Leanne Erwin

Experience

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  Wharton Small Business Development Center

  May 1995 - Apr 1996

  Consultant

  The SBDC is a non-profit joint collaboration between the University of Pennsylvania, the Small Business Administration, and the state of Pennsylvania, providing free technical assistance to small businesses, women-owned businesses, and minority-owned businesses in Philadelphia.• Managed client-load of 15 small businesses and start-ups. • Created year-long client-specific workplans with deliverables, timelines, and goals.• Assisted clients with business plan creation, business and asset valuation, marketing plan formation, financial statement development, grant and loan application completion, and compliance with Equal Employment Opportunity laws.• Performed research, collected data, and performed statistical analysis on small business, women-owned, minority-owned, and disadvantaged businesses in Philadelphia. Show less

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  Accenture (Andersen Consulting)

  Sept 1996 - Sept 1999

  Consultant

  Managed Care Client/Server System Implementation Project – Project scope was to convert claims processing function to new software for large Managed Care Organization. Served as System Configuration Team and System Testing Team lead consultant.Design & Configuration• Led team through all phases of design and configuration of provider and pricing subsystems.• Created multi-year workplan that tracked all resources and tasks from requirements analysis through conversion.• Reported to senior management on status of team, productivity variances, and resource planning and utilization.System Test• Led team through implementation of integrated system test. • Created testing approach which brought together medical management, benefit interpretation, and pricing functionality to ensure that all business rules and functions were operational.• Designed and built application to track and report all test conditions, cycles, and scenarios.• Designed and built application to track and report all system bugs and issues identified through system test. Show less

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  Vista Healthplan

  Jan 1999 - Jan 2004

  Director of Audit & Recovery

  Vista Health Plan was a large Managed Care Organization serving the Florida market. It was purchased by Coventry Health in 2007.Director of Auditing - Jan 2001 – April 2004• Led the post-acquisition operational integration efforts for all audit and financial recovery functions in a multi-million, multi-year, 8 company acquisition initiative. • Oversaw staff of 20 including manager, project managers, nurses, business analysts, and auditors. Department was responsible for auditing Claims and Customer Service associates and all claims processing system configuration. Department was also responsible for all overpayment identification efforts.• Responsible for ensuring that claims were paid accurately, and issues leading to incorrect payments identified and resolved.• Oversaw all overpayment identification efforts including claims analysis, medical chart review, itemized bill review, and RX utilization review. • Responsible for financial impact analysis of all hospital contract negotiations.• Prioritized, tracked, and was responsible for resolution of all system configuration and training issues identified via audits.• Served as operational liaison for cross-functional HEDIS reporting team to ensure accurate specification of measurements.• Served as operational liaison for cross-functional AHCA audit preparation team to ensure compliance with state compliance requirements.• Created project teams and managed multiple projects of various types including - quality improvement, issue resolution, system configuration, application development, business process redesign, and overpayment identification.Project Manager, IT Dept Sept 1999 – Dec 2000• Responsible for full project life-cycle of multiple small and large projects including: project team formation, creation of project plan and budget, requirements analysis, solution design and implementation, testing, and training. Show less

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  Impact Consulting

  Apr 2004 - Mar 2009

  VP Operations

  Impact Consulting is a full service multi-media and internet application development firm serving healthcare, managed care, and pharmaceutical clients. Company provides customized business-to-business, business-to-consumer, and internal business process application development. Company provides expertise and full SDLC project management: requirements analysis, solution design, technology development, business process development, system testing, user-training, and system roll-out.• Oversaw all resources related to program management, content development, graphic design, technology programming, and system testing.• Coordinated, prioritized, and allocated resources to ensure that project deliverables were on-time and on-budget.• Provided sales team accurate budgets and timelines for proposed deliverables. Show less

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  Northwest Medical Center

  Aug 2005 - Dec 2005

  Registered Nurse, Telemetry Unit

  Provided, assisted, and supervised direct nursing care to patients, in accordance with physicians' orders, recognized nursing techniques, procedures, established standards and administrative policies.

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  North Broward Hospital District

  Sept 2008 - Mar 2009

  Consultant, Emergency Preparedness Department

  • Researched, wrote and revised comprehensive emergency management plans for the four-hospital district. • Reviewed and modified four-hospital emergency preparedness plans for compliance with CMS and AHCA regulatory requirements and Joint Commission Hospital Accreditation Standards.• Created district-wide hospital evacuation plan.

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  Florida Department of Health

  Mar 2009 - May 2011

  Hospital Consultant

  • Coordinated planning activities and initiatives related to comprehensive regional public health emergency response plans.• Reviewed hospital emergency preparedness plans for compliance with CMS and AHCA regulatory requirements and Joint Commission Hospital Accreditation Standards.• Provided technical assistance to county health departments and other public health stakeholders related to public health preparedness and emergency response plans, policies, procedures.• Functioned as liaison between local/regional emergency response planning partners.• Assisted county health departments in the exercising of their public health emergency response plans.• Evaluated public health preparedness plans and learning management systems necessary to prepare staff for responding to public health emergencies in accordance with response plans.• Created emergency management knowledge management system for Broward County Healthcare Consortium. Show less

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  MicroVu

  May 2011 - Jun 2014

  Vice President, Audit and Recovery Operations

  MicroVu, Inc. is a data mining, audit, and recovery firm specializing in identification of overpaid healthcare claims. Services include claims data mining, DRG validation, coordination of benefits, hospital bill audits (on-site), durable medical equipment, and both inpatient & outpatient pharmacy claims. MicroVu’s diverse clientele include self-funded employers (including private, public, and labor sectors), large nation-wide health plans, mid-sized regional health plans, third party administrators, and Medicaid plans nationwide. • Led the value-creation strategy, including both organic and acquisition-based growth, for company.• Using PMI Framework and Methodologies, oversaw all aspects of the creation of this new business initiative for existing company.• Oversaw the creation of due diligence documentation, reporting, and presentations for the acquired entity in a multi-million dollar acquisition.• Led project team that designed and built all audit and recovery business processes.• Led project team through full system development life cycle (SDLC) to design, build, and deploy internal business applications as well as client-focused audit and recovery applications and algorithms.• Oversaw operational staff including: nurse auditors, claims analysts, recovery analysts, systems analysts, and supervisory and managerial staff.• Worked with clients to build organizational capacity to prevent future occurrences of overpayments and comply with changing regulatory requirements.• Prepared expense budgets and revenue forecasts for company-wide operations. Show less

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  Medical Reimbursements of America, Inc.

  Jan 2014 - Jan 2019

  Vice President, Payment Integrity

  MRA's payment integrity solution delivers technology-enabled services that ensure accurate reimbursement for health claims underpaid by Government and Managed Care payers. Using PMI Framework and Methodologies, oversee all aspects of the creation of this new business initiative for existing company.• Led the value-creation strategy, including both organic and acquisition-based growth, for the payment integrity portion of the platform. • Had P&L responsibility for all payment integrity operations with client portfolio covering over 5% of all US hospitals. • Oversaw the creation of due diligence documentation, reporting, and presentations for the acquired entity in a multi-million dollar acquisition.• Oversaw unit of analysts, auditors, nurses, appeals/ recovery specialists, and medical coders that detect contract anomalies, identify payment variances, and recoup underpayments. • Worked with clients to build organizational capacity to prevent future occurrences of underpayments and comply with changing regulatory requirements.• Led project team through full system development life cycle (SDLC) to design, build, and deploy internal business applications and underpayment algorithms.• Prepared expense budgets and revenue forecasts for unit operations. Show less

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  Transworld M&A Advisors

  Jan 2019 - now

  Vice President

  As Vice President at Transworld M&A I am honored to be a trusted Buy-Side and Sell-Side advisor to great companies. I assist business owners who are selling achieve their exit goals and I assist businesses that are buying acheive their acquisition-based value creation strategies.I specialize in lower middle market transactions and provide full life-cycle transaction support services to the M&A Managing Directors, as well as to brokers across the Transworld family.