Wylean Thomas
Powder Springs,Georgia
Summary
Results-driven project manager with 23 years of expertise in State Government Long Term Services and Supports (LTSS), Aged Blind and Disabled (ABD) Medicaid policy and eligibility, and Home and Community Based Services (HCBS) Waivers. Skilled in working under pressure and adapting to new situations and challenges, with a proven ability to identify customer needs, plan, prioritize, and coordinate large programs, achieving organizational objectives. Diligent and effective collaboration across multiple organizational levels and project teams.
Overview
24
24
years of professional experience
Work History
Independent Author
Self Employed Writer
Powder Springs, GA
10.2023 - Current
- Prepared and formatted work for publication and submitted to printers or publishers.
- Conceptualized, wrote, and edited a 105 page devotional and prayer book within a four-month timeline.
- Demonstrated strong time management skills by meeting self-imposed deadlines for manuscript completion and revisions.
- Implemented effective project planning and organization to navigate the writing and editing phases efficiently.
- Collaborated with editors, cover designers, and formatting professionals to ensure a high-quality final product.
- Established an online presence through author website and social media to promote the book.
- Demonstrated proficiency in project management, meeting deadlines for writing, editing, and publishing.
Senior Consultant - Medicaid/Health Policy
BerryDunn
Powder Springs, Georgia
10.2022 - 10.2023
- Built relationships with project team members including client contacts, stakeholders, federal partners, and vendor contacts.
- Managed multiple client engagements simultaneously while adhering to tight deadlines.
- Partnered with senior executives to identify key performance indicators for measuring success.
- Used knowledge and experience to provide subject matter knowledge and leadership; including helping develop client deliverables such as State Plan Amendments (SPAs) and waivers, complex analysis ongoing status reports, data and technical strategy plans, and presentations.
- Attended meetings and training with the project team, including the client and client vendors to achieve project goals.
- Developed own career plan
- Participated in marketing and business development activities, such as attended conferences, participated in industry groups, participated in prospective client business development meetings, reviewed Requests for Proposals (RFPs) and assisted with go/no-go decision-making, and developed responses to RFPs—in collaboration with BerryDunn’s Business Development team.
- Worked with cross-functional teams to achieve goals.
- Prioritized and organized tasks to efficiently accomplish service goals.
Balancing Incentive Program & Money Follows the Person (MFP) Manager
Department of Community Health Service Delivery & Administration Office
Atlanta, Georgia
07.2019 - 11.2022
- Had oversite over the federal program that provides grants that develop and use existing Medicaid resources such as the HCBS waivers to assist individuals in managing their care outside of a nursing home.
- Planned, administered, controlled the budget for the MFP program, and applied for capacity-building grants as appropriate.
- Worked with Options Counselors or Transition Coordinators who assisted in arranging home and community-based services (HCBS) through Georgia's Medicaid waivers.
- Interviewed, hired, directed, trained, managed, evaluated the performance of, and when necessary, disciplined and discharged employees.
- Monitored progress of projects against established benchmarks and timelines.
- Responded to legislative inquiries relative to program admission, services, and constituent concerns/complaints.
- Ensured compliance with rules, regulations, and policies related to the MFP program.
- Coordinated interactions between the Division and other agencies, as well as external customers.
- Designed programs and services to facilitate the transition of individuals who choose to transition out of institutions back into the community.
- Provided leadership, insight and mentoring to newly hired employees to supply knowledge of various company programs.
- Entered time and attendance logs in preparation for payroll.
- Planned and delivered training sessions to improve employee effectiveness and address areas of weakness.
Compliance Specialist III
Department of Community Health Medicaid Policy & Provider Services
Atlanta, Georgia
07.2014 - 11.2022
- Served as the Subject Matter Expert for all programs assigned, including Nursing Facility Services, Swing Bed Services, and the Nurse Aid Training Program.
- Conducted/participated in the development, review, revision, and implementation of policies, procedures, standards, and guidelines.
- Lead quality improvement initiatives to enhance service delivery efficiencies and effectiveness to achieve health outcomes of members.
- Provided customer service and technical support to providers and members.
- Responsible for all program Policy and Procedure Manuals and ensured policies were up-to-date at all times.
- Supported the Nurse Aid Training Program through contractor oversight and handled corrective action issues as needed.
- Ensured claims were reviewed and administrative reviews were managed for correct billing and payment to providers.
- Participated with program team and ongoing work groups to define program needs.
- Monitored program for quality, efficiency and effectiveness by data analysis and report review.
- Reviewed state, federal and other regulatory standards information relative to the program area in order to ensure high standards of quality improvement activities and compliance.
- Collaborated with Health Facilities Regulation Division by participating in meetings and reviewed on-site reviews, audits or surveys of clinical and treatment sites, as needed.
- Recommended programmatic and/or operational changes based on review, audit or survey results.
- Participated in staff training and kept up to date on current events.
- Facilitated Prior Authorization and Resident Review (PASRR) procedures.
- Acted as back-up for Hospice and Home Health programs.
- Monitored changes in relevant legislation and advised management of necessary actions.
- Verified documentation against compliance standards and communicated deficiencies to resolve issues.
- Prepared monthly reports on progress made towards meeting organizational goals around compliance matters.
- Established working relationships with regulatory agencies.
Program Consultant/Manager
RSM Outreach Project Long Term Care Unit
Atlanta, Georgia
10.2012 - 06.2014
- Managed 3 teams (2 Long Term Care Units & 1 Katie Beckett Unit).
- Interviewed, hired, trained, evaluated the performance of subordinate staff, and handled disciplinary actions of employees.
- Maintained close and routine interactions with various agencies and community partners in multiple counties.
- Managed administrative and programmatic activities of the teams.
- Ensured team understanding of policy and procedures.
- Monitored and evaluated work activities, including ensuring timely and accurate determination of benefits.
- Reviewed case records for accuracy.
- Facilitated resolution of customer concerns.
- Conducted monthly conferences and regular team meetings.
- Prepared various reports, as required.
- Maintained current knowledge of Medicaid program policies and procedures.
- Performed all required professional responsibilities as assigned by director.
- Coordinated the recruitment process of volunteers needed for specific projects or initiatives.
- Facilitated communication between various teams involved in implementing a given project or initiative.
Family Independence Case Management Supervisor
RSM Outreach Project LTC Unit
Atlanta, Georgia
11.2010 - 09.2012
- Supervised a team of 9 workers (1 Program Assistant & 9 Medicaid Eligibility Specialists).
- Ensured team understanding of policy and procedures.
- Provided new and veteran staff with in-house training to ensure cases were processed accurately.
- Monitored staff ALERTS, daily SOP list, and INFO PAC to ensure that client’s received their nursing home, CCSP, and Q-track benefits timely.
- Reviewed monthly production reports, compiled and submitted supervisor’s monthly report to manager free of errors.
- Ensured hearing notifications were filed timely and all applicable LTC MES employees were notified of the hearing timely.
- Participated in the interviewing process.
- Reviewed, approved, and submitted time, leave and travel for all staff timely and accurately.
- Completed office checks, monthly conferences, and monthly unit meetings.
- Ensured all information related to any vacant position was available and manager was notified.
- Attended and constructively participated in all required RSM/LTC Project meetings and trainings.
- Reviewed 5 cases per staff member monthly for case accuracy.
- Ensured equitable distribution of workload.
- Monitored case accountability system to ensure case records arrived at the appropriate location in a timely manner.
- Provided customer service via telephone calls and emails to employees, nursing home representative, managers, and applicants.
ABD Medicaid Eligibility Specialist/LTC Unit Interim Supervisor
Fulton County Dept of Family & Children Services Medicaid Policy Unit
Atlanta, Georgia
08.2005 - 11.2010
- Performed all Long Term Care (LTC) supervisory duties.
- Read LTC case records weekly for quality control actions.
- Conducted LTC trainings for nursing facilities and county staff in different regions.
- Provided new employee training and support.
- Conducted interviews with clients to determine eligibility for Medicaid.
- Assisted clients with all aspects of the application/review process and handled most inquiries.
- Evaluated policy and procedures in order to accurately convey information to clients.
- Documented case records and provided information on status of case actions.
- Interpreted and applied state and federal policy standards to case situations in regard to income and resources.
- Conducted 2007-2009 Performance Management Reviews on all State Office LTC staff.
- Participated in user acceptance testing.
- Oversaw problem resolution for the personal needs allowance benefits for SSI Nursing Home recipients and assisted with Nursing Home provider payment problem resolutions.
- Participated as back-up staff for state Nursing Home relocation team.
- Researched and resolved issues/inquiries from other agencies in regards to DHS county offices and staff.
- Responded to customer complaints as quickly and effectively as possible in order to resolve customer challenges.
- Participated on notices redesign team committee.
- Handled SHPS file for card distribution and payment issues.
- Dispositioned all return mail from DCH and ACS address change reports.
Medicaid Eligibility Specialist
Fulton County Department of Family & Children Services
Atlanta, Georgia
02.2000 - 08.2005
- Assisted clients with all aspects of the application/review process for ABD Medicaid and Food Stamps (interviewing, gathering of needed information, and approving/denying the case).
- Evaluated policy and procedures in order to accurately determine eligibility for all Medicaid classes of assistance.
- Extensively documented all Medicaid and SNAP cases.
- Answered all customer questions and concerns via telephone, scheduled appointments or in-office walk-ins.
- Covered vacant caseloads until the positions were filled.
- Conducted periodic/special reviews to determine continued eligibility.
- Documented and maintained case records.
- Provided information to clients on status of case actions.
- Provided technical assistance to MES staff and supervisors.
- Responded to and resolved all customer inquiries and complaints.
- Maintained up-to-date knowledge of state and federal regulations pertaining to Medicaid eligibility.
- Interpreted and applied state and federal policy standards to case situations in regards to eligibility.
Education
Incomplete Masters Degree in Education -
Grand Canyon University
01.2011
Incomplete MSW -
Clark Atlanta University
01.1999
Bachelors Degree in Social Work -
Talladega College
01.1998
Skills
- Exceptional customer service
- Stakeholder Communications
- Project Management
- Performance Evaluations
- Proficient with Microsoft Office System (Microsoft Word, Microsoft Excel and Microsoft PowerPoint)
- Proofreading Abilities
- Document Editing
- Staff Management
- Strategic Planning
- Policy Implementation
- Verbal and Written Communication
- Project Tracking
- Client/Customer Relations and Rapport
- Staff Training and Mentoring
- Works well independently
References
Available Upon Request
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
There is a powerful driving force inside every human being that, once unleashed, can make any vision, dream, or desire a reality.
Tony Robbins
Timeline
Independent Author
Self Employed Writer
10.2023 - Current
Senior Consultant - Medicaid/Health Policy
BerryDunn
10.2022 - 10.2023
Balancing Incentive Program & Money Follows the Person (MFP) Manager
Department of Community Health Service Delivery & Administration Office
07.2019 - 11.2022
Compliance Specialist III
Department of Community Health Medicaid Policy & Provider Services
07.2014 - 11.2022
Program Consultant/Manager
RSM Outreach Project Long Term Care Unit
10.2012 - 06.2014
Family Independence Case Management Supervisor
RSM Outreach Project LTC Unit
11.2010 - 09.2012
ABD Medicaid Eligibility Specialist/LTC Unit Interim Supervisor
Fulton County Dept of Family & Children Services Medicaid Policy Unit
08.2005 - 11.2010
Medicaid Eligibility Specialist
Fulton County Department of Family & Children Services
02.2000 - 08.2005
Incomplete Masters Degree in Education -
Grand Canyon University
Incomplete MSW -
Clark Atlanta University
Bachelors Degree in Social Work -
Talladega College
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