Summary

Senior Project Manager / Certified ScrumMaster

• Innovative technology project manager with a proven record of designing and delivering cost - effective and high-performance software to address complex business problems, increase profit, and enhance productivity. Experienced in all phases of the software development lifecycle SDLC, consistently adding value to projects and ongoing programs based on personal expertise. Expertly coordinates between business and technical teams to ensure accurate communication of requirements, goals, and problems. Hands-on manager who drives a culture of excellence organization-wide and is known for building bridges across internal and external teams. Areas of expertise:
• Project Lifecycle Management t Software Development Life Cycle t Project Ownership
• Team Development Empowerment t Team Leadership t Agile t Scrum Master CSM
• Project Development Planning t Business Analysis t Process Improvement
• Collaborative Development t System Integration t Quality Assurance
• Release Management t Training
• Scrum Fundamentals Certified, a Certified ScrumMaster, and currently have all of the Professional Development Units PDUs needed for my Project Management Professional PMP and currently enrolled in a PMP preparation class.

PROFESSIONAL EXPERIENCE

Confidential

Project Manager

• Project manager for the financial management component of the Colorado and Kentucky Health Insurance Marketplace/Exchange HIX, working directly with the client management, functional, implementation, security, compliance, and testing teams during design, configuration, implementation and system integration testing.
• Responsible for management of budget, schedule, issues, risks, scope and reporting project status.
• Orientated clients to the Agile/Scrum methodology as it related to the design, development, and release of their user stories as part of the evolving roadmap.
• Collaborated on detailed configuration definition for the Colorado exchange including: security roles, correspondence, workflow triggers, finance, accounting, and billing.
• Socializing enhancements to the custom Electronic Data Interchange EDI transactions for employer group enrollment, health plan coverage, and banking transaction including an e-Lockbox solution for checks and NACHA for ACH transactions.
• Facilitated joint work sessions with Colorado, Kentucky and Hawaii exchanges on X12 820 and 834 EDI transactions building consensus on a standardized implementation guided by CMS work sessions and companion guides for state benefit exchanges.
• Coordinated efforts to assure the Healthation Core System met Federal MARS-e compliance standards, assuring security of Personal Health Information PHI, Personally Identifiable Information PII, and Federal Tax Information FTI .

Confidential

Senior Project Manager

• IT project manager for ICD-10 Definition Phase of Care Delivery applications throughout the Colorado Region, working with business areas, vendors, and third party administrators to define requirements and schedule remediation, testing and training. Coordinated with 5010 team to guarantee end-to-end remediation to meet the federal deadline.
• Responsible for schedule alignment Colorado Region and vendor readiness dates for the ICD-10 initiative, mitigating risk by adopting plans for concurrent use of ICD-9 and ICD-10 codes and defining mapping strategies.
• Formalized vendor management plan, coordinated outreach, and maintained dashboard for regional and national stakeholders.
• Colorado regional representative in all joint national and regional meetings to provide status, voice issues, evaluate risks and collaborate on solutions.
• Worked with analysts, vendors and application owners to finalize the inventory of affected applications and interfaces requiring remediation taking change control measures with national as needed.
• Collaborated with business areas to determine key business and technical requirements, using the results to inform requirements documentation and the integrated schedule.

Confidential

Project Manager

• Provided management consulting focused on the development and implementation of IT solutions. Primarily focused on program and project management with broad authority to document functionality, evaluate design elements for usability, and track to schedule and budget.
• Responsible for project management, business analysis, implementation and support activities for our CareTech client in the configuration and extension of CareWorks for Detroit Medical Centers web portal solutions.
• Actively worked to improve sales performance, proposal response, capacity planning, and identifying add-on sales opportunities.

Confidential

Entrepreneur

Established online boutique specializing in imports and luxury items. Responsible for site content, data maintenance, product selection, inventory management, sales, billing, accounting, shipping, and customer satisfaction measures.

Confidential

Business Analyst

• Managed the on-time on-budget delivery of requirements for CustomerFocus Healthcare Relationship Management System HRMS appeals and grievances modules and extensions formalizing system specifications and documenting interfaces with Confidential t management systems. The solution improved customer service without requiring additional Health Plan staff.
• Identified and implemented enhancements to the requirements workbook for core system configuration, assuring customer understanding and buy-in.
• Facilitated frequent sessions with end users to demonstrate new product functionality and configuration, clarifying expectations, driving out additional requirements and obtaining acceptance.
• Analyzed correspondence configuration requirements, implementing and demonstrating a representative set as part of training which allowed the Client to configure and maintain their letters and notifications.

Confidential

CORE Agile Team Member

• Responsible for various features of a health community social media website focusing on usability, content, and functionality to assure site adoption.
• Charged with the member health profile component of the site, the key driver of the HealthMatch rules engine. Elaborated on design, key functional elements, and data content including plain language diagnosis ICD-9 and procedures CPT, prescription and non-prescription medications, treating providers and facilities, and other health information use to assist members in forming communities.
• Authored help, site content and content filtering rules using Community Server and XML.
• Conducted on on-line marketing activities to encourage early adoption and gauge response.
• Integrated components into the site and performed integration, regression, and functional testing during the alpha and beta phases.

Confidential

Project Manager, Professional Services

• Lead in implementing multiple new and upgraded solutions. Directed all phases of key client engagements including: Project planning, scheduling, gauging and reporting progress, test planning, release management and post-production support. Analyzed. refined, and tracked evolving business requirement against established schedule and budget. Prepared and executed test plans, working closely with the team to quickly resolve identified problems. Liaised with clients at the senior level to manage expectations and guide projects toward successful completion.
• Project manager on various Clinical CareAdvance implementations involving Case Management CM, and Disease Management DM, and Utilization Management UM for commercial and social insurers.
• Leader and core contributor on the Shared Health pilot implementation of Personal CareAdvance, an Electronic Medical Record EMR, for the Centers for Medicare and Medicaid Services CMS . Meeting the usability requirements defined by Meaningful Use and Section 508 compliance. Accomplished through innovative enhancements including screen reader compatibility for the visually impaired, plain language medical terms and simplified navigation.
• Socialized the Healthwise conversion for multiple clients, creating the roadmap, selecting the pilot upgrade site, and organized internal team orientation and training on the clinical content.
• Key contributor to the standardization and optimization effort for project management processes, templates, checklists, and best accepted best practices for the PMO, organized and centralized in SharePoint.

Confidential

Project and Area Manager, Consulting Services

• Held multiple, simultaneous positions, providing project management, business analysis, quality assurance, testing, and software/controls auditing as required for various projects. Led entire project lifecycle, with a focus on establishing and tracking controls toward established milestones. Served as the main point of contact with stakeholders, users, systems analysts, and quality analysts to socialize changes and assure a mutual understanding of 'to-be' processes and features.
• Project Manager for the replacement of UM, CM, and DM solutions, and a new Population Health Management PHM system for commercial and social insurers.
• Provided total software development lifecycle management for UM and Appeals and Grievances areas of Care Management for a large Payers, assuring functionality, quality, audit and compliance goals were met.
• Product Owner for the PDA-based laboratory courier routing and tracking solution for Propath Laboratories, significantly reducing route times and preventing lost or mis-labeled samples.
• Successfully managed one of the earliest integrated practice management systems for providers to expedite claims processing and prevent claims denials. This effort complied with HIPPA standards for X12 4010 transactions. streamlining eligibility/benefits determination 270/271, referrals/authorizations 278, and claims processing 276/277 between payers, clearinghouses and providers through the MedUnite portal.
• Elicited requirements, formalized as use cases, for the Waseel portal EDI transactions, formalizing the operational plan as the vision was refined through JAD sessions. The overall solution significantly improved accuracy in determining eligibility/benefits and decreased time and effort processing claims by providing real-time processing between provider organizations and insurance companies in Saudi Arabia.

Confidential

Competency Center Director

• Led operations for public sector competency centers, providing collaborative proposal development, project management, and business analysis. Supervised a large competency center within the implementation services organization with full authority for staff performance and development. Lead a strategic implementation team for as many as six concurrent ArcGIS projects. Established project controls, monitoring and measuring progress for bi-weekly presentation the steering committee.
• Championed the vision for a Public Sector Workbench and directed the initiative, ensuring a shared vision between stakeholders, serving as subject matter expert, and establishing Rational Unified Process RUP project framework for critical components of the product.
• Spearheaded the formation of a SWAT Team centered around customer implementations on beta and production releases of ArcFM, working closely with the solution provider on identifying potential enhancements and defect identification/resolution. The team successfully managing the on-time on-budget deployment of 12 production releases within 2 years.
• Led the effort for the automation of requirements capture, slashing 80 of the cost and time need from elaboration to sign-off by allowing clients to actively participate in requirements gathering and enforcing review/approval periods.

Confidential

Group Program Manager

• Served in a variety of roles with increasing responsibility to achieve the successful quarterly publication of the Micromedex Health Care Series and TOMES PLUS .
• Key contributor to the leadership, enhancement, production and support of the MICROMEDEX Healthcare Series, published in seven languages, and the TOMES PLUS system.
• Spearheaded the quality, ahead of schedule release of the DRUG-REAX Integration Toolkit for drug utilization screening, including drug, food, and laboratory test interactions, therapeutic duplication and antagonism, drug allergies, and kinetic dosing calculation.
• Collaborated with the University of Tokyo and on the first Japanese poison control application published in Kanji and Katakana.
• As project managed a cross-functional team that developed and published DrugNotes, providing easy-to-understand Confidential t education materials, meeting federal literacy standards.
• Eliminated search performance degradation through the re-architecture of the indexing system for the Micromedex Healthcare Series and TOMES PLUS, assuring prompt result for medical and industrial health professionals.
• Designed and developed the recursive pattern matching algorithm for an integrated index of all databases in the TOMES PLUS system, dramatically increasing customer satisfaction and boosting sales.
• Key contributor on the team developing a metathesaurus for controlled medical vocabularies including ICD-9, ICD-10, SNOMED CT, and CPT-4 codes to support a clinical decision support initiative.

SKILLS AND EXPERIENCE

Project Management Business Analysis Quality Assurance Personnel Management Vendor Management Electronic Data Interchange EDI Business Cases Health Insurance Exchanges HIX Personal Health Record PHR Electronic Medical Record EMR Utilization Management UM Case Management CM Disease Management DM Population Health Management PHM Healthcare Financial Management Medical Call Center Solutions Appeals and Grievances InterQual Milliman Healthwise Agile Principles Scrum Rational Unified Process RUP Waterfall Rapid Application Development RAD Microsoft Development Discipline Community Server Microsoft Office Professional Suite Microsoft Project Visio SharePoint CollabCenter SalesForce HIPAA ICD-9 ICD-10 CPT-4 SNOMED CT Diagnosis Related Groups DRG X12 EDI Transactions: 270/ /