Kathy Warling-Smith, PMP Healthcare and Health Plan Services & Education | Health Informatics and Care Management Non-Profits | Foundations | Philanthropy | Strategic MarketingComm | Program & Project Mgmt.
I'm an expert integrated communications professional, superior program manager, natural collaborator and leader
who is recognized for establishing long-lasting authentic relationships with external and internal stakeholders.
I'm passionate about:
A. Implementing program and product solutions efficiently and
B. Executing impactful strategic campaigns to achieve business goals.
As a self-starter, I am driven to complete tasks with precision and meticulous attention to detail.
This ensures that every project is executed with the utmost reliability and trustworthiness.
Simply put, I get things done.
Software Product Owner
User Experience & Business Goal Focus
Scroll below to access Portfolio of Illustration
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In 2020-2021, as the new Technical Project Manager, I inherited a Flat Backlog of 70 software tickets. After conducting stakeholder interviews, I prioritized compliance and business needs, incorporating 13 features, closing 13 outdated tickets, and organizing 41 for future development.
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I created sprint and general backlogs, scoped workflows, crafted user stories, and developed acceptance criteria in JIRA. I collaborated with Scrum Master and developers in daily stand-ups and addressed post-overview questions from trainers and operations. I also led monthly Change Review Board meetings, analyzing and presenting software requests, adding approved items to the backlog, and communicating outcomes to stakeholders.
Project | 01
Clarity on the purpose of a Caregiver Authorization Form creates improved customer experience and eliminates unnecessary expenses.
Problem - Inaccurate Selection of Mailing Resulted in Excessive Costs:
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During a new Medicaid client launch, agents submitted 88 caregiver authorization requests within the first three weeks, but only 28 were valid, leading to unnecessary mailing costs. Without intervention, this would have resulted in $37,800 in additional annual expenses. A software prompt enhancement prevented excessive costs.
Definition of Parent/ Child under 18 years old versus Caregiver/Child under 18 years old
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A parent or guardian can be a caregiver, but a caregiver is not always a parent or guardian.
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A parent/guardian must be identified for members under age 18 unless emancipated
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A minor does not need to designate a caregiver (unless emancipated, likely too young to make a decision)
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A parent/guardian does not need to receive an authorization form because the authorization form is intended to “designate use or disclosure of health information to allow the designated person to participate with the member in the health plan’s care management program(s). Only the minimum necessary information related to members’ current issues should be shared.”
Solutions to reduce and/or eliminate unnecessary expenses:
Application Enhancements
Enhance ‘Add Caregiver’ window for the Contact for Minor need.
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Add ‘/Contact for Minor’ to the window header as the window already captures the same items needed for Contact for Minor.
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Next to the authorization form button and label in parentheses state (only send for members 18 yo and older).
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Make the relationship content a mandatory field completion, not allowing the agent to save until it’s completed. Format the ‘Relationship’ label identical to Preferred Contact Method (red color and with an asterisk)
Banner Enhancements (Visual Indicators)
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Both the caregiver's phone number and the task indicator is in RED color as an alert to the user, remaining this color until the authorization form is uploaded.
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For the Caregiver number to turn green indicating this is a valid, usable number the signed Authorization form must be uploaded.
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An additional enhancement request to add phone in a different color (bright purple) if <18.
Scripting/Guidance Enhancements
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Provide guidance tip to agents by uploading updated scripting in system workflow (tip is not verbalized to the caller).
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If <18: Confirm parent/legal guardian name. Open Caregiver icon (after selecting continue.) Document contact information of the parent/guardian of the minor (first name, last name, relationship, phone number). Do not send an authorization form.
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While doing the script evaluation, I also identified more appropriate language when the agent is calling on behalf of a minor.
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May I speak with BONNITA TRAINING (or if a child: the parent or guardian of BONNITA)?”
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Outcome Projection
Elimination of an unnecessary step for a significant portion of member's parent/gaurdian and a cost savings for my employer.
Project | 02
Member Special Communication Needs Initiative resulting in improved member experience and accreditation quality improvement demonstration.
Problem
During initial enrollment, an agent records a member's visual or hearing communication needs on the Member Demographics page, but these needs are not revisited to check for changes later.
Solution
Create a new annual task in the agents' work queues for all active members, requiring them to make outbound calls to confirm any new or changing special needs.
Steps involved:
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The daily business rule processing identifies active members who have an enrollment anniversary in the next fifteen business days.
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Tasks are added to agents' worklists.
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Task link drives agent to Member Demographic Information page. Once the agent has confirmed the current Vision and Hearing Special needs and documents in the drop-down boxes (includes the option of ‘None’) a visual indicator confirms data has been captured.
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In addition, in the data tables, dates and times are captured to produce the task next year.
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Run data extract for existing member data for comparison in year two, where variable data is slightly different.
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Based on member confirmation:
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For those with visual impairments, distributed fulfillment will be in the desired format (large print/braille/thumb drive with recording).
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For hearing impaired members, throughout the system, associated member phone number listings will display a TTY indicator so agents can efficiently access a TTY Operator when making outbound calls.
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Project | 03
Model of Care Program's member-facing virtual meetings requires email correspondence, reversing existing software business rules.
Problem
During initial member enrollment, the Member Contact workflow captures preferred contact methods (phone, text, email) and first/second preferences, restricting contact to those options. However, a Model of Care Program audit identified a new feature—virtual conference calls with the care team—that creates an issue for members who didn’t choose email as one of their preferences.
Solution
The Software Engineer Principal was concerned about decoupling two elements since the business rule had just been implemented in the previous release. To address this, I held a meeting, sharing my screen to demonstrate how the current rule was problematic when email was an accepted contact method but not a top preference. This clarification enabled the successful implementation of the new feature, and agents were trained on the business rule update.
During the live Release Overview, a participant suggested the email inviting members to MS Teams meetings should state that replies are not accepted. As a result, this language was added to the Window Header, and all changes were documented in JIRA and included in the QA release notes.