SUMMARY:

• An accomplished and Innovative Business Analyst/Project Manager with a proven record of leadership and results. Extensive experience in implementing Health Care systems that support the business and Confidential t side of a hospital or clinic. Strong communicator at all levels of management, with superior verbal presentation and written documentation skills. A diverse professional who brings a positive attitude, solid technical and interpersonal skills, that is effective in establishing cross organizational collaboration.

TECHNICAL SKILLS:

Epic Full Life Cycle Skills: Full life - cycle implementation experience 14 years in the following modules Ambulatory, MyChart, Cadence, Prelude, Resolute, Tapestry, EpicCare Emergency, EpicCare In Confidential t, Pharmacy, Order Entry Build, Bridges

Cerner Skills: CPOE, FirstNet, CareNet, INet, SurgiNet, Cerner HNA Millennium

McKesson Skills: Horizon Med manager, Horizon Order Entry, Clinical Documentation

McKesson Star Skills: Hospital registration, Scheduling, Order entry, Radiology, Pharmacy, Lab and charge entry, Surgi-Server, Surgery workflow, Scheduling order entry, Radiology, Pharmacy, Lab and charge entry Healthquest (Medipac) Hospital billing

Eclipsys Skills: Sunrise Clinical Documentation, Analytical Reporting database, Nursing Documentation System, Sunrise Record Manager, Chart Management and Deficiency, AM/ Confidential t Financial Management

Other Skills: MS Office Outlook, Visio, HL7, SQL Server, UNIX, Windows NT, DB2, Healthcare Legacy

WORK EXPERIENCE:

Project Director

Confidential

Responsibilities:

• Continuous improvement production Client support projects with other departments and entities to define and meet project goals in terms of scope, quality, budget, and schedule
• Develop strategies for ambulatory EMR roll - out
• Write lesson plans and syllabus
• Write materials and assessments
• Conduct end-user sessions in classroom and in one-on-one sessions
• Development and maintenance of domains
• Support end users via on-site support, telephone or beeper coverage
• Performance reporting and analysis
• Revenue cycle management and contracting
• Vendor Selection . Bid Proposal Contracts.
• HL7 Perform requirements analysis for HL7 interfaces .
• Work with users to develop specifications for HL7 interfaces.
• Design and develop interface solutions.
• Deploy and test interfaces.
• Record defects triage and track the resolution and test defect fixes.
• Prepare test reports .
• Review business requirements workflows and functional technical specifications for testability and feedback.
• Cost Containment Director/Program Integrity MMIS / Consultant Current
• Budgets 50 Million Plus .
• Direct Reports 150 Project Managers .
• Sub Direct Reports 175 Business Analysts and Trainers.
• Directorship cost containment of program expenditures and processing controls .
• Modifications and refinements in service delivery, including new clinical and service interventions that reduce reliance on high cost services and settings of care.
• Expansion and refinements to department coordinated care management and medical caseManagement programs.
• Cost containment reporting tracked and reported.
• Oversee the data mining, research, and cost benefit analysis of cost containment and improvement.
• Review cost efficiency operations and performance.
• Oversee new and creative ideals to identify fraud and abuse.
• Gather business requirements .
• Oversee for developing investment cost,benefits,and risk on investment and benefits.
• Manage and coordinate insurance billing, collections, cashiering, and logging
• Ensure accurate, timely billing and collection of accounts
• Comply with third party requirements to meet and maintain operational cash flow
• Maintain current documentation of all reimbursement regulations
• Ensure computerized Accounts Receivable systems and applicable billing systems are profiled to meet such regulations
• Prepare reports relating to Confidential t account data
• Compile statistical data as needed
• Responsible for facilities Chargemaster with input from dept. managers
• Train all employees on hospital corporate compliance program
• Responsible for recruiting,, supervising and evaluating business office staff in accordance with hospital policies and procedures
• Prepare budgets for operations
• Operate within approved budget parameters for personnel, capital and operating expenses
• Do billing for hospital owned physicians and on - staff physicians

PCA Analyst

Confidential

Responsibilities:

• Collection and retrieval of clinical and financial data Support and promote project to other operational staff within the organization
• Installation choices/application configuration choices
• Process Redesign
• Operational policy and procedure development
• Acceptance testing
• Primary support contact, coordinate all application specific design or process questions
• Assist with troubleshooting of problems or questions from users
• Collect information regarding potential systems enhancement needs
• Coordinate software updates and changes with users
• Review and test each new release, communicate needed changes to Epic before users are permitted to access the new release
• Day - to-day operation and coordination
• Interface with conversions
• Data warehouse Core tables, reports
• Enterprise Masterperson index EMPI and Security
• Staffing resource for teams, oversees team deliverables
• Lead in rapid design, design build validation and implementation
• Interface specifications and development reporting warehouse analysis development
• EMPI strategy and development as well as coordination of EMPI clean up activities, design and implementation of security
• Enterprise medical imaging, Enterprise imaging areas Triple G lab roll out
• Implement Epic products across hospitals and clinic settings
• Manage timelines for areas
• Oversee all aspects of product design and implementation

Asst. Manager/Supervisor Payor Relations

Confidential

Responsibilities:

• Collaborating with end user community executing the following tasks as a part of the clinical systems implementation:
• Building, coding, testing, documentation, support and maintenance of Epic Ambulatory software
• Development of current and future state work flows of Ambulatory practices in Visio, population designated databases during the initial system build
• Troubleshooting: problems or questions from users
• Reviewing and testing new releases
• Communicating changes to Epic before users can access the system
• Conduct day - to-day communication with Epic s installation team, work with the project team and end users to tailor the system to the hospital s requirements
• Good working knowledge of relational databases. Client/server architecture
• Good understanding of ambulatory work flows
• General understanding of systems configuration
• Responsible for maximizing contract reimbursement through negotiation and management of all third party payor contracts
• Oversight of purchased service contracts under managed care risk arrangements
• Benchmarking and feedback on managed care utilization and oversight of referral management
• Negotiate major third party contracts
• Analysis of financial impact of new contracts and contract revisions
• Development and review of contract terms and conditions and provider contracts with various payor reimbursement studies
• Assist with recovery through payment analysis
• Coordinate all third party settlements
• Assist with implementation of contract revisions with Business Services Accounting Operations Credentialing and IS
• Compliance of payor contracts
• Provide communication on reimbursement information to Organizational Staff
• Oversee audits to ensure compliance with contractual changes
• Supervise over 35 staff members

Ambulatory Clinical Systems Business Analyst (Contract)

Confidential

Responsibilities:

• Full life Cycle Epic implementation experience in healthcare environment
• Serve as bridge between department end users and the Epic project team
• Maintain information about policies, procedures and business operation
• Conduct day - to-day communication with Epic s installation team and the hospital s project team
• Perform application quality assurance
• Analyze and document business processes
• Perform in depth analysis of work flows, data collection and report specification development
• Develop and document internal procedures that will be used in conjunction with Epic applications and interface with all levels of Ambulatory Care staff and technical team
• Clinical background in ambulatory setting and experience implementation of an Ambulatory/EMR system
• Understanding of ambulatory work flows and general understanding of system configuration
• Ability to interact with all levels of administrative, clinical and support staff in an academic setting
• Excellent analytical, communication and organizational skills
• Direct and coordinate Confidential t registration to ensure Confidential t safety, satisfaction and maximization of the organization s cash flow concurrent with maintaining and improving Confidential t-doctor and other consumer relationships
• Both receives and sets operational goals and strategies for the department
• Assures goals are accomplished through planning, implementing and directing of systems and programs and staff in a rapidly changing environment
• Develops and monitors adequate business systems controls and
• Develops or coordinates timely management and statistical reporting in areas of responsibilityProvides interaction with hospital clinic staff third party payors and other organizations
• Develops and maintains strong customer service oriented business unit
• Process improvement methodologies
• Handles stressful situations
• Implements Epic revenue cycle products in hospitals/clinics
• Manage timelines for areas. Oversee all production design and implementation
• Analyze coordinate, evaluate individual plans as they relate to plan objectives
• Rapid design, build, validate implementation, appropriate linkage with ambulatory and hospital clinic product areas

Tools: Used: Epic modules Ambulatory, MyChart, Epic Bridges, Cadence, Prelude, Resolute, EpicCare, Emergency, EpicCare In Confidential t—Pharmacy and Order Entry BuildIDX: implementation and consulting of CareCast and LastWord

Supervisor/Billing Enrollment

Confidential

Responsibilities:

• Supervise 30 team members, over seeing and mentoring
• Medicare/Medicaid/Private Pay Workers Compensation
• Medicare ABD
• Develop process for efficiency improvement within departments
• Manage vendor relationships