1. Kimberly D. GreenwoodKimberly D. Greenwood
29 Mapes Ave., 2nd
Floor • Newark, NJ 07112
(973) 277-6557 • kgreenwood50@gmail.com
PPROFILEROFILE OFOF QQUALIFICATIONSUALIFICATIONS
Solutions-focused Health Insurance Professional eager to contribute over 10 years of progressive Medicaid Contract Analyst, Compliance
Auditing, Account Management, Research Skills and Customer Service experience within high-volume insurance groups and healthcare
facilities. Strong contributor known for establishing effective relationships with regulatory and governmental agencies and distribute
statistical data to executive-level management. Excellent communicator who can handle multiple assignments within deadline-driven
environments. Key networker among industry professionals with talent for responding to diverse client issues. Ambitious self-starter who
demonstrates strong attention-to-detail and sharp analytical and problem-solving skills.
 Healthcare Attributes: Contributes expertise in various Health Plans (i.e. Medicare, Medicaid), Compliance, Quality Management,
Account Management, and Member Service, as well as (MLTSS) Managed Long Term Care Support Services, Disenrollment,
Member/ Provider Complaints, Marketing, Internal auditing, Contract agreements, NJ External Quality Review onsite auditing,
contract loading, affordable care act.
 Computer Applications: Proficient in Microsoft Windows 2000, Microsoft Office Suite, SMS, CSP Facets, eGRC, Compliance
Portal and Medical Management Systems, Microsoft Excel, Adobe Acrobat X Pro, Microsoft PowerPoint, Internet Explorer,
SharePoint and Citrix; willing to learn / master additional programs as necessary.
PPROFESSIONALROFESSIONAL EEXPERIENCEXPERIENCE
UUNITEDNITEDHHEALTHCAREEALTHCARE®, E®, EDISONDISON, NJ, NJ
2015-P2015-PRESENTRESENT
AASSOCSSOC. C. COMPLIANCEOMPLIANCE AANALYSTNALYST
 Identify compliance contacts/stakeholders to drive compliance program implementation within the business (e.g., compliance
committee, oversight structure, business process owners)
 Collaborate with applicable stakeholders to promote adherence to compliance programs among employees within my scope of
influence
 Develop/implement/facilitate compliance standards, policies, procedures and codes of conduct
 Develop/implement/facilitate auditing/monitoring processes to identify program issues and help the business address them (e.g.,
implementation issues, training needs, exceptions to program requirements)
 Respond to reported compliance issues and develop/facilitate corrective actions as necessary
 Collaborate with internal/external business partners to help develop and implement effective fraud and abuse detection and
reporting programs
 Drive completion of required compliance training among applicable employee populations
 Support consistent enforcement of disciplinary standards, collaborating with applicable stakeholders as needed (e.g., Human
Capital)
 Identify industry best practices for compliance programs to determine how our organization compares to other organizations in
applicable markets, and identify opportunities for improvement
 Demonstrate understanding of the impact of applicable laws, regulations, mandates and contracts on our business and operations,
including both segment-specific and enterprise-wide implications.
 Gather and maintain compliance-related data from applicable systems/databases for use in reporting/communications
 Develop and update compliance scorecards/reports, and communicate to applicable stakeholders (e.g., Key Compliance
Indicators)
 Assist with the day-to-day operations of the department such as ordering supplies, entering expenses, arranging travel for
departmental employees and coordinating/scheduling meetings.
UUNITEDNITEDHHEALTHCAREEALTHCARE®, E®, EDISONDISON, NJ, NJ
2008-20152008-2015
SSRR. C. COMPLIANCEOMPLIANCE CCOORDINATOROORDINATOR
 Reviewed and track federal, state, and local government requirements for the medical industry (specifically managed care) to
ensure consistent compliance (e.g., CMS, OIG, OSHA)
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2.  Developed and present trainings for topic-specific guidelines (e.g., Preparing for an EQRO Site Visit, HIPAA Awareness in Day-to-
Day Operations, Understanding Marketing Guidelines)Assisted with the day-to-day operations of the department such as ordering
supplies, entering expenses, arranging travel for departmental employees and coordinating/scheduling meetings.
 Investigated all allegations of non-compliance including HIPAA violations, Fraud, Waste, & Abuse Allegations, Security Breaches.
Investigations include researching, interviewing, reporting.
 Produced and maintain bi-weekly newsletters on Compliance-related issues sent to all employees.
 Developed trainings and track attestations for annual vendor & contractor compliance.
 Assisted with department-specific monitoring (i.e., verification of internal processes being completed), assist with clinic preparation
of State site visits.
 Assisted with developing Compliance trainings with other divisions of OptumHealth (e.g., UHN, other Collaborative Care groups)
AMERICHOICE OF NJ(A UNITEDHEALTH GROUP CO.), NEWARK, NJ
Quality and Operations Project Assistant 2006-2008
 Maintained regulatory correspondence which includes scanning, filing and distributing documents in a timely, organized manner
and being able to retrieve documents in a timely manner upon request.
 Monitored member educational and marketing materials for timely submission and approval which included sending materials to
the State for review, filing copies and coordinating Spanish translations.
 Assisted with the day-to-day operations of the department such as ordering supplies, entering expenses, arranging travel for
departmental employees and coordinating/scheduling meetings.
GENERAL COPIERS INC., RAHWAY, NJ
Administrative Assistant 2000-2006
 Provided administrative/clerical office support such as typing, filing, greeting visitors, answering/routing phone calls, providing
information and scheduling/coordinating appointments, meetings and conferences.
 Used office automation equipment to prepare correspondence, reports, input data, etc.; coordinated purchases of office equipment,
supplies and services; ensuring written materials are complete, accurate and contain correct usage of grammar, spelling,
punctuation, and structure; using time management techniques to meet deadlines.
 Handled various office duties such as: answer phones, filing, type proposals, and memos.
 Checked meter readings and handle all supply orders for the copier and fax equipment.
 Prepared and distributed customer invoices and purchase orders.
PAGET FREIGHT INC., ELIZABETH, NJ
Office Assistant 1998-2000
 Performed a variety of clerical, secretarial and administrative tasks in Ocean Freight forwarding for Bermuda.
 Responsibilities included handling multiple accounts for consolidation shipping to Bermuda, billing/ accounts receivables, as well
as insurance and filling.
 Prepared and distributed customer invoices, purchase orders and other materials.
 Responsible for bank deposits, tracking invoices and expenses
AADDITIONALDDITIONAL JJOBOB HHISTORYISTORY
Co-Assistant Manager, ASHLEY STEWART INC., KEARNY, NJ 1996 – 2009
EDUCATION
 Berkeley College, West Paterson, NJ
o Associates of Science Degree in Business Administration, (1996-1998)
AREAS OF EXPERTISE
 Regulatory Quality Clinical Compliance Corporate Compliance
 Root Cause Analysis Conflict Negotiations Process Improvement Complaint Resolution
 Audit Medicare Part D Medicaid Grievances
References Available Upon Request
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