Lawrance Policy Consulting Offers:
PROVEN ABILITIES AND RESULTS
- Over a decade of fee-for-service and managed care Medicaid experience as both a State of Indiana regulator and as a managed care contractor
- Designed and implemented the Indiana Medicaid Select aged, blind, and disabled managed care program and the Breast and Cervical Cancer Treatment Program
- Managed and operated the Hoosier Healthwise and Medicaid Select programs. Hoosier Healthwise is Indiana’s risk-based managed care program for low-income families, pregnant women, and children. Medicaid Select was the aged, blind, and disabled primary care case management program.
- Assisted in developing Indiana Medicaid managed care contracts and requests for proposals
- Administered the enrollment broker contract
- Assisted in the oversight of Indiana’s fiscal contractor’s claims, client services, and reference file departments
- Created and implemented a Medicaid incentive program which reinvested pay for performance funds back into providers and members
- Managed projects surrounding the ADVANTAGE Care Select external quality review, the bio-psycho-social model implementation, waiver auto-assignment and the Right Choices Program re-design
- Served on the implementation team for the Illinois Aetna Better Health integrated care program
- Led a Six Sigma team that reduced the processing cycle time of the Indiana Medicaid restricted card program from over 60 days to 15 days
Research and Policy Analysis
- Coordinated the legislative analyses for the Division of Aging and the Office of Medicaid Policy and Planning. This included representing the divisions to the Family and Social Services Administration legislative team and reporting to leadership on the status of bills and House and Senate committee meetings.
- Assisted the Aetna Medicaid Business Unit with writing the request for proposal (RFP) response to the Indiana Hoosier Healthwise bid
- Wrote portions of Indiana’s successful $21 million Money Follows the Person grant application
- Drafted Indiana Medicaid’s 1115 Family Planning Waiver and Childhood Lead Filter Paper Testing RFPs
- Completed a Six Sigma Black Belt project estimated to save the Indiana Family and Social Services Administration $167,000 in its first 15 months
- Turned around five months of not meeting Member Services call standards in the first full month of managing the ADVANTAGE Care Select call center. Exceeded all State call center requirements after that.
- Led the development of new methodology for restricting and rehabilitating ADVANTAGE Care Select members who over-utilize Medicaid services for our health plan. These efforts combined with those of other health plans standardized the program between fee-for-service, care management organizations, and managed care organizations.
Policies and Procedures
- Wrote, enhanced, and compared Medicare Advantage policies and procedures to CMS standards
- Maintained and updated call center program policies and procedures
- Created a staff training curriculum for new call center hires
- Edited Indiana Medicaid provider and contractor procedure manuals
- Represented ADVANTAGE Care Select at public meetings to providers, advocates, and stakeholders. Because of these outreach efforts, ADVANTAGE Care Select was held up at a public meeting as an example of a valuable Medicaid partnership.
- Organized and presented training sessions for new and existing staff including the creation of a Medicaid 101 course
© 2012 Lawrance Policy Consulting. All rights reserved. Site designed by Amber Medel Design.