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Response to RFP No. MED13002 State of West Virginia ... - DHHR

Response to RFP No. MED13002 State of West Virginia ... - DHHR

PRGX USA, Inc. –

PRGX USA, Inc. – Carlis Faler 2 o Designed and implemented two payment accuracy measurement projects o Coordinate private contractor audits o Drafted legislation for program integrity o Legislative Liaison o Committee for design of Electronic Health Records Incentive Payments Process o Member of MS Fraud Task Force Area Supervisor 1989‐1996 Managed the operations of eight regional eligibility offices o Leadership of eight regional offices consisting of eight managers, two supervisors and forty eight subordinate personnel o Lead leadership training sessions for eight regional offices o Coordination with sister agencies o Implemented training for computer software program for all regional offices o Oversaw budgeting and expenditures for eight regional offices o Implemented customer service program for eight regional offices

EILEEN ANSLEY Quality Control Manager With a focus on Quality Control, Eileen brings Medicaid specific knowledge and experience to this project. Eileen is an expert in ensuring that all procedures within the company conform to regulations, policies, contractual obligations, and legislation. Eileen has a broad and deep understanding of audit, customer service and business processes enabling a proactive approach to mitigating risks while maintaining quality delivery throughout. Education/Professional Certifications • Master of Science ‐ Instructional Technology ‐ Georgia State University • Bachelor of Science (B.S.), International Affairs ‐ Georgia Institute of Technology • Certified Software Quality Engineer (CSQE) • Six Sigma Black Belt • ITIL Practitioner Support and Restore • ITIL Foundation for IT Service Management PRGX Responsibilities • Compliance responsibilities include: HIPAA and SAS70 audit and oversight • Responsible for the implementation and management of the Quality Control Program governing contractual services provided. • Responsible for preparing and executing the Quality Control Plan, conducting quality control meetings; managing and coordinating all phases of quality control. • Coordinate quality control activities within the contract • Establish controls and monitor performance to ensure all work is completed within the requirements of the contract. • Provides effective communication regarding issues, objectives, initiatives, and performance to plan • Ensures delivery against QA goals and objectives, i.e. Meeting commitments and coordinating overall quality assurance schedule • Provide input to team members on any issues pertaining to the contract and its fulfillment • Implement and maintain quality procedures, quality control instructions, test methodology and specifications • Ensure that the audit program, reports and letters prepared by PRGX comply with HIPAA regulations as well as Federal and State Medicaid regulations, policies and guidelines,

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