed and assessed multiple plan processes through systematic auditing and monitoring to identify areas for improvement.
- Facilitated collaboration within cross-functional work groups across the organization.
- Coordinated annual CPE reciprocal audit to ensure compliance and operational integrity.
- Developed and assessed compliance policies and procedures to mitigate organizational risk.
- Developed and delivered detailed reports and documentation to support compliance and SIU investigation processes.
- Engaged in monthly discussions with CMS Regional Account Manager to address compliance issues and enhance operational alignment.
- Directed compliance operations for Samaritan Health Plans as interim officer, managing team activities and fostering regulatory compliance.
Business and Employment Specialist 1 – Trade Act Case Manager
OED
08.2014 - 03.2015
- Provide training and support to the training case managers to ease workloads.
- Create purchase orders from billing authorizations and pay invoices in purchase order system as needed.
- Research and solve billing issues for vendors.
- Recognize barriers when speaking with customers and respond with available resources.
- Research and file petitions with the Department of Labor on behalf of potentially eligible companies.
- Recognize concerns and forward information to training case managers as needed.
- Assist with participant needs when case managers are out of office.
- Analyze information to determine when to make computer changes to allow or stop benefit payments.
Medicare Membership Accountant III
Regence Blue Cross Blue Shield
08.2006 - 09.2013
- Worked processing member applications for supplemental insurance coverage.
- Underwriting, loading coverage and generating documents.
- Excellent working knowledge using both IBM, Facets, Microsoft Excel, WordPerfect, Microsoft Word, Outlook.
- Processed incoming codes from CMS on a daily basis.
- Tracked incoming and outgoing LIS payments between RBCBSO and CMS.
- Beta testing for transmission system implementation.
- Created and implemented a report process for queuing letter generation.
Education
High School Diploma -
South Albany High School
Albany, ORSkills
- Strong written and verbal communication
- Process improvement
- Team leadership and direction
- Problem-solving
- Project management
- Detail-oriented
- Strategic planning
- Decision-making
- MS office applications
- SharePoint
- Data collection & research
- Attention to detail
Timeline
Government Programs Program Manager
Samaritan Health Plans
09.2020 - 10.2024
Compliance Analyst III
Samaritan Health Plans
04.2015 - 09.2020
Business and Employment Specialist 1 – Trade Act Case Manager
OED
08.2014 - 03.2015
Medicare Membership Accountant III
Regence Blue Cross Blue Shield
08.2006 - 09.2013
High School Diploma -
South Albany High School