SUMMARY:

• Information Technology professional wif 10 years experience in healthcare and finance
• Responsible for defining, managing, planning, developing staff and implementation of IT projects and/or solutions in support of IT business objectives
• Dynamic leader and mentor wif project management and organizational skills
• Experienced in projects requiring expertise in both applications development and infrastructure delivery
• Proven abilities for providing project artifacts including; LOE, Budgets, Project Plans, Project Schedules, Risk/Issue Logs, Status Reports, Charter/Scope, deployment schedule
• Expert skills in the use of IT standard practice and processes, including; PMI, SDLC
• Ability to lead interdisciplinary project teams through influence, teams include; architecture, development, testing, business analysts, system analysts, SIT and UAT
• Planning and coordination of project persons including; business/technical stakeholders, quality assurance, and project oversight
• Experienced communicator capable of customizing delivery throughout all levels of an organization’s

PROFESSIONAL EXPERIENCE

Confidential - Washington

Technical Project Manager

Responsibilities:

• Project manager for workstreams on the KPCC program
• Managed regional reporting remediation workstreams Mid Atlantic, SCal, CO & GA
• Implementing complex projects in a matrixed organization
• Hosted team touch point calls to track work efforts and help resolve issues
• Managed resources across different time zones (EST, MST & PST)
• Partnered wif stakeholders to ensure alignment and visibility or needs
• Engage wif business unit/client leadership to ensure proper expectation setting
• Identify and logging Issues and Risks
• Escalation of critical issues for resolution guidance
• Provided status reporting to internal and external stakeholders - weekly dashboard and guardrail reports
• Implementation of project life cycle methodologies SDLC
• Worked closely wif the PMO to ensure all project artifacts are completed to meet compliance requirements.
• Claims Epic Tapestry AP, Clarity and CDW reporting
• Software: MS project, SharePoint, Excel, Visio, MS Word, IBM Notes, CDW, enterprise date warehouse, claims adjudication: Clarity claims reporting, (EDI - 834, 837) SQL Server, data mart, Medicare, Medicaid, UB04, ICD9/ ICD10, MSDRG, HCFA 1500, CMS 1500

Confidential - Washington

Technical Project Manager

Responsibilities:

• Successful project management of software enhancements to IRIS a regulatory Title 21 CFR Part 11 compliant system
• Managed software enhancements based on business requests to improve ease of use and workflow functionality of an in-house system. .Net/ SQL 2012
• Managed monthly bug fix releases
• Provided status updates and weekly reports to management and stakeholders
• Managed the Software Development Life Cycle (SDLC), including communication, integration, scope, timeline, quality, and risks for all projects
• Host daily Scrum meetings
• SDLC Waterfall / Agile
• Managed Adobe forms and Adobe Lifecycle ALC implication project
• Managed project Storage Array Build: HP 3Par- HyperV5 node cluster setup - WAN config
• Managed in-house and offshore development teams
• Software: MS project, SharePoint, Excel, TFS, .Net, Test Track, Visio, MS Word, Outlook, Adobe Acrobat, ALC (Adobe Life Cycle)

Confidential - Washington

Technical Project Manager

Responsibilities:

• Healthcare Reform projects (HCR) Affordable Care Act (ACA) - Woman’s Contraceptive Religious Exemption (Mandate Project)
• Multi claims platform implementation (6 claims platforms and enterprise data warehouse)
• Enterprise date warehouse, BI business intelligent, ETL extraction, transformation, and loading and reporting
• Coordinate and monitor delivery across cross functional project teams
• Managed application development teams technical design documents (TDD) web applications using J2EE, XML, JSP, DB2 and member portals
• Create project plans and communicate deadlines and expectations to team (MS Project)
• SDLC Waterfall/ Iterative
• Planning workflow of processes to ensure proper integration
• Resolving problems and communicating resolutions and corrective action
• Review time and resource estimates for complex projects
• Manages staff and offshore resources across different time zones and locations
• Project hours manage in PlanView / PV reporting - MS Project
• Requirements, tech responses and test cases managed in RecPro, RQM and Clear Quest
• Claims EDI, membership 835 (Payment and Remittance Advice), EDW Enterprise Data Warehouse, Data Warehouse- Business Intelligence express-script pharmacy drug, client reporting, benefit configuration, IVR,, Customer Service systems, GUI
• Adjudication platforms: (WGS, TriZetto Facets, ACES and CHIPS)
• Software: Microsoft .Net Excel, MS project, Web portals, SQL, PowerPoint, Visio, MS Word, Outlook, Adobe Acrobat, ITIL (Information Technology Infrastructure Library)

Confidential - NY

Technical Project Manager

Responsibilities:

• Managed software design and enhancements of bond optimization refinancing applications
• Managed application development team programming language: C#, VBA - using linear programming approach
• Coordinated wif clients to understand business requirements and facilitate translation to design schema
• Risk identification and mitigation - identify actions needed to address gaps/defects
• Updating stakeholders of status and risks
• Produced project evaluations, scope and objectives
• Responsible for gathering metrics, performance, capacity and project status
• Managed software design and enhancements
• Develop time and resource estimates for complex projects / applications
• Documentation of software for finance applications
• Software: MS Excel, MS project, PowerPoint, Visio, MS Word, Outlook, C#, VBA

Confidential

Project Manager

Responsibilities:

• ICD-10 compliance initiative (Mandate Project)
• Work streams for ICD-10 project: Facets claims, provider portals, Medical management prior authorization and provider communications
• Facets ICD9 &ICD10 dual processing institutional claims
• Upgrade Facets NetworX Standalone Pricer, NetworX Integrated Pricer
• Migration CarePlanner to Alineo MEDecision software
• Responsible for defining project scope and project charter
• Support development of executive presentations
• Develop and distribute status reports including dashboards for Executive Sponsors
• Maintain budget and forecasting - PMO activities
• Drive business decisions and understanding of impacts/next steps
• Supervising activities of Business Analysts (BA)
• Report project status weekly (Clarity)
• Software: MS Project, Clarity, MS Excel, Share Point, PowerPoint, Claims adjudication: (TriZetto Facets), (EDI - 834, 837) SQL Server, data warehouse, data mart, Medicare, Medicaid, UB04, ICD9/ ICD10, MSDRG, HCFA 1500, CMS 1500

Confidential - Phoenix, AZ

Project Manager

Responsibilities:

• Managed projects from inception to deployment and post go live monitoring; MACESS EXP upgrade claims workflow SW, state encounters, Web portal and reporting projects
• Managed projects utilizing MS Project thru entire SDLC lifecycle
• Responsibility for all aspects of small to medium scale projects
• Coordinated and facilitated work breakdown and construction of work schedules WBS
• Monitored and maintained project performance metrics including sizing effort, actual effort and financial expenditures
• Manages multiple projects using staff and matrix resources across time zones and locations
• Developed project plans and ensured milestones were met according to schedule
• Created project status reports through the entire SDLC lifecycle
• Managed in a heavy matrix organization
• Promotes professionalism of all employees, manners, and attitude

Software: MS Project, MS Excel, MS Access, PowerPoint, Claims adjudication: (Diamond, COSMOS and TriZetto Facets), Ingenix, (EDI - 834, 837) SQL Server, Oracle, data warehouse, data mart, Medicare, Medicaid, Citrix, UB04, ICD9, MSDRG, HCFA 1500, CMS 1500

Confidential, Phoenix, AZ

Project Manager / Healthcare Analytics

Responsibilities:

• Managed projects and implementation of operational strategic initiatives
• Projects wif preparation and management of project plans (SDLC)
• Managed projects for claims pend reduction
• Managed analysis projects for tools to monitor clams adjudication
• Managed custom tools and models for use for performance modeling, risk analysis and financial exposure (11 health plans)
• Analysis of claims adjudication process using Six Sigma methodology
• High-level diagnostic tools for claim process monitoring using Six Sigma principals
• Directed development activities of analyst’s which included DSS (Decision Support System)
• Provide subject matter expertise in the analysis and preparation of specifications and plans for development/modification of application business systems
• Recommend initiatives and programs to optimize and improve claims processing
• Responsible for maintaining and enhancing existing automation processes
• Expert use of MS Project, MS Excel, MS Access, PowerPoint, SQL, Visio, MS Word, Power Point, Outlook, Adobe Acrobat R/W, QCSI, TriZetto, QMAC’s, QNXT

Other Software: SQL server 00/05, (EDI - 834, 837), Query Analyzer, UB04, ICD9, Medicare, Medicaid, MSDRG, HCFA 1500, CMS 1500