Description
Summary of Responsibilities Provided project management for government and private health plan implementations Managed contract opportunity pipeline to pursue new business opportunities Led business development for government sector opportunities Responsible for project budget and staff resource estimations Led Medicaid proposal development, evaluations and presented to executive team Provided system evaluations and selections for Medicaid and commercial systems Managed a team of business analysts to support a Medicaid expansion program Responsible for Health Plan Provider Network development Developed marketing material for conferences and client presentations Provided leadership for the development of detailed business requirements and documenting the needs of the client department/agency Worked with account managers and clients in defined project governance documents and defining project or program scope Trained and managed project managers in establishing project management methodologies and standard processes to improve product rollout to clients Ensured that deliverables and functionality were achieved as defined in the Project Charter, funding documentation and subsequent project plans Ensured that project implementation met strict guidelines and requirements for timely and successful implementation Responsible for building team and professional development Worked to optimize business performance by recommending balanced approaches to configuration/system design and maintenance Created mapping documents and handles loading configuration into the core system Assisted with development of business requirements and technical design for reports, letters, conversions, interfaces, extracts and file inputs Executed system tests (unit, integration, regression), analyzes and reports defects Conducted training assessments and used the results to improve future training Created General Project Status Reports and met with Executive Committee on Project Status Ensured project objectives were accomplished within the project budget and schedule Responsible for managing project risks, communication to stakeholders, ongoing status reporting, including project health * Responsible for overall management of the vendor relationships and addressing issues with resource constraints * Company Name Hubbert Systems Consulting, Inc. (HSC) Project Name Internal Project Support Start / End Dates May 2010 - January 2011 Position Title Project Manager Summary of Responsibilities Responsibilities included: Providing Project Management Subject Matter Expertise to HSC's response to proposals for new business opportunities Providing comprehensive MITA State Self-Assessment in accordance with CMS guidelines and * Providing Gap Analysis and a road map to lay out the path for MITA implementation to support APD and RFP development. Company Name CNSI Project Name State of South Dakota Start / End Dates June 2008 - April 2010 Position Title Subject Matter Expert / Team Lead Summary of Responsibilities Responsibilities included: Serving as Subject Matter Expert and Team Lead for the Program Integrity Management (PI) business area Providing subject matter expertise on the MITA methodology and the delivery of the AS-Is and To-Be assessments * Design Development and Implementation of MITA aligned business processes for Identify Candidate Case and Manage Case - an implementation the following system: * Survey Tool - provided the capability for the state, members, and providers to complete surveys to obtain information to improve the quality and delivery of care * Audit Studio - provided the front-end and middle tier to generate standardized queries, on-demand queries and reports * Case Management System - allowed the state to generate establish, review and monitor cases activity related to fraud and abuse, grievances, appeals and sanctions * DxCG - used for predictive modeling, risk analysis, and episode grouping analysis to identify patterns of utilization, risk, predictions, treatment patterns, provider profiling to improves the delivery of services Company Name State of Louisiana, Department of Health and Hospitals, Bureau of Health Services Financing (BHSF) Project Name MMIS Project Oversight/MARS Manager Start / End Dates April 2000 - May 2008 Position Title Assistant Section Chief / Program Manager Summary of Responsibilities Responsibilities included: * Providing oversight of the MMIS Fiscal Intermediary contract and acting as principle assistant to the MMIS Section Chief which oversaw five key areas for a certified Medicaid Management Information System: * Managing the Fiscal Intermediary (FI) and Medicaid Administrative Reporting Systems (MARS) staff in the preparation of the annual mandated federal reports (i.e. MSIS 2082) * Providing oversight on the development and validation of the MARS Data Warehouse Project * Managing data and quality controls to ensure the integrity of the data * Coordinating and managing decision support measures to support reporting initiatives Supporting research and analytical function for BHSF and other agency and non-agency personnel Responsible for new program development relative to MMIS. Coordinated development efforts to implement Program Operations programs such as PCCM, KidMED, and PACE to link, track and measure health outcomes for the provider and patient populations Creating the Medicaid RFP for Independent Verification and Validation vendors and FI for MMIS Project Manager for the Medicaid Information Technology Architecture (MITA) implementation Developing the MITA Assessment Tool Developing the Medicaid Data Warehouse System Designing, Developing and Implementing, Medicaid Decision Support System ("Mediplex") Concept Design for Residence Emergency Alert and Locator System Developed the 2004 and 2007 LA MMIS IV&V RFPs and APDs and * Preparing budgets and providing oversight for fiscal activity. Company Name University of Phoenix Louisiana Campus Project Name E-Business/Database Management Start / End Dates December 2006 - June 2009 Position Title Faculty / Instructor Summary of Responsibilities Responsibilities included: Providing classroom instruction for E-Business 400/405, a course which introduced the model for conducting business-to-business and business-to-consumer electronic transactions. Topics included the application of e-business strategic management, how to leverage technology to enhance business processes, the unique characteristics of e-marketing, and how the legal, ethical, and regulatory environments act as a filter for conducting e-business and * Providing classroom instruction for CIS/319, a course which introduced the fundamentals of computer systems and the role of information processing in today's business environment. Topics included an overview of information systems, systems development, operating systems and programming, and database management. Company Name State of Louisiana, Department of Health and Hospitals, Division of Health Economics Project Name Various Start / End Dates November 1997 - April 2000 Position Title Policy Planning Analyst Summary of Responsibilities Responsibilities included: Managing Predictive expenditure and revenue trends in the Medicaid program Performing data collection, model development, economic, statistical and other quantitative analysis, enhancements to the accuracy and relevance of the existing analytical products, and presenting the results of the analysis both within and outside of the Department Assisting in the development of the Executive Information System/Decision Support Computer System (EIS/DSS) by providing the background necessary to build an accurate and useful data system Researching and reporting on all facets of the Medicaid program including service utilization trends changes in eligibility and recipient counts, and the effect of policy changes and * Creating the Louisiana Medicaid Annual Report (1998), the Department of Health and Hospital SECURE Report (1998) and the Louisiana Medicaid Report (1999). Company Name State of Louisiana, Department of Social Services, Office of Family Support Project Name Various Start / End Dates November 1996 - November 1997 Position Title Eligibility Examiner Summary of Responsibilities Responsibilities included: Conducting interviews with clients and making other collateral contacts for verification in determining initial or continuing eligibility or ineligibility for major assistance programs and * Examining applications and case records for claimants for public assistance for completeness of factual information to document determination of eligibility for public assistance.
Accomplishments
Highlights:
Keywords
