Company Capabilities

We're passionate about tackling complex healthcare challenges and delivering real-world results. For over 18 years, we've partnered with leading healthcare organizations to optimize operations, navigate complexities, and achieve measurable success. This capabilities statement provides a comprehensive overview of our expertise across various healthcare service areas. Whether you're looking to streamline workflows, improve patient care delivery, or ensure compliance with regulations, Nerdie Girl Consulting offers a tailored approach and a proven track record to help you achieve your goals.

Completed Projects

  • Medicaid Enrollment Optimization Project

    Client: Optum

    Role: Healthcare IT and Project Management Consultant

    Technology Used: Salesforce, ContractHub, ServiceNow, MS Project, AS/400

    Description:

    Led a critical IT integration project enhancing Medicaid enrollment processes.

    Achieved a 75% increase in operational efficiency.

    Managed stakeholder communication and developed strategic roadmaps.

  • Texas Health and Human Services Commission - Government Healthcare Pharmacy Edits Implementation

    Client: Gainwell

    Role: Scrum Master - Pharmacy Consultant

    Technology Used: Azure DevOps, SharePoint, GitHub

    Description:

    Spearheaded the implementation of complex government healthcare pharmacy benefits programs.

    Optimized configuration to meet Texas-specific regulatory requirements.

    Achieved a 95% stakeholder satisfaction rating.

  • State of Delaware MMIS Health Plan Implementation

    Client: Centene Corp.

    Role: Project Manager III

    Technology Used: Scrum/Agile methodologies, MS Project, ServiceNow

    Description:

    Successfully managed the State of Delaware MMIS Health Plan implementation.

    Ensured compliance with Medicaid standards.

    Achieved 91% on-time and within-budget delivery.

  • Pharmacy Benefits Management MMIS Vendor Drug Program

    Client: State of Texas Health & Human Services

    Role: Project Manager

    Technology Used: MS Project, SharePoint, ServiceNow

    Description:

    Led critical projects ensuring efficient access to covered medications.

    Managed program updates, vendor management, IT upgrades, and COVID-19 reporting.

    Conducted audits and contributed to a 35% cost saving through effective vendor selection.

  • ServiceNow Migration and Modernization Project

    Client: Sally Beauty Holdings

    Role: Project Manager

    Technology Used: ServiceNow, MS Office Suite, Jira Cloud, Power BI

    Description:

    Directed the strategic migration of Sally Beauty's ServiceNow instance.

    Improved IT service management and operational efficiency.

    Developed comprehensive project plans and managed stakeholder communication.

  • Medicare Part D Testing and EDI Transition to IngenioRx Migration

    Client: Anthem, Inc.

    Role: Clinical Business Analyst

    Technology Used: ServiceNow, JIRA, Confluence, Atlassian, Lighthouse, RxClaims (AS/400)

    Description:

    Managed the ERP supply chain function for EDI transition.

    Conducted comprehensive UAT and QA/QC testing for Formulary and Utilization Management lists.

    Ensured 100% accuracy and compliance with CMS regulations.

  • Pharmacy Benefits Configuration Project

    Client: CVS Health

    Role: Domestic Benefits Coding Advisor

    Technology Used: ServiceNow, AS/400, Lighthouse, Benefits builder, Salesforce, Excel, MS Office, MS Project, Visio

    Description:

    Managed the loading of complex billing codes for benefit plan designs.

    Developed coding strategies and designed complex coding solutions.

    Exceeded client satisfaction score targets and reduced service warranty payments.

  • Crisis Service Project under the 1115 Medicaid Waiver

    Client: Dallas County

    Role: Project Manager - Jail Diversion Crisis Services

    Technology Used: MS Office 2012, SAS, SaaS, CMS reporting systems

    Description:

    Led the successful implementation of a crisis service project.

    Reduced jail recidivism by 22%.

    Achieved 100% compliance with DSHS regulations.

  • Appeals & Grievances Migration to Cognizant's QNXT Platform

    Client: Parkland Health (PCHP)

    Role: Appeals & Grievances Sr. Project Consultant

    Technology Used: MS Office Suite, SharePoint, QNXT

    Description:

    Managed the complex migration of Appeals & Grievances processes.

    Ensured regulatory compliance and operational efficiency.

    Developed user-friendly workflows and maintained A&G policy compliance.

  • Project Portfolio Management for EPIC Applications

    Client: Baylor, Scott & White Health

    Role: IS Planning Project Portfolio Management

    Technology Used: ServiceNow, EPIC applications, RedHat, RedCap

    Description:

    Managed a portfolio catalog of EPIC applications.

    Conducted audits of in-flight projects and enhanced overall portfolio efficiency.

    Ensured system stability and adherence to security protocols through RedHat and RedCap upgrades.