Krishna Mistry

Business Function Lead (Health Insurance Specialist) @Centers for Medicare & Medicaid Services

Baltimore, MD, US

Drafted the Statement of Work, Standard Operating Procedure, and Independent Government Cost Estimate for a multi-million dollar contract to combat fraud, waste and abuse- Conducted yearly Quality Assurance Surveillance Plan audits of a contractor to ensure compliance with the Standard Operating Procedure- Engaged in compliance efforts with over 100 providers to enable them to terminate the business relationship with an owner or managing employee who is a felon or an individual excluded by the Office of Inspector General- Serving as a subject matter expert for the felonies revocation authority by reviewing over 2500 cases from staff for quality control purposes- Processed over 500 cases for potential administrative action, where there was a felony conviction, federal healthcare exclusion, or other adverse legal action.