Nineteen years of diverse consulting experience in project/program management, regulatory compliance and process standardization. Results oriented leader with the ability to work independently or in a team environment to meet corporate objectives. Dedicated focus on promoting excellent communication, transparency and collaboration when executing projects.

CORE SKILL SETS

• Full Life Cycle Project Management
• Business Operations
• Strategic Planning
• Process and Workflow Development
• Regulatory Compliance Management
• Client/Vendor Relations
• Program Management Office
• Management of 40 Employees
• Communication and Leadership
• Medicare Regulations/Operations

Professional Experience

Confidential

Regulatory Program Management Office-Senior Consultant

Responsibilities:

• Interface between business areas and Strategic Initiatives Office regarding all aspects of regulatory project planning, expectations and progress reports. Identify outliers based on portfolio level reports and work with PMs to improve project plans.
• Lead transition from excel based project management approach to MS Project for all regulatory projects. Work with multiple program office structures to develop standardized project templates, guidelines and reporting. Lead training for all PMs and monitor/track efforts to strengthen current project plans and schedules.
• Oversight of the Integrated Master Schedule consisting of 50 individual project plans aligned with the overall regulatory objectives of the bank. Build requirements for customized reports for multiple levels of senior management.

Confidential

Program Management Consultant

Responsibilities:

• Oversight of multiple projects related to the Appeals and Grievances department for the Medicare line of business. Identify process gaps and potential areas of risk with case file processing.
• Design department wide SharePoint solution to manage all aspects of the department's day to day operations and manage all aspects of implementation
• Design and implement a new quality assurance process to replace the existing email based process. Eliminated excess manual tracking and email issues which consumed large amounts of time for staff to maintain. Resulted in reduction in staffing needs for the QA department.

Confidential

Director of Regulatory Implementation

Responsibilities:

• Development and oversight of regulatory change management process for all business functions in the Medicare division. Lead team of compliance staff to ensure that new or changing regulations issues by the Centers for Medicare and Medicaid CMS have been incorporated into national and local business functions.
• Project oversight/monitoring of compliance related initiatives and lead multiple workgroups with business leaders to ensure successful implementation. Perform regulatory analysis and communicate requirements across the organization.
• Assessment and tracking of compliance actions issues from CMS, including impact on STAR ratings and service area expansion efforts. Reporting and communication to executive management on the Past Performance Scoring Methodology which assesses the level of compliance at the legal entity level.

Confidential

Change Management/Medicare Operations Consultant

Responsibilities:

• Perform Operations Assessments to determine gaps in the business area processes, policies and procedures required to meet CMS Medicare regulatory requirements. Ongoing analysis of business functions and QA/monitoring activity against CMS audit guide elements to facilitate integration of process updates.
• Lead the design and roll out of the Regulatory Change Management process using a central repository for regulation management across the entire Medicare division for support of MA, MA-PD and PDP plans.

Confidential

Senior Project Management Consultant IS Program Office

Responsibilities:

• All aspects of project management governance for the Group Underwriting System project.
• Build and manage resource and work schedules for internal and external PEGA development team. Identify cross-functional dependencies and develop reporting dashboards to raise awareness and facilitate communication with Senior Leadership.

Confidential

Strategic and Project Management Consultant

Responsibilities:

Create and implement operational processes for the Health Services division of Care Improvement Plus, a Medicare SNP plan, and its parent company, XL Health. Partner with corporate Directors to negotiate new vendor contracts, build and implement workflow/communication processes, and manage regulatory compliance requirements.

Collaborate with Medical Affairs staff to create project plans, schedules and resource requirements for all active projects for 2006. Develop standard project templates for new program development projects, and provide training for staff on project management techniques.

Confidential

Senior Project Management Consultant IS Program Office 2/01/05 to 11/30/05 Responsibilities: Provide project management guidance and support to internal project managers and project leads. Work with project managers to understand the IS Program Office standard processes for running projects, provide PMO templates and instructions, and monitor adherence to standards. Act as liaison between IS management and Business area clients on cross functional projects. Recommend solutions for conflicting project priorities, and directly manage high priority Information Services projects.

Confidential

Responsibilities

Develop strategies and lead all project initiatives to reduce substantial processing backlog of Provider credentialing and Re-credentialing files due to change in regulatory requirements. Resulted in a 50 reduction in open inventory and achieved compliance with NCQA accreditation standards.

Perform complete operational redesign of the Credentialing department, including workflows/reporting mechanisms, and filled in as acting manager of 40 staff during management transition.

Confidential

Responsibilities

Lead representatives from 13 departments in the Health Services division and the Director of Compliance to develop business requirements based on the operational impacts of the HIPAA regulations, communicate those changes, manage project plans, and write division-wide communications.

Confidential

Project Management Consultant

Responsibilities: Provide all levels of project management consulting to clients, including project scoping, requirements and project plan development, and liaison between client and outside vendors/clients. Clients are listed below.

Confidential

Project Scope: Work with the newly formed PMO to implement standardized methodologies, provide mentoring for junior and mid-level project managers, and create WBS templates. Assist in the creation of tools to manage client communications, resource management, and status reporting.

Confidential

Project Scope: Review current relationships between CSC and DuPont, including contractual requirements, support initiatives and metrics management. Recommend solutions to operational challenges and act as lead during development and implementation.

Confidential

Project Manager/Business Analyst Responsibilities: Provide IT project management and business analyst consulting services to clients with a focus on the pharmaceutical industry. Clients are listed below.

Confidential

Project Manager Global Help Desk Migration Project

Confidential

Consultant - Business Continuity Planning

Confidential

Project Manager Global PC/Laptop and MS Office Suite Upgrade

Confidential

Business Analyst

Confidential

Title: Regional Manager /Northeastern Seaboard

Confidential

Title: Senior Compliance Consultant