TECHNICAL SKILLS:

Information Systems and Technology: Workday, FTP, EDI, Clearinghouse transaction processes; HIPAA transactions (ANSI X12 837, 270/271, 276/277, 278, 835 and 275, Dental claims/inquiries), ICD9 and 10 coding transactions, IBM Services, BCA ITS releases, Blue Card, Oracle, Business Objects, IVR, Windows, Unix, Citrix, VMWARE, DB2, Data Center, Migration and Warehouses, Web and E - Commerce systems, legacy mainframe systems, MMIS, Financial Systems, COBOL, DB2, JCL, Web development (3 tier system), SQL, JCL, Clarity, Planmate, TFS, TrackIT SharePointSoftware: MS Project 2003, 2007, MS Project Server/Enterprise Server, Quality Center, Visio, PowerPoint, Access, Word, Excel, Outlook, Lotus Notes, SharePoint, TIBCO, Informatica, FoxPro, Power BI, Tableau, BI360

PROFESSIONAL EXPERIENCE:

Project Coordinator/Consultant

Confidential

Responsibilities:

• Plans and executed Organizational Design Project
• Leads meetings
• Created and re-designed SharePoint pages for HR department and Global sites
• Works with team members on Business Process modernization
• Created invoicing pages for budget tracking for Human Resource operations

Confidential

Senior Project Manager

Responsibilities:

• Plans and executes multiple large projects for Global Health Insurance products.
• Leads business to conclusions and mentors through UAT completion and production sign off.
• Leads IT and Infrastructure teams globally to upgrade Taxes on premium base on new laws in Canada
• Works with Legal and Compliance
• Mentors business teams through User Acceptance Testing.
• Mentors and leads new agile teams.
• Successfully led 5 teams to implement a new Care Management model; changing from a Fee for Service model.
• Successfully worked with the following areas to determine the best requirements and systems to implement Care Management: Marketing, claims, third party vendors, providers, audit and business intelligence, payers, legal, statistics, payroll, and case managers to determine risk stratification.
• Met with CMS monthly.
• Implemented online changes front end GUI for enrollment and providers.
• Project included web changes, mobile app changes and training.

Confidential

Senior Consultant/Strategist

Responsibilities:

• Plans and executes the process of implementing Business Intelligence and Business Analytics through-out the organization.
• Leveraging BI360, SQL, Power BI and Tableau for the prototype.
• Reviewing organization maturity level for BI and BA.
• Created prototype to display the possible data analytics trending
• Successfully builds relationships with senior stakeholders throughout the company for buy-in to project
• Manages vendor relationships and invoicing.
• Acts as SME and Lead analyst as needed with off shore partners.

Confidential

Senior Project Manager

Responsibilities:

• Organized foundational projects which involved changing the Infrastructure and moving data from all platforms across the Confidential .
• Created ETL process that sent clean data to new warehouse. This provided trend data in analytics for Retirement and Case Management. The process included data clean up, data definition (across the company), road-mapping, creation of dashboards and the ability to pull data as needed ad-hoc.
• Successfully worked with Retirement Assets and Business Intelligence teams to produce a product for Senior Executives to pull statistical data as needed
• Worked with Data modelers and Architects to ensure clean infrastructure and hardware without impacting other clients
• Introduced Agile methodology to the team and department.
• Used TFS to organize sprints, backlogs, and user stories.
• Completed first launch of the Retirement Plan Assets (first data mart).
• Successfully set up JAD and WBS sessions.
• Performed BA and SCRUM Master Functions as needed.
• Managed vendor relationships (outward facing) and internal relationships.
• Responsible for ensuring effective change management occurred in the adoption of the new platform.
• Completed comparison on PowerBI Tools, Cognos, and back end Microsoft Platforms and IBB.
• Used TrakIT and TFS to track projects and project metrics.
• Worked with teams to roadmap priorities and set up back logs.
• Began CRM analysis using SAP and reviewing marketing strategies as first in line.
• Used BPRM practices to set up a new ITIL construct for retirement benefits.

Confidential

Senior Project Manager

Responsibilities:

• Implemented Workday modules including HCM and Financials.
• Implemented Workday which included bringing the accounting, consolidation, planning, procurement projects, reporting and analytics into one financial management system.
• Used BPRM successfully linked business strategy with IT / people based operations.
• Worked with end users after GO LIVE performing UAT Testing ensuring all functions within the HCM and Financial Modules were working in accordance to the BRD.
• Provided an integrated approach from design to execution and control using process models.
• Successfully lead teams to identify tools and processes due to audit findings.
• Successfully organized the development of processes within the FDA and Quality relevant compliance.
• Ensured quality templates were re-worked in accordance to the audit.
• Responsible for leading a CAPA audit with five project managers under the program. This occurred while implementing new ITSM methodology and standardized tools, processes and Quality Assessment program.
• Ensured SAP tool set was standardized.
• Acted as Scrum Master for the project which encompassed 24 sprints and debugging of the Workday Modules.

Confidential

Senior Project Manager

Responsibilities:

• Created new infrastructure for Workday. Implemented structures and process flows for transactional data that providers needed to follow up on commissions
• Implemented Workday for HCM and Financial modules. Managed HCM and processes including key features such as:
• Workforce planning
• Replaced broker system after using data analytics to determine structure and polling of data via Cognos
• Reviewed current state of provider system and replaced with BPRM structure using Microsoft .Net a core processer for claims and patient reporting
• Set up GUI browser for providers to be able to see where their claims were in the process.
• Worked with key HR, IT, and Business Stakeholders to identify proper payroll and timekeeping requirements.
• Brought in Vendors for assessments in handling B2B with providers and licensing practices in several states.
• Implemented ServiceNow for provider and user interface including executive dashboards.
• Implemented PMO Office Standards and BA Center of Excellence.
• Analyzed infrastructure methodology while working with both CIO, Senior Management, and Legal/Governance teams.
• Successfully implemented the standard for which the IT and Business Customers were trained to follow for projects.
• Acted as Scrum Master for Agile projects in multiple infrastructure projects.
• Reviewed and weighted ServiceNow for the implementation of IT consolidated processes for change management, claims, and reporting.
• HPP successfully bid for additional Medicaid and Medicare work and determine that fee for service should be replaced with Care Management.
• Successfully lead the team to leverage existing systems for Care Management using data integration, patient stratification & Intake, upgrading care coordination based on patient engagement and used performance management embedded analytics to determine the Care Management outcomes and risks.

Confidential

Senior Project Manager

Responsibilities:

• Successfully implemented new HCM software and application EPICOR with features such as:
• Mobile access through Workday
• HCM through Workday
• Transactional data (after migration and Cloud rules)
• Successfully led a team of eight project managers to fully implement a new ITIL, new methodology including change control while following quality management. After completion, these processes were integrated into the PMO Office which was in need of clarity.
• Developed project plans, risk plans, execution plans, tollgate check lists, and forecasts, where she used Agile Methodologies.
• Led ERP project for Financials using SAP to develop financial reporting and audit procedures.
• Executed BPRM for Vendors on a regular basis, experienced with off shore resources as well.
• Centralized all documentation on SharePoint (used as source for PMO)
• Used ServiceNow for Incident Management and Service Mapping while successfully moving rules to the Cloud.
• Tailored analytics to position Confidential Blue to expand Medicare Services from a fee for service model to a care management model. Worked with providers, ACOS and dedicated team to provide the algorithms needed for risk stratification on patient data.
• Tailoring tools including implementation of ServiceNow for ITSM modules.
• Worked with HR, IT, and Senior Management to create new job descriptions, new pay grade (competitive market) and determining market value of employees with benefits vs. contractors.

Confidential

Senior Project Manager

Responsibilities:

• Successfully developed and led project team to organize software implementation.
• Successfully reviewed eight projects for compliance and returned over two million dollars in budget funding for 2015.
• Successfully integrated the eight projects on the SharePoint site for easy maintenance and tracking of documentation and compliance, suggested looking a further tools such as Clarity or Planmate.
• Successfully read new RFP and determined course of action for Blue Distinction and CMS Out of Pocket Max projects.
• Delivered Practice Management Application Suite (BPRM) including:
• A browser-based user interface
• A unified One View architecture for RPMS
• Tightly linked to RPMS patient and clinic data
• A consolidated Patient Registration and Scheduling interface

Confidential

Senior Project Manager

Responsibilities:

• Integrated the various AIDS HealthCare, (they are active in four states) she recommended Workday for further solution since the RAM software cleaned up the data but, did not offer statistical analysis, transactional analysis, and various other reports that are available in Workday.
• Developed and let a team and program managed HIV and AIDS clinic updates and changes to their software.
• Standardized clinical care templates and PMO templates in an effort to have a cohesive PMO across the country.
• Documented requirements including detailed functional and non-functional for team to use and develop test cases.
• Successfully developed and led project team to organize software implementation on the client site.
• Strategically organized all areas of Client Medicare and Medicaid on client site. This created a collaborative environment for Business Requirements Sessions which allowed them to stay on budget and within scope
• Identified key Medicaid and Medicare requirements per each State and CMS rules and regulations.
• Implemented the use of Agile within company acted as Scrum Master
• Integrated the RAM software with the AIDS Health Care Technology to implement Care Management in Dade and Monroe Counties. (California Medicaid/Medicare has different rules)

Confidential

Senior Project Manager

Responsibilities:

• Successfully developed and implemented across legacy systems to new Provider Portal across (14 states creating Provider information files per each state DHH requirement netting estimated cost savings of $4 million).
• Developed a team to analyze the current practice in the PMO and best practices.
• Responsible for the implementation of the new process across the company.
• Strategically operationalized project to grow for future business.
• Developed BI line for Medicare Advantage products in order to follow trends.
• Successfully lead the Re-Procurement of a State Contract including updating the systems, software, timelines, and business process improvements to meet or exceed the new requirements.
• Achieved new business process model for processing Claims with third party vendors using an ERP model with SAP.

Confidential

Senior Project Management

Responsibilities:

• Successfully developed, refined, and documented requirements for ServiceNow customized open source code within budget and on time.
• Attended customer requirement-gathering, analysis, and status meetings.
• Identified and implemented opportunities for process improvements and technology upgrades.
• Reviewed Functional/Transaction Design Documents created by developers.
• Coordinated back-office integration with enterprise applications.
• Supported and participated in test execution and other QA activities.
• Supported the delivery of product and application demonstrations and presentations.
• Provided or supported application training for clients as required.
• Escalated issues/risks to management.
• Tested ServiceNow application heavily modified for ETS systems.
• Supported and analyzed bugs and production issues.
• Familiarity with social media and Web 2.0 technologies.
• Supported and developed BPM documentation for new system tracking bug/production issues.
• Migrated data from various DataMarts to Informatica Warehouse leveraging existing DataMart to supply the need for statistical reporting across the company.
• Developed business practices for new statistical reporting.

Confidential

Senior Project Manager

Responsibilities:

• Implemented Workday for Human Capital Management for the global partners and vendors.
• Implemented Workday for mobile apps for adjusters out in the field.
• Supported and participated in test execution and other QA activities.
• Successfully developed, refined, and documented requirements for Property and Casualty Brokers and Marketing teams to create internet applications (four major projects).
• Attended customer requirement-gathering, analysis, and status meetings.
• Identified and implemented opportunities for process improvements and technology upgrades.
• Developed team relations with senior executives in both Re-Insurance, Off-Shore Marine, and Billing.
• Coordinated back-office integration with enterprise applications.
• Migrated provider data marts, worked with Type one and two dimensions, Fact Tables, Star Schema design, Operational Data Store (ODS), leveling and other Data Warehouse concepts while driving project.

Confidential

Senior Project Manager, Consultant

Responsibilities:

• Successfully implemented new Life and Auto products for American Family Insurance using diverse methodologies and technologies; i.e. Mainframe, XML, DB2, COBOL, and Web Services.
• Property and Casualty - Created new Agent Facing portal pages for Providers to submit new applications for Life Product.
• Delivered project on time and within budget.
• Assigned and achieved the implementation of ServiceNow for modules chosen by the stakeholders.
• Acted as Scrum Master to complete and upgrade over 111 known defects over a one month period.
• Experience with full development cycle of a Data Warehouse, including requirements gathering, design, implementation, and maintenance.
• Worked with type one and two dimensions, Fact Tables, Star Schema design, Operational Data Store (ODS), leveling and other Data Warehouse concepts.

Confidential

Senior Project Manager, Consultant

Responsibilities:

• Completed application development and implemented HIPAA5010 and expansion for ICD10 Dental products. Coordinated and organized onsite and off-shore teams for project initiation, implementation and change management.
• Acted as Primary SME liaison for vendors and business to the technical team.
• Managed business and vendor expectations.
• Led requirements elicitation and documentation.
• Collaborated and organized meetings with team onsite and off shore for all phases of the project (Initiation through Implementation and Change Management).
• Property and Casualty expansion of new contract with substantial government program requiring Depart of Defense Clearance in order to handle data.
• Works with data modeler for infrastructure changes for new EDI transactions.
• Add new Business Process Model for new dental line and integrated into business strategy for expansion.