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Senior Program Manager Resume

Traverse City, MI

SUMMARY:

  • Strategic Initiative Leader Expert in leading highly visible strategic innovations and initiative from ideation to ROI and delivered outcomes/results.
  • Specializes in healthcare IT initiatives and re - engineering.
  • Expert in performance improvement with provable results - redesigned the Medicare Advantage enrollment system resulting in cost savings of $800K/yr and increased enrollments by 22%.
  • IT leadership -- Working with both onsite and offshore teams, managed the full system development life cycle (SDLC) - Implemented a new module in Facets with customizations resulting in an enhancement to operations
  • Implemented two new modules for QNXT claims system to enhance automated testing and care management.
  • Managed programs with strong fiscal and financial controls - managed a $52 million program over multiple years and kept the multiple projects in line.
  • Act as high-value advisor and support person to Chief Executive Officers.
  • Design Project Management Offices, mentor Project Managers, and manage project lifecycles.

KEY COMPETENCIES:

  • PMP Technical Initiatives Strategic Implementations Business & Financial Modeling Business Re - engineering
  • Vendor Selection & Management Talent Development Market Expansions Consensus Building Analysis
  • P&L Problem Solving Due Diligence Needs Assessments Performance Management Goal Setting

PROFESSIONAL EXPERIENCE:

Confidential, Traverse City, MI

Senior Program Manager

Responsibilities:

  • Demonstrate exceptional leadership in design and orchestration of business development, business re-engineering, and technology implementation initiatives for extensive client base.
  • Manage projects for clients involving up to 120 Confidential, up to $25 million budgets, selecting and managing multiple vendors, managing international teams, agile and waterfall processes, while optimizing activities of more than 50 direct reports.
  • Design Project Management Offices, facilitate establishment of processes, procedures and oversee procurement processes.
  • Select and monitor outsourced service providers, mentor Project Managers, manage project teams, and provide reporting throughout project lifecycles.
  • Managed the client relations for Medicare Advantage for 330,000 members on an interim basis including directing several major projects that implement the Johns Hopkins ACG process, directing improvements in member engagements, and implement a new system that interacts with prospects and members including RFP and vendor selection.
  • Directed $5.9M budget and team of 40 in design/development of system architecture and integration with three HIEs enabling physicians to exchange clinical information real time - created robust Population Management Platform for analytics/care management of chronically ill Medicare patients expected to decrease operating costs by estimated 5% and increase patient outcomes/longevity.
  • Developed system architecture, managed RFP for integration of four systems and recruited team of 50+ in two-year development of $17.4M state-of the art care management system supporting care coordination of 400K patients in medical home environment with 22 office locations, five hospitals and 900 physicians — resulted in reduction of admission rates by 2% and of readmission rate by 18%.
  • Led team of 35 in $4.5M project to design/implement robust patient management system for 65,000
  • Identified tool that could predict changes in health status and software that improved case management and established four primary care clinics - reduction of hospital readmissions alone generated cost savings of $1.1M in first 12 months.
  • Led team of 40 in health affordability/utilization management project to integrate authorization for drugs (pharmacy, home, office and mail) with existing online claims processing systems and HIPAA-compliant transactions - implementation of medical management generated $2.2M savings.
  • Set up Project Management Office within Medicare Advantage to manage $25M project portfolio, implemented reporting and risk assessment and 90-day segmenting process to enhance delivery of previously stalled projects - in first quarter, delivered 12 of 12 project segments on time.
  • Reengineered web-based enrollment process for provider of Medicare Advantage health insurance enabling real-time feedback to sales team - reduced number of Confidential processing applications and time required for enrollment from five weeks to eight days, generating cost savings of $1.1M on staffing alone.
  • As interim president, developed network of 55 MDs and application to DHHS for Shared Savings Program and designed Care Coordination Process integrating evidence-based medicine guidelines - achieved $700K cost savings by designing support network and implementing robust care management process.
  • Developed Project Management Office for Fortune 500 enterprise and launched processes throughout organization to include development of Project Management Manual and mentoring process in support of Project Managers. Designed and established secure Internet access for staff and contractors, including project dashboard for senior executives.
  • Collaborated with 16 organizations in design of unified management services organization facilitating sharing of uniform medical record among 600 clinicians. Designed customer requirements and built consensus for concept of uniform medical record. Prepared RFP and headed staff selection process with extensive background and capability verifications.
  • Teamed with medical school faculty surgeons, local surgeons, operating room staff, and anesthesia staff in development of process improvements, improving utilization of operating room resources, encouraging local surgeons to patient admissions at Yale-New Haven Hospital, and maintaining high revenue levels.
  • Identified a closed hospital for reopening and negotiated its use by Loyola residents in staffing clinics of new location. Developed additional location to justify hire of additional residents in Family Practice, Pediatrics, General Surgery, Internal Medicine, and General Medicine for Loyola Medical School in Chicago.

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