SUMMARY

• To utilize my Senior Leadership skills in Portfolio, Program or Project Management roles within the healthcare industry to effectively partner with clients to address their strategic initiatives in systems implementations, software development and business process improvements.
• Management Consulting & Executive Effectiveness
• Portfolio / Program / Project Management
• Large - scale Technical Initiatives (System Implementations & Upgrades, New Product Roll-Outs, Data Conversions, Enhancements & Maintenance/Clean-Up Efforts)
• Significant experience with Enterprise-Level Financials & Oversight, including Budgeting/Forecasting for Multi-Million Dollar Projects, Capital Funding, Core Projects, Client-Funded Projects, Total Cost of Ownership and Departmental Cost Centers
• Business Process Analysis/Re-Engineering/Cost-Benefit Analysis
• Proven Professional with over 29 years in healthcare industry, including previous 3 ½ years leading large programs at Confidential
• Portfolio and Program Management and Accountability of budgets of $20+ Million and teams of 300+ resources
• Experience with planning and execution of phased multi-year system release schedule to support Open Enrollment & other key business milestones
• Senior Management / Leadership experience and skills critical to the successful implementation of system or business process changes to satisfy client business requirements
• Experience in various Software Development Life Cycle phases, including:
• Project Management
• Software Development and Technical background, including Software Development, Applications, Interfaces, Conversions, Configuration/Build, Database Queries
• Technical Experience with key design, data model and database concepts within various managed care/healthcare applications and ability to learn new systems/applications
• Senior Business and Big 4 Consulting with significant EDI/HIPAA experience
• Release Management processes and tools
• Significant E xperience with Largescale New System Implementations / Upgrades (including multiple Facets/Trizetto Projects):
• Project Manager/Lead position on 7 Large Facets System Implementation/Upgrades)
• Strategic Test Phase Planning, Testing Readiness and Execution
• Experience with multiple types of testing, including System Testing, User Acceptance Testing, End-To-End Testing, Regression Testing, Configuration Testing and Performance Testing
• Experience with multiple testing tools and defect tracking tools, including planning and management of test cases, test scripts, test logs, defects and test metrics
• Industry experience in healthcare, financing, automotiv e
• Management and Oversight of on-shore and off-shore resources and Regional/National team model.
• Medicare/CMS, Confidential and Confidential -10/X12 v5010
• Experience working with external vendors and trading partners

EXPERIENCE DETAILS:

Confidential, Silver Spring, MD

Program Manager

Responsibilities:

• Provided Senior Leadership oversight and accountability of 300+ IT team members and budget of $20+ Million for multi-year program
• Planned and managed calendar of system releases across 50+ impacted systems to support multi-year phased roll-out of a new Medicare Advantage product to support key business milestones of Ready to Sell & Enroll for Open Enrollment and Ready to Administer & Provide Care for coverage effective dates.
• Managed full financial process to prepare budget, forecasting, tracking of actuals, reporting variance, client-funding recharge agreements, funding requests via change management for both capital and operating expenses
• Completed weekly and monthly status and financial reporting to Executives, Business & IT Stakeholders through Project Server and Presentations
• Managed / Mentored team of Project Managers and Master Scheduler
• Collaborated with Program Manager Peers across Business and IT on National and Regional teams for readiness assessments, execution strategy and mitigation of risks and issues
• Provided recommendations for planned deliverables and operational workarounds
• Conducted oversight of project schedule in MS Project
• Conducted resource / capacity planning & mitigation of constraints
• Defined and managed program-level RAID items (issues, risks, decisions, change control)

Regional IT Project Manager

Confidential

Responsibilities:

• Planned and managed regional effort to support National scope / requirements
• Facilitated deep dive analysis of regional membership system ( Confidential ) and related business flows to produce a set of technical strategic recommendations to prepare system for future replacement
• Prepared and presented status reports on weekly National status meetings

Program Manager

Confidential

Responsibilities:

• Completed weekly and monthly status and financial reporting to Executives, Business & IT Stakeholders through Project Server and Presentations
• Managed / Mentored team of Project Managers and Change Control Coordinator
• Defined and managed program-level RAID items (issues, risks, decisions, change control)
• Provided recommendations for planned deliverables and operational workarounds
• Conducted oversight of project schedule in MS Project

Confidential, Fargo, ND

Health Plan Portfolio Manager

Responsibilities:

• Oversight of Delivery and Budgets for 20+ projects across Health Plan Portfolio
• Participation in weekly Steering Committee Meetings with Vice-President & Directors from PMO and Application & Security / Architecture Teams
• Daily coordination and strategy planning with Senior Leadership from various technical teams
• Point of escalation for issues / risks across projects in portfolio

Confidential

Program Manager

Responsibilities:

• Provided HIM program oversight and management of multiple projects within the program
• Managed SDLC for deliverables with business and IT based on requirements from CMS and Confidential business
• Planned and managed monthly iWay Releases
• Coordinated with external vendors for planned deliverables and operational workarounds
• Created and maintained project schedule in MS Project
• Completed weekly status reporting to Confidential Business, IT and Confidential through Project Server and Meetings
• Defined and utilized new Confidential templates for tracking of Deliverables and Program Status
• Conducted resource / capacity planning
• Managed program issues/risks

Confidential

Project Manager

Responsibilities:

• Managed analysis and requirements gathering across several applications for Confidential -10 impacts
• Coordinated development activities and UAT for system remediation changes across multiple teams and external vendors
• Created and maintained project schedule in MS Project
• Completed weekly status reporting to Confidential Business, IT and Confidential through Project Server and Meetings
• Managed project issues/risks

Confidential, Rancho Cucamonga, CA and Silver Spring, MD

Functional Certification - Testing Lead

Responsibilities:

• Gathered input from Testing Team resources to create workplan of test planning activities
• Collaborated with Project Management, IT, Business SMEs and Infrastructure Readiness Team to in corporate test planning activities into Master Project Plan
• Managed Testing Team resources in the execution of the test planning activities per workplan
• Prepared weekly status reports to communicate progress, report issues and identify risks
• Coordinated environmental and tools dependencies with Infrastructure Readiness Team

Confidential

Development Lead / Project Manager

Responsibilities:

• Coordinate development estimates and workplan management for client requests for Confidential custom enhancements
• Manage Software Development Life Cycle activities for concurrent Confidential development projects with development teams, including internal Trizetto teams and on-shore/off-shore resources, to satisfy client requirements
• Complete issue management and risk management for planned development work
• Gather and present status to Executive Management and Project Manager at client organization and Trizetto
• Maintain status of specific requests on internal support tracking systems

Confidential

Interim Director

Responsibilities:

• Contributed Facets database / data model expertise for Facets mapping for claims and provider data extracts
• Completed troubleshooting / resolution of Facets batch input / output errors
• Completed detailed validation of Facets database conversion
• Prepared batch testing plan; completed analysis / validation of batch output
• Provided high-level project guidance / oversight

Confidential, Albuquerque, NM

Consultant - Project Manager

Responsibilities:

• Planned and managed analysis, design, configuration, testing, implementation and claim adjustments related to Facets system configuration corrections.
• Prepared detailed work plan of work activities
• Prepared weekly status reports to communicate progress and report issues / risks to Executive Management
• Reviewed / Analyzed Facets configuration processes for process improvements
• Completed troubleshooting of Facets system errors to identify and implement corrections
• Worked with Trizetto teams to define, plan and manage solutions to reported issues

Confidential

Consultant - QA Manager

Responsibilities:

• Collaborated with QA, Project Management, Development, Business SMEs, External Vendors and Executive Level to create Master Test Plan for Facets 4.71 Upgrade Project
• Managed QA Testing Team resources to execute testing activities associated with Facets 4.71 Upgrade Project
• Prepared detailed work plan of test execution activities
• Prepared weekly status reports to communicate progress, report issues and identify risks
• Performed QA Capabilities Assessment / Gap Analysis against Best Practices / Process Improvements
• Defined business requirements for a full suite of QA/Test environments and associated environment management processes
• Reviewed / Analyzed Facets Configuration Processes and Process Improvements

Confidential, Philadelphia, Pennsylvania

Testing Lead

Responsibilities:

• Worked with business customers to define requirements and approach for Facets Claim Payment Regression Testing Automation process.
• Prepared detailed work plan of development and execution activities
• Developed detailed claim matrix and used data mining/queries of Facets back-end databases to extract regression test claims to satisfy specific bill types, services, providers, etc.
• Worked with development resource to confirm business requirements, detailed design and coding of automated script
• Participate in detailed testing efforts and database queries to support testing
• Prepared weekly status reports to communicate progress, report issues and identify risks

Confidential, Albany, New York

Testing Project Manager

Responsibilities:

• Defined and presented overall testing strategy for the project, including testing phases for system, user acceptance, performance and end-to-end testing
• Coordinated testing readiness effort, including creation of test plans, test cases and test scripts, for multiple testing phases
• Prepared detailed test execution schedule, including data setup and batch dependencies
• Coordinated reporting of defects and retesting of fixes with Facets Configuration and development teams
• Troubleshooting of Facets Configuration issues
• Prepare daily, weekly and phase ending status reports
• Work with process team to confirm business requirements and desk levels associated with testing effort
• Managed daily work assignments for 20-25 testing resources
• Participate in detailed testing efforts, data mining and database queries to support testing

Confidential

Facets Configuration Testing Lead

Responsibilities:

• Defined and executed test plans for Facets claims associated with ongoing configuration builds for benefits, product and pricing (some for NetworX pricing module).
• Coordinated resolution of configuration defects with configuration build analysts.
• Communicated test results to business areas and provided support for UAT of test scenarios.
• Worked with department management to plan testing of upcoming monthly configuration releases.

Confidential Healthcare; Silver Spring, MD

Project Manager

Responsibilities:

• Participated in all of the Project Management and Testing processes related to the project
• Prepared testing timeline, key milestones and resource plan for all testing phases based on predefined Go Live date
• Prepared and coordinated execution schedule with vendor (Trizetto) for batch processing jobs related to Parallel Testing, SIT/UAT and End-to-End Testing
• Designed full End-to-End Testing Plan to in corporate test cycles for new 4.31 workflows and associated test scenarios, as well as coordination of tasks with vendors
• Prepared and managed testing calendar for SIT/UAT and End-to-End Testing
• Prepared 4.31 testing metrics and presented to Executive Management
• Coordinated business validation of testing components, resolution of testing issues and tracking of testing feedback (i.e. pass/fail) from the business
• Oversight of creation and maintenance of test scenarios by testing team members
• Assisted with the prioritization of Release 4.31 development activities with Trizetto and client development teams
• Participated in formal user training and configuration training for 4.31 Customer Service Module

Confidential, Farmington Hills, MI

IT Project Manager

Responsibilities:

• Create and maintain workplans in MS Project for Automotive Credit Application Systems
• Complete Project Management tasks according to Project Management Methodology
• Complete Scope Management tasks, including change request development/submission
• Manages tasks required to develop and enhance infrastructure which processes XML messages using XI50, Websphere, MQSeries and J2EE components
• Report, manage and escalate issues and risks affecting project success
• Complete Defect Management tasks, including preparation and analysis of project defect reports
• Participate in deliverable review meetings
• Participate in weekly Project Status Meetings with Feature Teams
• Coordinate and schedule code promotions and software releases associated with assigned features
• Assist with resource planning

Confidential, Grand Rapids, MI

Testing Project Manager

Responsibilities:

• Created and maintained master component tracking tool for scope management and testing inventory of all components for Facets 4.21 Upgrade and related projects
• Prepared testing strategy, timeline, key milestones and resource plan for testing of all components in project inventory based on predefined Go Live date
• Defined and coordinated prioritization of Release 4.21 development activities with Development Lead based on business requirements
• Prepared and coordinated test execution schedule for batch processing jobs
• Oversight of business validation for testing components, resolution of testing issues and tracking of testing feedback (i.e. pass/fail) from the business
• Oversight of creation and maintenance of test conditions by testing team members
• Prepared weekly 4.21 Executive Summary for Testing and presented to client Executives and Business Leads at Facets Oversight Meetings
• Prepared weekly 4.21 project metrics and presented at Project Management Meetings and Testing Team Meetings
• Prepared daily component metrics and distributed to testing team members and subject mater experts
• Interfaced with other development teams to manage scope and testing availability dates
• Worked with development team to merge letter headers into letters documents in MS Word
• Escalated 4.21 testing issues to Program Manager

Confidential, Troy, MI

Testing Project Manager

Responsibilities:

• Maintained master component tracking tool for testing inventory of all components for Facets 4.11 Upgrade and related projects
• Coordinated Release 4.11 development activities with Trizetto Development Lead for the design, development, delivery, release management and tracking of 4.11 remediation items
• Oversight of business validation for testing components, including distribution and coordination of test output to business testing leads, resolution of testing issues and tracking of testing feedback (i.e. pass/fail) from the business
• Reviewed and approved all Trizetto promotions of code and documentation for 4.11 development and break-fix activities
• Oversight of maintenance of 4.11 Test Tool database of test conditions including updates by business and IT
• Oversight of maintenance of Peregrine and Onyx databases of 4.11 tickets including leadership of defect status meetings, interfacing with business testing leads in their reporting of issues and validating solutions, as well as the coordination of business and Trizetto resources in ticket management
• Prepared weekly 4.11 project metrics and presented to client Executives and Business Leads at Functional Leads, Key Lead Forum meetings and Sponsorship Meetings
• Prepared daily component metrics and distributed to business testing leads and client Management
• Interfaced with other development teams in weekly meetings for resolution of code requests between projects
• Contributed to troubleshooting of Configuration Issues
• Provided assistance to project team in preparation and execution of test plans
• Ran daily project meetings/conference calls as needed
• Escalated 4.11 development, ticket resolution and business validation issues to Portfolio Manager

Confidential

Project Manager

Responsibilities:

• Created and maintained workplans in MS Project and ABT Workbench
• Completed resource planning and budgeting, including processing of resource/contract extension requests
• Completed Scope Management tasks, including change request development/submission
• Reported, managed and escalated issues and risks affecting project (including entry of NSI Issues Log maintenance)
• Prepared and communicated daily and weekly status reports and Powerpoint presentations to Executive Management at both Trizetto and BCBSM
• Managed time reporting activities for all team members, including review and verification of management reports and timesheets in MS Project Web Access
• Completed Defect Management tasks, including preparation and analysis of Peregrine defect reports
• Defined deliverables and completed deliverable submissions/task closures
• Interacted with Testing Prime/Functional Lead, team members and other department leads to monitor work activities and statuses, and to identify project issues
• Participated in weekly Project Manager Status Meetings with NSI Portfolio Manager and other NSI Project Managers
• Coordinated and managed code promotions and software releases in PVCS for break-fixes and enhancements submitted by Trizetto
• Completed Project Management tasks according to requirements/knowledge gained during BCBSM Project Management Methodology Training and SDLC