Description
QUALIFICATIONS SUMMARY Accomplished Medicaid Management Information System (MMIS) Project and Systems Manager with 20+ years Technical, Analytical, and Management Skills. * Proficient at delivering highly critical projects on time, under budget, and in scope as is evidenced by the Louisiana HIPAA project * Overall management for implementing all HIPAA-mandated initiatives for the Louisiana MMIS. Under his management, Louisiana achieved prestigious CMS "Top 5" State standing for HIPAA and was used as CMS approved HIPAA EDI "Best Practices" which served as a guideline for other states * Successful in managing large staff of 80 + and coordinating projects spanning multiple technical platforms and operational teams and stakeholders * Adept at applying innovative solutions to complex Medicaid Management Information System (MMIS) issues and problems by identifying root cause of deficiencies * Highly skilled written and oral communication skills to a diverse range of audiences from system programmers to executive board members * Adept at minimizing impact to ongoing operations and external interfaces/dependencies during the reengineering of highly complex and integrated systems * Proficient in large-scale systems development * Expertise in all aspects of Medicaid management including proposal preparation, requirements analysis, general system design, detail system design, development and testing, accepting testing, systems implementation, and ongoing operations and maintenance. Medicaid on responsibility for the extraction of DB2 data tables into the appropriate formats for load to the Accenture People Soft retirement system. Work performed utilizing COBOL, DB2, SQL, JCL, Librarian and TSO/ISPF./ Management Information System ICD-10 diagnosis Conversion Project. Hands on responsibility for requirements analysis coding/testing implementation and post implementation support. On-boarded several new managed care organizations including Magellan Aetna and United Healthcare. Responsible for requirements analysis coding/testing implementation and post implementation support for all FFS claims/MCO encounter processing to facilitate compliance to HIPAA regulations. Also remained responsible for the maintenance and enhancements for all X12N EDI transactions.
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