Shonkeya Shaw
Stockbridge,GA
Summary
A knowledgeable Medicaid professional, with 8 years’ experience in eligibility, enrollment, policy, reporting, business operations and staff training. Demonstrates strong analytical, communication, problem solving and teamwork skills by spotting issues and implementing corrective actions. Poised to making meaningful contributions and achieving positive results to an organization.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Business Analyst I
Georgia Department of Community Health
10.2020 - Current
- Analyzed and rectify Medicaid eligibility and policy questions from DPH, DHS, DFCS, PCK, CMS, Katie Beckett Team, Children's Healthcare of Atlanta, Change Healthcare, Alliant, and other organizations.
- Evaluated performance data and research cases to address issues to send to DFCS for implementation.
- Investigated member eligibility cases, verify documents, and make imperative Family Medicaid updates.
- Assisted with implementation and performance strategies on Family Medicaid, Presumptive Eligibility, and CMO.
- Conducted analysis and make regulatory updates to Family Medicaid, Presumptive Eligibility, CMO, CCSP, to implement necessary changes to maintain compliance.
- Conducts audits on Qualified Hospitals and Family Medicaid to examine patterns and performance regulations.
- Examined and research standardized reports, data, and recommend corrective actions for improvement initiatives.
- Knowledgeable of Medical Assistance Plans rules, regulations, projects, and resources to meet agency needs.
Administrative Assistant III/Supervisor
Georgia Department of Community Health
08.2019 - 10.2020
- Prepared Deloitte, Department of Public Health, GDOL Contracts and Amendments for approval and implementation.
- Attended meetings with Deloitte, DHS, and Medicaid staff to discuss ongoing operations, policies, and implementation.
- Created requisitions, manage funds, receive and processes monthly invoices for Deloitte, DHS, GDOL, Staples, and Xerox for payment processing. Submit CMS Monthly Billing Report.
- Manage, Train, and mentor other Administrative Assistants in the department.
- Assisted in selecting applicants for interviews, onboarding new hires and completing the Network Access Form.
- Built and maintained business relationships with other departments and staff and through timely responses to inquires and going above and beyond to accommodate unusual requests,
- Communicate requisition updates, compliance procedures, and payment processing to staff and departments.
- Completed forms, reports, logs, and records to quickly handle all documentation for human resources.
- Continually sought methods for improving daily operations, communications with clients, recordkeeping, and data entry for increased efficiency.
- Supported company leaders by managing budgets, scheduling appointments and organizing itinerary.
- Created and maintained detailed administrative processes and procedures to drive efficiency and accuracy.
Operations Analyst
Georgia Department of Community Health
03.2018 - 08.2019
- Handled member issues, resolved complaints, and provided useful resources to Healthcare professionals.
- Go over the policies and compliance procedures to members and providers regarding CMO and Family Medicaid.
- Attended meetings with DHS and DPH to discuss regulatory updates and CMO updates.
- Gather and analyze reports data in Gateway to create a new member, add benefit plan and aid category in GAMMIS.
- Respond to requests from Alliant to verify citizenship and request immigration status from DFCS.
- Prepare forms and memos on a letterhead to be distributed to the Division.
- Prepare presentations and meetings for the conference room.
- Designed plans to improve operations and suggested changes to systems for overall organization.
- Assessed operational performance to identify areas for improvement.
Education
Business Coach
Alabama State University
Montgomery, ALOPS Contact Compliance, MCMP-II
DCH
Atlanta, GA2019
HIT & MITA
Medicaid Institute
Atlanta, GA2018
Associate of Science - Health Records Management
Ashworth College
Norcross, GA2011
Skills
- Medicaid Program Administration
- Business Acumen
- Change Management
- Policy Compliance
- Communication
- Care Coordination
- Eligibility Enrollment
- Attention to Detail
- Member Support
- Regulatory Compliance
- Collaboration
- Financial Management
- Strategic Planning
- Leadership
- Microsoft Office Suites
- Forensic Auditing
- Team Integration
Certification
- Certified Medicaid Professional MCMP-II
- MLC Administrative Professional
- Certificate, DCH State Purchasing
- Certificate, DOAS TGM Procurement Card Certificate
- DOAS eProcurement for Approvers Certificate
- DOAS Ambassador
- DCH Notary Public, State of Georgia
Timeline
Business Analyst I
Georgia Department of Community Health
10.2020 - Current
Administrative Assistant III/Supervisor
Georgia Department of Community Health
08.2019 - 10.2020
Operations Analyst
Georgia Department of Community Health
03.2018 - 08.2019
Business Coach
Alabama State University
OPS Contact Compliance, MCMP-II
DCH
HIT & MITA
Medicaid Institute
Associate of Science - Health Records Management
Ashworth College
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