TONYA BASS

Manage and closed 275 2Myer’s and Stauffer/CMO cases for the Program Integrity unit.

• Evaluate CMO performance through monthly analytic reports.
• Engage with affiliated vendors for compliance management.
• Request CMO claims data through GAMMIS for MFCU referrals.
• Collaborate with the Office of Analytics and Performance Improvement for posting investigative reports.
• Ensure efficient dissemination of investigation information

Developed 20 Division workflows for operational efficiency.

• Created cross-functional performance data reports for Deputy Inspector General.
• Conducted detailed business analysis for internal business units.
• Identified and addressed data quality issues.
• Provided feedback on data impacting business processes.
• Planned and oversaw internal projects.
• Prioritized 4 performance projects, resources, and competencies for job enhancement.

• Collaborated with the Review and Investigations team on potential fraud cases.
• Managed 4 multiple contracts for Fraud, Waste, and Abuse detection and prevention.
• Regularly met with the 10 direct reports team for progress updates and risk identification.
• Monitored complex data analysis from the SURS sub-system and MMIS claims system.
• Provided business process improvement for the Case Intake Unit and Data Analytics Unit.
• Supervised the Data Analytics Team for statistical reports and data-driven decision support.
• Monitored fraud hotline complaints and case referrals.
• Created 4 internal/external SharePoint Case Management sub-sites for Program Integrity.

• Managed diverse data pulls for the Data Integrity Analysis Unit.
• Analyzed and interpreted Medicaid claims data.
• Identified trends, patterns, and potential issues in data for improved efficiency and regulatory compliance.
• Implemented a Strategic/Performance Dashboard website for data performance.
• Led strategic planning for the Office of Inspector General.
• Interpreted and transformed data into business conclusions.
• Validated data results and trained 40 staff on data reporting in Laserfiche.