Denise Scavo

About Denise Scavo

Population health administrator, with a well rounded background of audit management…

Experience

1. Perm Medical Review Manager

   Empower AI

   Dec 2020 — Present · Reston, VA, US

   Direct oversight and management of nurses and coders performing Payment Error Rate Measurement (PERM) audit for CMS. Responsible for meeting contractual timeliness, quality measurements, and reporting requirements. Responsible for gathering, maintaining, and interpretating State Medicaid policies and federal rules, and regulations pertaining to Medicaid claim payment for all fifty states, District of Columbia, and Puerto Rico. • Guided continual process improvements across the PERM Medical Review and Policy teams. This resulted in improved communication with states and CMS, ensuring appropriate medical review claims decisions were consistently rendered. • Performed weekly and ad hoc client meetings with CMS. The purpose of these meetings was to develop review criteria, coordinate communication with states, ensure client’s needs and expectations were met, and set precedence for future PERM audit activity.• Met on a routine basis with other contractors and teams involved in PERM. As a result of these meetings, I was able to glean information useful to Empower AI’s review teams, anticipate where challenges could be proactively remediated, and implement process improvements.• Directly managed a team of nurses and completing PERM medical review audits on HER, using MCG, 3M Encoder, and state and federal Medicaid policies. Developed succession planning for the team. Responsible for onboarding, staff training, performance improvement activities, and performance evaluations.• Produced annual reports for CMS. These reports detail barriers encountered during the audit cycle, and successes celebrated with states during the audit year, and audit results for each state audited.

Education

• Drake University

  Master of Public Administration - MPA, Healthcare

• Grandview University

  Bachelor of Science - BS, Sociology

• Grandview University

  Bachelor of Science - BS, Registered Nursing/Registered Nurse

• GrandView University

  Bachelor of Science, Nursing

  2008 — 2010

• GrandView University

  Associate of Arts (AA), Sociology

  2008 — 2010

• Drake University

  Master of Public Administration, Healthcare

  2011 — 2013

Skills

• Government Contracting
• Process Improvement
• Management
• Program Development
• Scalability
• Healthcare Management
• Ehr
• Healthcare Information Technology
• Public Speaking
• Healthcare
• Operations Management
• Case Management
• Quality Assurance
• Business Process Improvement
• Employee Training
• Care Coordination
• Leadership
• Policy
• Account Management
• Medicaid
• Training
• Nursing
• Project Management
• Public Health
• Staff Development
• Public Policy
• Operating Budgets
• Business Analysis
• Hospitals