- An experienced manager and project leader having worked in both staff and consultant positions.
- Overseen a variety of enterprise - level system and strategic initiatives involving multiple technologies and process improvement techniques.
- Work covered industries in healthcare, on-demand software development, vendor system implementations, and electronic publishing, and included the overlapping roles of management, program management, project management, account management and relationship management.
SOFT SKILLS: Waterfall, SDLC, Agile, Kanban, product management, release management planning, project management, program management, account and relationship management, vendor management, business analysis, data analysis, user acceptance testing, contract negotiations, SLA development and management, strategic planning, CMMI, technical writing, PMO management, project portfolio management, PMBOK methodology, contact center processes.
TECHNOLOGIES: Facets Claims, Facets Workflow/Call Center, Optum CES, Data Warehouse reporting, SaaS, IkaClaims, IkaSales, Confidential data warehouse, BI front-end tool (Cognos), Epic Systems EHR, Quality Center, SharePoint, QNXT, Documentum, XplanaLOR (digital asset database), ServiceNow, IVR, XplanaLOR digital content manager, PlanView, Platinum PM, and Innotas enterprise project/resource management systems, Oracle CRM, Dublin Core metadata tagging guidelines, taxonomy development, RDF tagging, SharePoint, MS Project/Server, Excel, Word.
Senior Project Manager
- Support internal business processes and implementation with multiple vendor systems to replace legacy applications for the Connector Authority Call Centers.
- Work with the vendor and CCA IT to provide extracts for internal data warehouse use.
- Manage the delivery of vendor documentation to support CMS and IRS security standards.
Senior Project Analyst
- Perform cost and resource assessments regarding requests for information services projects.
- Work involves coordination with business units, IS service centers, and vendors.
- Work with management to develop scoring standards to determine priority of projects based on support of company’s strategic goals.
Senior Project Manager, Business Integration/Enterprise PMO
- Project management support of business operations (Enrollment, Claims, Clinical Services, Contracting, Provider Relations) as well as Legal, Finance and Customer Service Call Center, with close coordination with IT.
- Projects involved new product implementations, process efficiencies, data analysis, and regulatory reporting, to reduce costs and stay within guidelines
- Regulatory and analytical reports driven from the data warehouse and production databases.
- Process improvement and system modification to reduce pended claims.
- Support for WellSense Plan in corporation of New Hampshire’s Healthcare Protection Plan, and their subsequent inclusion of waivered services.
- Upgrade to Optum CES, and supported upgrades to Facets and Treatment Cost Navigator
- Improvements in claims adjustments, appeals processing, claims turnaround time, and provider satisfaction with claims processing.
- Implementation of Confidential ’s Treatment Cost Navigator tool available via the member portal. Included Call Center protocols for members seeking costs via a telephone call.
Senior Project Manager
- Project manager for provider site rollouts to improve enrollment into Senior Care Option plan.
- Massachusetts and CMS compliance regulations around sales and marketing and outreach activities and documentation.
- Coordination with Atrius Health to identify those members who might qualify for SCO offerings.
Senior Product Release Project Manager Business Intelligence / Implementation Project Manager
- Project, account, and client implementation management / support to health plans converting from legacy systems to IKA SaaS products.
- Sales portal development, with partnership with a health plan in Buffalo.
- ProHEDIS tool development and release management to allow plans to constantly monitor and report for HEDIS measures.
- Claims systems implementation for health plan clients in Pennsylvania and Kentucky, working with client IT staff and affected business units.
- Data warehouse development to support client reporting to track claims processing, sales, regulatory reporting, and predictive analysis.
- Product enhancements for the claims and data warehouse systems through agile release management approach.
- Resource management processes and measures to monitor resource availability and historically track usage.
Senior Project Manager
- Project Management support for various initiatives regarding planning, business process improvement, cost savings, and member and provider communications.
- Cost savings changes within our pharmacy offerings.
- Identification and prioritization of projects within strategic portfolio to help plan efficiencies and new product offerings.
Senior Product / Project Manager
- Oversee projects in support of digital learning.
- Development of the company s digital asset manager database that stored, tagged and compiled digital assets for reuse.
- Multiple projects creating E - books for secondary Spanish language courses, and European and American history through iterative release cycles
- Subject taxonomies and topic maps for chemistry, physics, Calculus, and psychology for use in digital asset databases
- On-line math program that supported the Singapore Math methodology
- Self-study physical therapy diagnosis and exercise on-line program
Confidential, Holliston, MA
Senior Project Manager
- Provided short-term project management support for software development scoping & analysis for a client involved in micro-loans for small businesses based on credit card purchases.
Confidential, Bourne, MA
- Program / Account management support for software/hardware engineering group specializing in leading - edge technologies.
- Network traffic and rerouting software for internet services
- Software to support processing chip testing machines
- Software to drive mobile sales tracking and inventory via Windows CE devices
- Development of an instant messenger for phone company customers
- Prototype software designed to drive a dedicated student notes/class management notebook computer
Confidential, Waltham, MA
Director, Planning Support / Strategic Planning, Information Technology
- Managed a staff of project analysts to support major program work within the company. Projects included:
- Implementation of the Program Management Office to support and lead a large - scale system redesign including Facets implementation and integration, and new development.
- Partnered with business units to set up a model office to help with business process reengineering and integration planning
- Set up of UAT review and product functional delivery process
- Level 3 CMMI standards implementation. Lead consensus and implementation of supporting SDLC process and supporting documentation
- Implementation and administration of Plan View, the enterprise project and resource management system
- New project review process to evaluate new requests for fit into current strategic plan and support of current project portfolio objectives