SUMMARY:

• Accomplished senior level IT professional with broad - based expertise in project management, systems design, development, implementation and support.
• Extensive background in the healthcare insurance and pharmaceutical industries, trained in Confidential GxP regulations.
• Adept at analyzing existing technology and implementing cost-effective software and infrastructure solutions.
• Excel at problem solving, team building, project management and software delivery.
• Performance driven leader with exceptional organizational skills and aptitude to motivate and energize large cross-functional teams.
• Partner with key stakeholders to effectively plan and execute strategic enterprise-level business initiatives.

EXPERTISE AREA:

• Project Management
• Systems Integration
• Vendor Management
• Application Development
• Technology Security
• Quality Assurance

PROFESSIONAL EXPERIENCE:

Confidential, New York, NY

Sr. Project Manager

Responsibilities:

• PMO claims re-pricing portfolio manager, allocated and managed project resources via Innotas.
• Managed quarterly internal software releases of Confidential developed custom calc beans and qualifiers (i.e. negative/non-qualifying, embedded/nested, etc.) for NetworX Pricer.
• Coordinated SDLC activities across on-site, remote (virtual) & offshore teams, collaborated and negotiated with stakeholders on Scope Management/Change Control, issue resolution and acceptance of project milestones.
• Initiated projects utilizing ClearQuest & Jira, created project charters and established e-time codes for financial tracking.
• Managed project artifacts in a shared repository to support project audits and establish a historical knowledgebase.
• Reviewed Technical design documents (TDD’s), Business requirements documents (BRD’s) & use cases, SQA & UAT test plans, contingency plans, implemented automated large-scale regression tests & managed risk.
• Created anonymous SharePoint Lessons Learned project polls for process improvement as part of project closure activities.
• Performed Schedule Management, Monitoring and Controlling Project Work, tracking, reviewing and reporting project progress against performance objectives.
• Subject matter expert in all areas of repricing and in the configuration and use of NetworX. Configured rate sheets, routing rules, comment rules, qualifier groups, calcs, code groups, mailboxes, users, roles and system properties.
• Educated staff and arranged demos of potential new product acquisitions including Payment Bundling Administration (PBA), Modeler, Claim Test Pro, Healthcare Process Automation Service (HPA) "Robots".
• Participated in Change Advisory Board ( Confidential ) meetings and planned & coordinated software deployments with release managers.
• Eliminated over $150K annually in extended maintenance software fees.
• Negotiated and executed Cognizant, TriZetto, Confidential and other third-party software vendor contracts and custom product enhancements statements of work (SOW’s).
• Eliminated a $15M balloon payment by renegotiating and consolidating multiple contracts.
• Governed web applications and attained the top BitSight Security Rating in the Healthcare/Wellness industry.
• Managed Oracle and SQL Server database encryption projects, Oracle 12c database upgrade, SQL Server 2014 & 2016 database upgrades and assisted with an Informatica PHI data masking project which contributed to HITRUST certification.
• Co-managed a ServiceNow implementation to track and manage ITIL processes including Incident, Problem, Knowledge, Change, Configuration and Service Catalog.
• Led infrastructure projects including ColdFusion, IE & GoldenGate upgrades, Informatica & Embarcadero implementations.

Confidential, New York, NY

Director of Technology

Responsibilities:

• Managed Confidential aQDen ( Confidential ) application running on Microsoft SQL Server 2000 and spearheaded the migration to Trizetto QNXT healthcare payer enterprise application software.
• Improved data quality which increased claim adjudication rates by 40%, eliminated an 18-month reporting backlog and enhanced operational efficiencies.
• Designed and implemented a Medicare Part D retiree prescription software system that enabled the capture and transmission of key data points, resulting in the receipt of over $20M annually of retiree drug subsidy (RDS) center payments to the Union not previously realized.
• Project manager for legacy accounting software migration to Confidential .
• Led initiative to outsource the printing and mailing of provider and member checks, eob’s and predeterminations to a third-party vendor resulting in annual savings of over $80K.

Confidential, Springfield, NJ

Sr. Systems Analyst Programmer

Responsibilities:

• Managed Back Office Associates data migration team to convert data into SAP Orders to Cash system.
• Coordinated, designed and executed extract, transform and load (ETL) processes from several heterogeneous platforms (IBM DB2, IBM IMS, HP3000 Image and Oracle databases) into a single SQL Server “staging” database for data analysis, scrubbing and conversion of master and transactional data into SAP R/3.
• Created, maintained, documented and monitored over 150 SAP batch jobs including program variants and report layouts, monitored idoc transmissions between SAP and webMethods.
• Created accounts receivable interface file from SAP to Schering Plough Animal Health division using ABAP and ftp.
• Designed a critical contract-pricing interface capable of processing transmissions of over 1 million BDC sessions.
• Supported and enhanced GxP Customer Service System on HP3000 MPE/iX using Cobol, Image and View.
• Proactively identified opportunities to improve compliance with Confidential regulation 21 CFR Part 11 and implemented DBAudit, Security3000 and VEAUDIT for Sarbanes-Oxley compliance.
• Maintained all application interfaces between HP3000 and Warehouse Management System (WMS) via NRJE and ftp.

Confidential, Lakewood, NJ

Manager of E-commerce

Responsibilities:

• Managed a data warehouse team consisting of developers, dba’s, analysts and business subject matter experts.
• Developed a real-time sales operational data store (ODS) from HP3000 Image database to Microsoft SQL Server as the initial phase of a corporate data warehouse.
• Automated over 150 sales reports which resulting in a cost savings of over $60K per year.
• Designed and implemented a star schema and generated OLAP cubes for sales analysis, evaluated several business intelligence tools including Business Objects and ProClarity.
• Created operational concept documents, proof of concept documents, system requirements documents, system design documents, system test plans and system implementation documents.
• Conducted frequent system design meetings with both business and technical groups, conducted design and code reviews as well as coded database reconciliation and re-synching routines.

Confidential, New York, NY

Director of Decision Support

Responsibilities:

• Implemented a data warehouse solution and managed the data warehouse team.
• Designed and coded data extract and data cleansing programs.
• Developed an interactive eligibility reporting system.
• Received commendation for successful completion of Confidential remediation project, acted as Corporate Confidential Project leader for Powerhouse reporting systems.