SUMMARY:

• Mr. Joseph is a Senior Management Consultant with over thirty (30) years of experience managing large, mission critical information technology programs/projects in the state/local government and healthcare industries - including budgets in excess of $100M and geographically dispersed cross-functional teams. His professional consulting career has encompassed working with government programs, including Health & Human Services (HHS), Medicaid, Medicare, Veterans Health Administration, Workers Compensation, Public Health, and Mental Health, as well as state and local e-commerce and public university based academic medical centers. He has worked with top tier clients on strategy development, requirements analysis, business/systems design, systems implementation, full lifecycle testing and operational deployment. He is well versed in multiple technical areas including business/data modeling, Business Intelligence (BI)/Data Warehousing, Service Oriented Architecture (SOA), ITIL (Information Technology Infrastructure Library), Medicaid Information Technology Architecture (MITA) and Electronic Data Interchange (EDI). He has served in trusted advisory roles for Federal/State agencies and private sector companies, working effectively throughout the organizations from the C-Suite to line staff.
• In addition, he is a Subject Matter Expert (SME) in the areas of Medicaid, Medicare, Patient Protection and Affordable Care Act (PPACA), Health Information Technology for Economic and Clinical Health Act (HITECH), Healthcare Insurance Portability and Accountability Act (HIPAA), and Health Information Exchanges (HIE)/Regional Health Information Organizations (RHIO). More specifically, he has led custom software development, BI and packaged implementations, including multiple health care claims management systems and Medicaid Management Information Systems (MMIS).

PROFESSIONAL EXPERIENCE:

Confidential

Lead/Project Manager

• Leading the strategic planning and implementation of a statewide health and human services business intelligence solution, including multiple source data integration, data cleansing/governance and systems architecture to support advanced reporting and analytics.
• Responsible for balancing business priorities, developing delivery models, creating resource models, budget management and maintaining quality.
• Provide project management, serve as subject matter expert and manage the business analysis for the State of Ohio’s implementation of an enterprise-wide health and human services (HHS) business intelligence system.
• Coordinate multiple vendors to design and deploy a robust and flexible business intelligence technical architecture; integrate multiple data sources and provide advanced reporting/data analytics.
• Manage multi-organizational, multi-disciplinary teams to determine, articulate and codify business intelligence business requirements.
• Direct the design and implementation of source to target mapping; extract, transformation and loading (ETL) processes; creation of logical and physical data models/designs; design and implementation of data marts and implementation of pre-defined and ad hoc reporting.

Confidential

Manager

• Managed business/information systems projects and served as Subject Matter Expert (SME) for large healthcare organizations.
• Provided project management and technical leadership to leading large healthcare organizations implementing the Patient Protection and Affordable Care Act (PPACA) and the Healthcare Insurance Portability and Accountability Act (HIPAA) requirements.
• Responsibilities included planning information systems consolidations, full lifecycle testing of ICD-10 application systems modifications, Senior Project Manager for large health plan implementation of the Medicare/Medicaid Dual Eligible Demonstration and served as a HIPAA transactions/EDI technical Subject Matter Expert (SME), Solutions Architect and Senior Project Manager for a large government payer organization.
• Key clients included:
• Excellus Confidential
• Health Care Service Corporation (HCSC)
• Health Net
• Harvard Pilgrim Health Plan
• EmblemHealth
• Department of Veterans Affairs, Veterans Health Administration (national provider and payer organizations)

Confidential

Technical Delivery Leader and Project Manager

• Led business and technical analysis, as well as provided project management for healthcare organizations implementing state-of-the-art claims processing, EDI and business intelligence/data warehouse systems.
• Directed delivery of an advanced highly customized Medicaid Management Information System (MMIS), with responsibility for client acceptance and satisfaction.
• Directed a large team of over 200 Systems Managers, Team Leaders, Business Analysts, and Systems Engineers;
• Solution included Service Oriented Architecture (SOA)/Enterprise Service Bus (ESB-TIBCO);
• Commercial Off The Shelf (COTS) product integration;
• Extract, Transformation and Loading (ETL-Informatica) tools;
• Data warehousing/decision support functionality;
• Standards based Electronic Data Interchange (EDI); and,
• Customer self-service Web portals.
• Responsible for leading large healthcare organizations implementing advanced information management, business intelligence and data warehouse solutions.
• Documented business requirements and data sources for data warehouse implementations.
• Developed testing strategy and led the test case development, as well as the test execution of an enterprise-wide membership Operational Data Store (ODS).
• Key clients included:
• Ohio Department of Jobs and Family Services (ODJFS)
• Dean Health Plan

Confidential

Manager

• Managed critical information systems projects and served as Subject Matter Expert (SME) for large healthcare organizations.
• Led large healthcare organizations in the implementation of advanced electronic commerce and data management applications, including compliance with the Healthcare Insurance Portability and Accountability Act (HIPAA) requirements.
• Key clients included:
• Department of Veterans Affairs, Veterans Health Administration
• The Ohio State University
• Commonwealth of Puerto Rico
• CIGNA
• Michigan Education Special Service Association
• Group Health Incorporated

Confidential

Senior Manager

• Managed the Healthcare Insurance Portability and Accountability Act (HIPAA) compliance projects for healthcare providers, integrated delivery networks and clearinghouses.
• Developed HIPAA 4010 standard electronic transaction implementation strategies, including technology architecture and vendor partnering.
• Completed detailed data element mapping to implement automated coordination of benefits processing for national provider network.
• Key clients included:
• Mt. Clemens Health Systems
• WebMD

Confidential

Chief Technology Officer

• Built a technology delivery organization from the ground up to deliver state of the art, fully integrated e-Commerce applications for state/local governments.
• Responsible for defining and managing project scope, budgets, constraints, schedules and client deliverables.
• Completed requirements analysis, systems design/architecture and testing of custom software.
• Directed the development of Web portals incorporating e-Commerce applications.
• Directed the development and operations of a state of the art, secured data facility for application hosting, software development and internal network/office automation management.
• Key clients included:
• Ohio Bureau of Motor Vehicles (OPLATES)
• City and County of Honolulu
• Florida Department of Management Services

Confidential

Technology Services Manager

• Directed all aspects of $54M outsourcing project of the Ohio Bureau of Workers Compensation (BWC) Health Partnership Program; responsible for all aspects of project management, including budget management, scope management, risk/issues management and client communications.
• Project included facilities management; customized software development and support; electronic commerce development and operations, as well as customer service and consulting.
• Responsible for directing the activities of a state of the art data center including customized software development; data warehouse implementations; systems administration; database administration; network administration; EDI implementation; and, disaster recovery planning.
• Responsible for Year 2000 compliance and vendor liaisons.

Confidential

Manager,nce

• Managed the custom development and implementation of the Kentucky Childcare Management Information System.
• Documented client specific requirements, completed high-level and detailed design, supervised application customization, and coordinated testing, as well as production implementation.
• Managed the Development Center of Excellence, providing custom programming and production operations support.
• Coordinated first statewide deployment of the childcare management information system.

Confidential

Section Chief, Applications Development

• Managed Systems Analysts, Programmer Supervisors and Programmer Analysts supporting the complex, highly customized Ohio Medicaid Management Information System (MMIS).
• Led the transition from implementation vendor to State staff support.
• Chaired interagency information technology committee responsible for planning for the information systems impact of a major statewide health reform initiative; the committee included Departments of Mental Health, Mental Retardation/Developmental Disabilities, Health, Aging and Alcohol and Drug Abuse Services.
• Led the software enhancements projects to support major policy initiatives, including managed care, long term care, drug rebate, home and community based waivers and eligibility system interfaces.
• Responsible for supporting Federal audit activities.
• Led procurement efforts for major projects, including Pharmacy Point of Service and Medicaid Decision Support System.
• Responsible for full systems lifecycle, including documenting business requirements, developing high-level design/solutions architecture, developing and validating detailed design, supervising programming, planning and conducting testing and coordinating production migration.

Confidential

Advisory Business Analyst

• Served as Project Leader responsible for a major component of a large IBM mainframe medical claims processing system, writing proposals, negotiating with vendors, developing budgets and participating in all phases of systems development.
• Collected and documented claims pricing and adjudication business requirements, developed high-level systems design documents, including data exchange specifications, coordinated with external systems integration vendor to complete detailed design and programming, developed test cases/scripts and conducted automated testing to validate requirements implementation.