SUMMARY

• Senior Health IT Program Manager. A talented technical leader who has directed all phases of IT and analytics projects. Experienced in program management, software development and analytics across government, commercial, non - profit and education communities. Built and lead teams in project management, software development, statistical modeling and IV&V efforts. Skilled liaison between executive, technical, operations and clinical personnel. Experienced with healthcare systems, health information/ insurance exchange, ACA/ Medicare/ Medicaid systems, clinical informatics, clinical quality measure development, data quality, fraud detection/ prevention systems, client relationship management, client delivery assurance, solution architecture and best practices in software and analytics management.
• Passionate about working to promote improvements in clinical care quality, patient safety, public health and detecting and preventing fraud, waste and abuse. Deep understanding of the unique issues and requirements of working with healthcare data such as system interoperability and security needs of HIPAA, PHI and PII. Experienced with implementing strategy and policy updates for health organizations including Affordable Care Act (ACA) requirements and evolving health IT standards and architectures.
• Managed, executed work and mentored and trained others in every aspect of Software Development Life Cycle for a wide variety of information systems. Experienced with many software development and management tools and able to pick up new technologies quickly.
• Strong communicator with wide variety of stakeholders including executives, clients, team members, external contributors and the public. Successfully served as primary interface and point of contact with government authorities and managed tasks with geographically dispersed team members and complex reporting structures. Utilized proven project management methodologies to ensure high quality and timely deliverables (i.e. - PMBOK, CMMI L3, ITIL). Experienced in managing project/work order plans and schedules, technical and financial reports, project risk, resources and ensuring contract compliance and performance excellence.

TECHNICAL SKILLS

Project Management: Program/Project/Staff Management, Financial/Contract/Vendor Management, Strategic Planning, Business Development and Proposal Writing, Risk Management, Communications Management, Consensus Building, Development of Policies, Procedures and Standards, Experience in Creation and Management of Consulting Business, Change and Configuration Management, System and Component Testing and Operations Management, ITIL, CMMI Level 3

Functional Areas: Clinical Informatics, Healthcare Information Systems, Performance Measures Development, Data Quality and Governance, Database Design and Development, Data Warehousing, Business Intelligence (BI), Gap Analysis, Requirements Analysis, Software and Web-based Systems Development, SDLC / EPLC / XLC, Agile, Scrum, Standards Development, Health Insurance Exchange, Health Information Exchange, Survey Research Methods, Sampling Estimation, Descriptive / Correlation Analysis, Business Process Analysis, Change Management and Version Control, Technology Evaluation / Selection / Adoption

Software Specialties: SQL, Oracle, SQL Server, MySQL, MS Access, Analysis Services (SSAS), SAS, SPSS, Clementine, MDX, Visual Basic, JAVA, J2EE, XML, HTML, COGNOS, SourceSafe, Subversion, ProClarity, MS Office Suite/Project/Visio, SharePoint, Quality Center, WebEx, LiveMeeting, Captivate

PROFESSIONAL EXPERIENCE

Confidential

Health IT / Management Consultant

Responsibilities:

• Co-founded PII, a data analytics, information technology and management consulting company.
• Provide subject matter expertise on customer engagements. Lead business growth activities and operations.
• Serving as Business Development Capture Manager and Solution Architect supporting proposal development and client relationship building. Supported large team proposals including CMS application redesign and NITAAC CIO-SP3.

Confidential

Manager, Program Management Office

Responsibilities:

• Built Program Management Office; leading PMO activities for the Exchange Operations Support Center (XOSC) for the Centers for Medicare and Medicaid Services (CMS) supporting the Federal Facilitated Marketplace (FFM) / HEALTHCARE.GOV systems. Designed and implemented process improvements across the program including use of CMS XLC standards, Risk Management, Request Tracking, Change Management, Project Prioritization, Meeting Facilitation, Status Reporting and Document Tracking. Responsible for client communications management, project management, strategic planning, budgeting, process improvement, staff management and development, contract compliance and business development for Tier 1, Tier 2 and Tier 3 technical support. (Coordinating efforts of 200+ person team)

Confidential

Senior Director, Health IT

Responsibilities:

• Served as Director of Operations for the Automated Provider Screening (APS) Development Project for the Centers for Medicare and Medicaid Services (CMS) Center for Program Integrity (CPI), a complex, healthcare provider fraud, waste and abuse prevention analytics application. Responsible for building client relationships and managing client communications, providing staff, vendor and project management, financial management (EVM), recruitment, staff mentoring, assuring contract compliance and driving performance excellence. Led performance improvement activities to successfully lift this troubled project out of the CAP it had when I joined it. (Coordinated efforts of 50+ person team)
• Served as Business Development Solution Architect supporting proposal development and client relationship building. Wrote content and PWS for winning $12.9M HHS Financial Systems IV&V proposal. Wrote content, WBS and staffing on winning $6.1M CMS MACBIS Requirements proposal.
• Served as team leader for the Independent Verification and Validation (IV&V) of the Centers for Medicare and Medicaid Services (CMS) Federal Marketplace Program System (FMPS) development project. Involved in providing health exchange subject matter expertise, conducting and leading IV&V tasks, managing client communications including presentation of assessment results, staff and project management, recruitment, staff mentoring and delivery of complex, sensitive government client documents.

Confidential

Senior Project Manager, Functional Team Manager

Responsibilities:

• Managed multiple large confidential projects providing client communications, staff and project management, budgeting / EVM, recruitment, requirements gathering, change control board participation, system deployment, testing and documentation; development and delivery of training program. Managed team collaboration site (SharePoint). (20 person, geographically dispersed team.)
• IHS Meaningful Use Interoperability Production Deployment project. Systems include MPI, HIE, C32, NHIN Connect and other components of the IHS HIE across 200+ IHS facilities. Managed various aspects of system deployment. Developed and manage 508 compliant training program; coordinated training delivery with deployment. Participated on winning proposal for $3.5M contract.
• IHS Clinical Decision Support Contract / iCare Population Health Analytics System / ePrescribing / ED Dashboard / Prenatal and other projects. Involved client communications and project management for application development, enhancements and testing of client-server applications in MS-Windows and RPMS / Cache environments.
• IHS ICD-10 Implementation project. Managed analysis, requirements and documentation activities.
• Served as Project Manager (PM) for the confidential CONNECT / HIE development project involving patient information exchange from across IHS and external federal agencies. Included software development, architecture design and integration of Master Patient Index (MPI), Personal Health Record (PHR) and Service Oriented Architecture (SOA). Improved team development processes including communications and configuration management; implemented TeamTrack and Subversion.
• Served as PM for the IHS MPI, PHR-SOA Independent Verification and Validation (IV&V) project.

Confidential

President, Health IT Consultant

Responsibilities:

• Created and operated Confidential, an information technology and management consulting company.
• Led Confidential ’s business growth activities, managed employees and provided expert support to clients.
• Served as Lead Author for the Scheduling and Prior-Authorization Use Cases for the confidential, supporting Health IT standards development and the American Health Information Community (AHIC), providing context for the selection of harmonized standards for the electronic exchange of healthcare information between EHRs, PHRs, and other healthcare tools or systems. Participated in NHIN and CONNECT research activities.
• Supported Veteran’s Health Administration Data Quality (DQ) program through analytics to uncover errors in clinical data, such as patient identity and medical coding, the recommendation of solutions and processes for corrections in data and systems, setup policies & procedures for DQ team on analytics, operations, data governance, etc., coordinated DQ efforts across VA, developed data management and training plans and participated in industry standards organizations (ie - HITSP) on healthcare data quality. Supported development of a Patient Care Data Warehouse and OLAP reporting system integrating data from disparate VA and DOD systems including VistA.
• Developed current state systems matrix as part of a “Best Practices in Health Care Informatics/Intelligence: A Future State Roadmap” for a mid-west healthcare company.
• Provided management support for Financial Industry Regulatory Authority (FINRA) new member acceptance determination process and fraud and abuse monitoring enhancements.
• Utilized Oracle, SQL Server, Analysis Services, SQL, XML, SAS, Crystal Reports, FTP

Confidential

Director, Professional Services

Responsibilities:

• Supported business growth activities. Identified marketing niches, wrote proposals and marketing materials.
• Supported existing clients and contracts. Provided expert functional support to clients.
• Developed policy and procedure documents and implemented change and configuration management system for Food and Drug Administration (FDA). Provided support for ColdFusion / BI based project management system. Utilized Oracle, SQL, ColdFusion, Subversion

Confidential

Associate

Responsibilities:

• Deputy Team Lead for a business practice offering public health quantitative analytic support. Responsible for engagement management, business development and proposal writing; grew team from 2 to 25.
• Provided analytic, development and management support to:
• Social Security Administration (SSA) for Disability Decision Improvement Predictive Models, survey design, data collection and analysis, model development, data visualization for process improvement
• Confidential) for survey sampling support
• FDA data mining and predictive modeling for enhanced screening of high risk imports and improved workload balancing
• SSA OIG for their National Investigative Case Management System.
• Centers for Medicare and Medicaid Services, Discount Prescription Drug Card Monitoring program analysis and database development
• Department of Homeland Security, emergency preparedness capability database development
• Utilized Oracle, SQL, SAS, SPSS, Clementine, JAVA, Hyperion, Cognos, Metastorm, MDX, Visual Basic

Confidential

Director

Responsibilities:

• Managed team of eight programmers within the Strategic Policy and Analysis Division. Coordinated work with statisticians, medical directors, other executives and external stakeholders.
• Project lead on Physician Practice Pattern Analysis (PPA) program. Designed performance metrics and reporting formats, developed metric algorithms, data models and analytic tables, managed operational efforts including delivery to physician organizations; coordinated multi-departmental teams. Performed analysis on PPA findings, network physician inquiries, re-credentialing staff inquiries. Incorporated claims and encounter data analysis. Used ICD-9, CPT, DRG.
• Developed Behavioral Health Analytics included clinical condition coding and episode grouping techniques.
• Developed Pharmacy Analytics included NDC and clinical condition coding.
• Responsible for Data Quality Analysis, Requirements Analysis, Stakeholder Interviews, Development and Enhancement of data models and analytic tables. Clinical studies / reports developed: HEDIS / NCQA Accreditation, Hospital Daily Census, Employer Group Renewal, Cost and Risk Analysis, Quality Improvement Initiatives, Group and Member Benefits Evaluation and Pharmacy Utilization Patterns. Performed OLAP and web technology evaluation.
• Provided analytic support to Clinical Specialist Committees in Oncology, Orthopedics, Cardiology, Gastroenterology, Medicaid, Medicare, Medical Coding team for policy and quality improvement
• Participated in HIPAA requirements training and evaluating respective departmental processes.
• Performed business process analysis. Created policies, procedures, programming standards and project management tools. Setup new configuration management system Visual SourceSafe.
• Utilized Oracle, SQL, SAS, XML, MDX, Visual Basic, Brio, ProClarity, NovaView, VSS, SSAS, FTP

Confidential

President

Responsibilities:

• Managed all aspects of business; Finances, Contracts, Staff, Business Development and Communications.
• HEDIS Reporting systems - Extensive work designing and developing for numerous health plans, including, National HEDIS Pilot Project in 1994 for HealthPlus. Supported NCQA Accreditation process.
• Data Quality Analysis for Medical Coding staff.
• Healthcare Quality Improvement analysis and support. Created healthcare databases. Fraud/abuse claims data mining. Developed disease screening intervention programs. Requirements analysis, stakeholder interviews, consensus building.
• Performed analysis and development for Accounting, Contract Administration, Inventory and Order Tracking, Serology Diagnostics, and Genetic Toxicology Schedule systems.