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Mmis Product/program Manager Resume

SUMMARY

  • He is a Senior Health Information Technology Consultant with over thirty (30) years of experience with federal, state, local government and commercial healthcare.
  • He has been a trusted advisor to senior management, including C - Suite executives, at the Veterans Health Administration, state Medicaid agencies, large commercial health plans and healthcare provider organizations.
  • He has worked with top tier clients on strategy development and execution.
  • He has directed the planning, implementation and operations of multiple, mission critical information systems, responsible for project budgets in excess of $50M and teams of over 200 resources.
  • He is well versed in both Agile and Waterfall systems development methodologies and in multiple technical and solutions architectures; including business/data modeling, data integration, cloud computing, Software as a Service (SAAS), Business Intelligence (BI)/Data Warehousing, Service Oriented Architecture (SOA), ITIL (Information Technology Infrastructure Library), Medicaid Information Technology Architecture (MITA) and Electronic Data Interchange (EDI).

PROFESSIONAL EXPERIENCE

Confidential

MMIS Product/Program Manager

Responsibilities:

  • Serving as a senior business and technology consultant to Confidential for the development and implementation of the next generation, components based Medicaid Management Information System (MMIS).
  • Serving as a Nexus Scrum Master, directing fourteen domestic and global Agile/Scrum teams developing the Provider Enrollment/Management product components.
  • Utilizing advance management tools, Microsoft Visual Studio Team Foundation Server, to control and manage Features, User Stories and Product Defects development and delivery.

Confidential

Lead/Project Manager

Responsibilities:

  • Leading the strategic planning and implementation of a statewide health and human services business intelligence solution, including multiple source data integration, data cleansing/governance and systems architecture to support advanced reporting and analytics.
  • Responsible for balancing business priorities, developing delivery models, creating resource models, budget management and maintaining quality.
  • Provide project management, serve as subject matter expert and manage the business analysis for the State of Ohio’s implementation of an enterprise-wide health and human services (HHS) business intelligence system.
  • Coordinate multiple vendors to design and deploy a robust and flexible business intelligence technical architecture; integrate multiple data sources and provide advanced reporting/data analytics.
  • Directing a comprehensive Data Management program, including Data Governance, Data Quality, Metadata Management, Release Management and interface with Master Data Management.
  • Directing the design and implementation as Scrum Master using Agile/Scrum approach to source to target mapping; extract, transformation and loading (ETL) processes; creation of multi-tiered Relational, Data Vault and Dimensional data models; design and implementation of data marts and implementation of pre-defined and ad hoc reporting.
  • Integrating data from key operational systems, including the Ohio Medicaid Management Information System (MMIS), Pharmacy Benefits Manager (PBM), Integrated Eligibility, Medicare, Home Healthcare Electronic Visit Verification (EVV), Medical Management, Financial Management and other State agency/commercial data sources, into relational and dimensional data models.
  • Supporting transition to healthcare value-based reimbursement for the Ohio Medicaid program.

Confidential

Manager

Responsibilities:

  • Managed business/information systems projects and served as Subject Matter Expert (SME) for large healthcare organizations.
  • Provided project management and technical leadership to leading large healthcare organizations implementing the Patient Protection and Affordable Care Act (PPACA) and the Healthcare Insurance Portability and Accountability Act (HIPAA) requirements.
  • Responsibilities included planning information systems consolidations, full lifecycle testing of ICD-10 application systems modifications, Senior Project Manager for large health plan implementation of the Medicare/Medicaid Dual Eligible Demonstration and served as a HIPAA transactions/EDI technical Subject Matter Expert (SME), Solutions Architect and Senior Project Manager for a large government payer organization.

Confidential

Technical Delivery Leader and Project Manager

Responsibilities:

  • Led business and technical analysis, as well as provided project management for healthcare organizations implementing state-of-the-art claims processing, EDI and business intelligence/data warehouse systems.
  • Directed delivery of an advanced highly customized Medicaid Management Information System (MMIS), with responsibility for client acceptance and satisfaction.
  • Directed a large team of over 200 Systems Managers, Team Leaders, Business Analysts, and Systems Engineers;
  • Solution included Service Oriented Architecture (SOA)/Enterprise Service Bus (ESB-TIBCO);
  • Commercial Off The Shelf (COTS) product integration;
  • Extract, Transformation and Loading (ETL-Informatica) tools;
  • Data warehousing/decision support functionality;
  • Standards based Electronic Data Interchange (EDI); and,
  • Customer self-service Web portals.
  • Responsible for leading large healthcare organizations implementing advanced information management, business intelligence and data warehouse solutions.
  • Documented business requirements and data sources for data warehouse implementations.
  • Developed testing strategy and led the test case development, as well as the test execution of an enterprise-wide membership Operational Data Store (ODS).

Confidential

Manager

Responsibilities:

  • Managed critical information systems projects and served as Subject Matter Expert (SME) for large healthcare organizations.
  • Led large healthcare organizations in the implementation of advanced electronic commerce and data management applications, including compliance with the Healthcare Insurance Portability and Accountability Act (HIPAA) requirements.

Confidential

Senior Manager

Responsibilities:

  • Managed the Healthcare Insurance Portability and Accountability Act (HIPAA) compliance projects for healthcare providers, integrated delivery networks and clearinghouses.
  • Developed HIPAA 4010 standard electronic transaction implementation strategies, including technology architecture and vendor partnering.
  • Completed detailed data element mapping to implement automated coordination of benefits processing for national provider network.

Confidential

Chief Technology Officer (CTO)

Responsibilities:

  • Built a technology delivery organization from the ground up to deliver state of the art, fully integrated e-Commerce applications for state/local governments.
  • Responsible for defining and managing project scope, budgets, constraints, schedules and client deliverables.
  • Completed requirements analysis, systems design/architecture and testing of custom software.
  • Directed the development of Web portals incorporating e-Commerce applications.
  • Directed the development and operations of a state of the art, secured data facility for application hosting, software development and internal network/office automation management.
  • Key clients included:
  • Ohio Bureau of Motor Vehicles (OPLATES)
  • City and County of Honolulu
  • Florida Department of Management Services

Confidential

Technology Services Manager

Responsibilities:

  • Directed all aspects of $54M outsourcing project of the Ohio Bureau of Workers Compensation (BWC) Health Partnership Program; responsible for all aspects of project management, including budget management, scope management, risk/issues management and client communications.
  • Project included facilities management; customized software development and support; electronic commerce development and operations, as well as customer service and consulting.
  • Responsible for directing the activities of a state of the art data center including customized software development; data warehouse implementations; systems administration; database administration; network administration; EDI implementation; and, disaster recovery planning.

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