CAREER SUMMARY

• Over 30 years of in-depth Information Technology IT experience in the Healthcare Industry. Accomplishments span clinical, financial, technological, complex systems and enterprise
• architecture, HIPAA and other healthcare compliance, development, implementation, and integration projects spanning numerous platforms and operating systems.
• Project and program management, structured architectural design, and functional and technical project requirements definition.
• Real world experience with a variety of methodologies throughout the full range of the standard development and acquisition lifecycles.
• Current focus includes widespread EHR implementation, Healthcare quality and medical informatics, National Health Information Network NHIN , Integrated Healthcare Exchange IHE , HL7 and other standards for interoperability, CONNECT and Health Information Exchanges HIE , along with the transition from HIPAA 4010 to 5010 and from ICD9 to ICD10.
• Strong interpersonal and communication expertise, training and presentation skills that deliver results.

PROFESSIONAL EXPERIENCE

Program Manager

confidential

• Design, develop and document administrative and program fulfillment processes and procedures to satisfy the requirements of the ARRA HITECH grant program for HIT Regional Extension Centers.
• Developed EHR implementation and meaningful use project roadmaps and template project plans to be used by field representatives assisting over 1300 primary care providers in the state of Tennessee to achieve meaningful use of health information technology HIT .
• Developed and delivered customized training modules to program team on project management and use of toolkit components to ensure program integrity and consistency.
• Serve as the program's Subject Matter Expert SME for knowledge areas including the ARRA HITECH legislation, final rules for Meaningful Use and Certification, and efforts toward integration and interoperability via standards such as HL7, SNOMED, and LOINC, HIEs and gateways such as CONNECT.
• Manage access and correct usage of a Customer Relationship Management CRM provided by the Office of the National Coordinator ONC to facilitate grantee documentation of program progress.
• Developed graphical performance dashboards and management reporting to track progress and facilitate rapid response to issues at the Director and Regional Manager level.
• Actively participated in and contributed to ONC Communities of Practice and Workgroups to develop best practices and toolkits for Project Management and Implementation co-lead and
• Vendor Portfolio Management.
• Technologies: Electronic Health Record EHR , HL7, SNOMED, LOINC, HITSP, IHE, CCD, Health Information Exchange HIE , National Healthcare Information Network NHIN , CONNECT, ICD9, ICD10, MS Office Suite, VISIO, Salesforce CRM, DreamTeam PM for Salesforce, PMBOK.

Senior Consultant/Project Manager

confidential

• Produce project management deliverables, monitor and report project status, risks, and issues, update project plan, schedule, and scope as needed.
• Perform in-depth needs analysis and prepare requirements for a Medicaid-focused Electronic Data Warehouse EDW and Business Intelligence BI system.
• Serve as the project's Subject Matter Expert SME for knowledge areas including CMS planning document needs, Medicaid business and IT processes and functions, and the CMSO's Medicaid IT Architecture MITA , and Integrated Healthcare Exchange IHE topics such as the NHIN and government agency efforts to become integrated via standards such as HL7 including the CCD and the ARRA-HITECH meaningful use standards, and gateways such as CONNECT.
• Conduct and document interviews and JAD sessions to collect EDW needs and requirements. Participate in the development, delivery, and acceptance of all project deliverables.
• Technologies: Electronic Medical Record EMR , Electronic Health Record EHR , EDW/BI, DSS, MITA, DICOM, HL7, HITSP, CCHIT, IHE, CCD, Web Services, Health Information Exchange HIE , National Healthcare Information Network NHIN , CONNECT, ICD9, ICD10, MS Office Suite, MS Project, VISIO, PMBOK.

Business Owner/Manager

confidential

Managed day-to-day operations, staff, payroll, and veterinarians in boarding kennel, grooming, and veterinary business.

Senior Business Analyst

confidential

• Performed as is and to be business process architectural analysis for claims subrogation third party liability business area for combined provider/payer organization in preparation for major legacy system replacement.
• Conducted systems needs analysis and documented requirements for replacement application system in context of architectural migration.
• Analyzed and documented existing subrogation system integration and designed more efficient standards-based integration for planned systems.
• Developed use cases, workflow, business process, and data flow diagrams, and prepared final development project proposal document and project plan.
• Technologies: .NET, SQL Server, Web Services, MS Office Suite, MS Project, VISIO, ANSI X12, HIPAA, ICD9, HCPCS.

confidential

• Conducted state-wide analysis of business architecture processes and systems in use across all state, county, and municipal public health business units using a variety of structured analysis techniques such as use cases, documenting business rules, transaction mapping, and decision tables.
• Identified existing and emerging RHIOs and HIEs in the state and elsewhere, in addition to the existing Public Health Information Network PHIN , and captured architectural and data requirements for new public health system.
• Interacted with management/administrative, clinical, vendor, and staff IT resources.
• Performed JAD facilitation during state-wide clinic site visits to elicit new system requirements, including electronic medical record EMR and administrative and surveillance functionality.
• Performed gap analysis of requirements with existing systems.
• Researched potential technical solutions for requirements with multiple healthcare software and system vendors. Assessed products for adherence to IHE and HITSP standards, NHIN and HIE capabilities, Master Patient Index MPI capabilities, and HIPAA compliance.
• Identified all integration needs within proposed solution modules/systems and other state systems and mapped HL7/CCD and HIPAA transaction standards to specific interfaces required.
• Managed two on-site senior business analysts and various off-site and off-shore resources to produce nine document deliverables required by the client.
• Made recommendations for solutions to meet requirements, and produced proposed plan and 5-year projected budgets for implementation and production costs based on recommendations.
• Managed and met client expectations for deliverable contents and quality for this high-profile enterprise architecture project.
• Technologies: Electronic Medical Record EMR , DICOM, HL7, HITSP, IHE, CCD, Web Services, Health Information Exchange HIE , National Healthcare Information Network NHIN , Public Health Information Network PHIN , ICD9, ICD10, MS Office Suite, MS Project, VISIO,
• PMBOK.

confidential

• Gained expertise in CMS' Medicaid Information Technology Architecture MITA initiative through training with MITA team, attending conferences, participating in NMEH framework 2.0 design meetings, and studying all written materials and enterprise architecture literature.
• Coordinated resources and planned project activities for scheduling workload related to producing deliverables during the implementation of the MMIS Medicaid Management Information System .
• Performed business process modeling, and MITA gap analysis and state business architecture self-assessment for the Iowa Medicaid program, and developed reusable methodology for processes.
• Researched and assessed applicability of MITA goals of achieving a Service Oriented Architecture SOA to integrate all system components using shared web services conducted across an Enterprise Service Bus ESB , and assessed multiple systems' adherence to healthcare information standards emerging for use in systems integration and integration via the NHIN.
• Monitored on-going developments in MITA, providing feedback and input to MITA team products.
• Developed and delivered MITA training to state and vendor staff in a multi-vendor MMIS implementation.
• Performed architectural assessment and technical review of all Iowa state Medicaid Management Information System MMIS project requirements and design documentation for implementation project, and provided recommendations leading to establishment of a Medicaid enterprise architecture plan aligned with MITA.
• Member of Savage Mill Group states' advisory team to CMS' MITA team .
• Presented methodology for Iowa's MITA state self-assessment at MMIS Conference 2005.
• Technologies utilized: MITA, ESB, SOA, HIPAA, ICD-9-CM, NDC, DICOM, NHIN, Serena TeamTrack, MS Office Suite, VISIO, Project Workbench.

confidential

• Taught Introduction to Healthcare IT classroom course for senior-level students in Healthcare Administration degree program.
• Technologies utilized: MS Office Suite, proprietary UOP web tools.

confidential

• Established communication with fiscal agents for multiple state Medicaid plans, developed test plans and conducted tests of HIPAA-compliant claims transactions. Made adjustments to implementation schedules to reflect progress in testing process.
• Gained understanding of complex integration used to process HIPAA transactions through a major healthcare clearinghouse.
• Designed changes for C programs, scripts, and parameter files to customize solutions for payer variations.
• Transmitted converted test files and retrieved results for analysis.
• Developed training materials and conducted training for Business and Quality assurance analysts. Technologies utilized: HCPCS, ICD-9-CM, HIPAA, UNIX, C, ClearCase, TeraTerm Pro, Gentran,
• Validator, and Claredi.

confidential

• Facilitated JAD requirements definition and validation sessions for HIPAA-compliant replacement Medicaid Management Information System MMIS system with state staff and EDS developers in highly-charged political environment.
• Consulted with EDS managers and multiple state agencies to plan training curricula for system implementation for interChange MMIS, and analyzed and documented current and to be business processes as input to training modules.
• Planned and coordinated training workload for over 300 trainees and 5 trainers, including physical and technical infrastructure set-up of classrooms and implementation of training applications based on complex system architecture.
• Reviewed user documentation and test cases under development, and delivered training modules and provided consultation during user acceptance testing phase for QA.
• Developed curricula and training materials and delivered training for multiple MMIS components including Reference, Third Party Liability, Fraud and Abuse, Imaging/OCR, Call Center/Customer Service, and Recipient.
• Technologies utilized: HCPCS, ICD-9-CM, NDC, DICOM, MS Project, MS Access, VISIO, Oracle, Avaya PBX/ACD, IVR, RRI, interChange, Business Objects, Data Warehouse, and DSS.

confidential

• Provided project planning and initialization, data mapping and gap analysis, consulting for IT services organization servicing nation-wide Delta Dental Plans and Medi-Cal.
• Developed scoping level HIPAA implementation project plan.
• Assessed integration issues with two legacy systems and a client/server implementation under development to produce conceptual architecture, documented use cases.
• Created presentation materials and participated in Client Conference HIPAA Roundtable sessions.
• Developed HIPAA Impact Assessment methodology and Conceptual Design for insurance claims processing and eligibility systems remediation for 5 million compliance project.
• Authored and presented Technical HIPAA Awareness Training for over 100 division staff members and received outstanding attendee evaluations.
• Technologies: EDI, e-commerce, ANSI X12, HIPAA, CPT-4, MS Project, MS SQL Server, CICS, VSAM, COBOL, IBM Mainframe, Rational Unified Process RUP , translation gateways.

confidential

• Performed in-depth analysis of business and data requirements using ANSI X12.N EDI standards and recently finalized HIPAA regulations. Developed solution designs and documented requirements and specifications in a multi-regional, multi-platform environment for a large combined health plan and health care provider organization.
• Analyzed and documented all HIPAA Code Set requirements.
• Developed Conceptual Data Architecture Model for multi-platform multi-site integration for EDI translation and communication of HIPAA transactions.
• Detailed functional decomposition of all HIPAA transactions.
• Technologies: EDI, XML, e-commerce, ANSI X12, HIPAA, ICD9CM, CPT4, UNIX, MS Project, Lotus Notes, MS Access, DB2, Oracle, ERWin, BPWin, ABT Project Workbench, VISIO.

confidential

• Managed internal move process for departmental restacks and new space acquisition and remodeling, coordinating with system users in each department to ensure zero downtime.
• Planned and executed systems infrastructure accommodations, including LAN/WAN and telecommunications, desktop and shared peripheral access, and ergonomics.
• Managed internal and third party resources.
• Moved over 300 individuals in 15 departments over 4 buildings..
• Technologies: Windows NT, NT Server, PCs MACs, CSUs/DSUs, Server Room Configuration, 10BaseT, Cabling Configuration, Domain Architecture, LAN to Mainframe Integration, Lotus Notes, MS Project 98, VISIO, VRU, Call Center.

confidential

• Analyzed, developed architecture, and managed the implementation of all systems integration requirements between a turnkey client/server Workers' Compensation Bill Review system and Insurance Company clients' mainframe systems.
• Designed and managed certification and implementation of EDI electronic data interchange reporting.
• Researched and documented electronic reporting standards EDI for all 50 states, as well as upcoming Federal HIPAA standards.
• Developed EDI specifications, and testing and certification processes as enhancements to Bill Review system.
• Analyzed and wrote specifications for integrated Claims Management and Case Management
• modules to complement Bill Review system.
• Technologies: ANSI X12, HIPAA, ICD-9-CM, CPT-4, UNIX, MS Project, LAN to Mainframe Integration, Power Builder, Sybase, IMS, COBOL, DB2, SQL, Internet, Client/Server, Middleware, Expert System, 3-tier architecture.

confidential

Project Manager, Technology Evaluation and Consulting

• Provided consulting services to ITS and Clinical and Administrative departments throughout the Northern California region including project management, full development life-cycle methodologies, technology and supplier evaluation, and implementation management. Managed 6 direct reports, all senior consultants and analysts.
• Developed distributed architecture proposal to obtain 2.5 billion in funding for Northern California regional infrastructure to accommodate electronic medical charting and tracking.
• Administered 15 million corporate contract with Sybase.
• Installed Sybase as a component of the IVR system and provided consulting to the Northern California Call Center.
• Developed and presented Electronic Commerce EDI white paper to regional senior management. Evaluated PACS digitized radiology systems and vendors, and developed proposal for 12
• million multi-site pilot project.

Manager, Information Services Innovation Support

• Provided consulting in the areas of project management, programming and integration services for Innovation Projects in clinical, administrative and technical departments.
• Established and developed technical team and development environment for introduction of new information technology architectures at regional data center.
• Managed 10 direct reports including senior analysts, programmers and administrative resources. Serviced up to 50 simultaneous projects.
• Implemented first client/server development environment at data center. Established first server to host connectivity at data center.
• Initiated and sponsored internal technical seminars open to all 700 employees at data center to introduce new technologies such as client/server, object-oriented analysis and design, voice recognition, wireless telecommunications, hand-held PCs and digital ink.

Senior Business Analyst, Systems Development

• Performed needs analysis, systems requirements definition, technology and vendor evaluations, project proposals, cost/benefit analyses, and project management and implementation services to clinical departments throughout the Northern California region.
• Selected, customized, and implemented an innovative multi-site Genetics system 1.7 million which integrated patient information for clinical, laboratory and administrative purposes.
• Established the first proof of concept test lab at the data center, and negotiated donated or loaned components from vendors for specific testing purposes.
• Developed technical concept and financial analysis of mainframe appointment scheduling, notification, and tracking system for use in other Kaiser regions 4.5 million investment to be
• recovered via charge back over 4 years .
• Technologies all Kaiser Permanente : PCs, MACs, client/server, UNIX, IBM RS/6000, Pick, Pick Blue, DB2, Sybase, SQL Server, Data Warehousing, Document Management Systems, EDI, e-commerce, Project Workbench, MS Project, T1, ATM, OOA, OOD, Tandem, DEC VAX, IEF, GUI, ANSI X.12, MVS, RAD, VRU, Call Center, 3-tier architecture, n-tier architecture, PACS.

confidential

• Analyzed, developed, documented, installed, and trained users on PC-based back office management tools and the interfaces to a turn-key Credit Union software package.
• Developed 8 modules to assist CU managers with asset analysis, loan management, credit assessment, etc., using data communication scripting after data extraction from DEC VAX custom relational database.
• Technologies: DEC VAX, VMS, Pascal, Lotus, Microfocus COBOL, ASM, Telecommunications Scripts.

confidential

• Provided hardware and software solutions to a variety of clients including hospitals, attorneys, accountants, auto wholesalers and small manufacturers.
• Converted 20 years of international virology data 300 K samples from flat file FORTRAN system to Revelation relational database for St. Jude Children's Research Hospital.
• Technologies: Banyan Vines, Novell Netware, ASM, COBOL, Rbasic, Basic, Systems Integration, CASE tools.

confidential

• Analyzed, designed, documented and implemented Medical Records Management and Admissions/Discharge/Transfer including new Master Patient Index MPI systems for major multi-site regional hospital.
• Wrote technical and end user documentation, and conducted user training. Analyzed and implemented programs to accommodate centenarian patients.
• Technologies: COBOL, CASE tools, ICD-8-CM, CPT-4.