Coach of the Quarter – Charles Offutt

Charles Offutt is a Database Analyst II who strives to meet and exceed customer expectations and helps others to do the same. Charles practices a hands-on approach to leadership and enjoys helping others understand, adapt, and develop their role within the department. His strong problem-solving and organizational skills also help guide the team. You can often find Charles and his team around his whiteboard drawing illustrations of data structures and assigning projects. Charles’ uses knowledge and skills he gained during his  previous military service to assure that his team works efficiently and meets deadlines and goals. This has earned him the nickname "Drill Sargent” Charles understands the big picture and is always looking for ways to automate, improve, and exceed team, department, and company goals.

Team of the Quarter - Program Integrity Modeling and Analytic Support (PIMAS) Edits Team

With five different clients for each contract, the Program Integrity Modeling and Analytic Support (PIMAS) Edits Team is always on their toes. Along with day-to-day collaboration with partner companies, the team regularly faces significant and unexpected challenges, including contract modifications, workstream updates, and urgent requests. A recent high-profile Centers for Medicare and Medicaid Services (CMS) project required recoding all existing algorithms for Fraud Prevention System (FPS) edits. These are very important since they are used to identify improperly billed Medicare claims. The project required programming in a new language, validating the results, and going live in only three months. To multiple stakeholders, this timeframe seemed like an impossible mission. However, the team demonstrated their excellence by surpassing all expectations with 100% no variance or with explainable variance and by delivering the project early. In addition to achieving this difficult goal, the team continued to meet all performance metrics with a fantastic attitude and spirit of collaboration.

Team Members: Nathaniel Adams, Helen Cheng, Ratesha Davis, Bryan DeMarcy, Dorothy Page, Rita Palermo, Brenda Parker, Dumbiri Powell, Freddavia Ross, Antonietta Sculimbrene., Thomas Smith, and Justice Tobias

Process Improvement of the Quarter – Edit Management System (EMS) iFlow Automation Application Program Interface (API)

The EMS iFlow Automation API automates the Review Choices Demonstration (RCD) healthcare common procedure coding system (HCPCS) code decisions. The API updates the decisions and documents steps in iFlow as reviews and decisions are made in EMS. This affects approximately 40,000 updates each day and saves the reviewers approximately one minute per update, ultimately reducing the time for the provider to receive an updated status. Since its implementation, almost two million reviews have been processed, saving more than 29,000 hours.

Team Members: Kenneth Arenz, Jason Autry, Wayne Brumfield, Tyrone Cadenhead, Brian Corner, Rajakumar Durga, Pradeeptha (Mary) Gali, Jim Goodwin, Hepziebah Jayaseelan, Nazim Jeelani, Wendellyn Ladapo, Kevin Langston, Jaideep Pinglikar, and Jagadish Vattikuti

Special Mention Team Members: Priyanka Baddam, Aditya Deshmukh, Sandeep Reddy Gade, Karthi Kashi, Rodney McClellan, Sunil Tuppale

Associate of the Quarter – Bryan DeMarcy

Bryan DeMarcy, a Statistical Programming Analyst II, is relentless in his pursuit of excellence and has proven himself as an outstanding team member. His work has earned he and his team positive feedback from both internal and external customers. Bryan uses every opportunity to share his knowledge with the team and conducts training sessions. Recently, he took the lead to educate the team on programming language for a high-profile CMS project. Bryan's passion, dedication, expertise, and leadership helped his team successfully complete the CMS recoding project ahead of schedule.