Fiscal Stabilization & Standardized Rate Governance for NE DD

Every fiscal year, the Nebraska Division of Developmental Disability (NE DD) undergoes mandated rate adjustments and budget re-allocations that directly influence support levels for thousands of individuals. Following the implementation of our end-to-end integrated billing system, these migrations grew significantly in technical complexity. What was once a localized data update evolved into a high-stakes synchronization effort involving multiple technical interfaces, external vendors, and thousands of provider accounts. Without a standardized approach, these transitions posed a recurring risk of billing discrepancies and provider revenue instability.

To address these challenges, I spearheaded a multi-year effort to move the state away from reactive troubleshooting toward a proactive, standardized fiscal migration framework. This required a deep Business Analysis of the state’s fiscal cycle to identify recurring bottlenecks and data gaps. I designed a unified migration flow that synchronized data delivery from both the state and the platform ends, ensuring that budget updates were accurately reflected in authorizations before a single claim was generated. To manage the increased complexity of the integrated environment, I established a "pre-migration" validation phase, mimicking state data in local environments to stress-test the logic against service-type variations.

Beyond the technical migration, I institutionalized a "Zero-Surprise" protocol for the onboarding and offboarding of providers and services. By establishing clear technical specifications and formalizing communication channels, I successfully closed the gaps between state agencies and engineering units. This systematic approach to Data Governance ensured that new rates were mapped correctly from day one, drastically reducing the manual back-and-forth and the operational friction typically associated with fiscal year turnovers.

The result of this strategic overhaul is a stabilized and predictable fiscal environment for the state of Nebraska. By establishing these Reporting Management standards, I have transformed a high-pressure manual event into a repeatable, low-volatility operational cycle. This process is now a core component of the state’s annual calendar, providing leadership with peace of mind and ensuring that providers across the state receive accurate, on-time payments regardless of the underlying policy changes.

Projects & Accomplishments

Nebraska Division of Developmental Disability

The NE DD Billing Evolution – From Implementation to RCM Mastery

In 2013, the Nebraska Division of Developmental Disability (NE DD) faced the immense challenge of transitioning from a fragmented legacy environment to a unified, integrated EHR system. As the Lead QA and eventual Project Manager, I spearheaded the initial implementation, which centered on building a custom Individual Budgeting and Authorization framework. This foundational phase required the coordination of multiple high-security interfaces with the state’s MMIS and legacy infrastructures to ensure that every individual's funding was accurately reflected and controlled.

By 2015, I led the strategic expansion of this project into a complete End-to-End Billing Integration. This was a mission-critical shift that required bridging the gap between raw service data collection and the complex world of X12 EDI exchanges. I managed at least half a dozen distinct technical teams to architect the automated generation of 837 claim files and the subsequent processing of 835 response files. This closed-loop system allowed the state to handle original claims, adjustments, and voids with surgical precision. Acting as a key liaison between state leadership and our engineering units, I ensured that every modular hand-off—from demographic intake to claim adjudication—met the highest standards of Data Governance and Release Management.

In 2020, I further enhanced the platform's utility by leading a high-priority EVV (Electronic Visit Verification) project. This involved designing a unidirectional data pipeline to an external state vendor, ensuring that NE DD met federal compliance requirements without disrupting the existing provider documentation workflows. Throughout the 12-year lifecycle of this contract, my focus remained on creating a transparent, reportable, and resilient system. Through rigorous UAT Management and Cross-Functional Orchestration, I successfully delivered a product that not only met the state’s immediate needs but became a blueprint for automated fiscal oversight within the agency.