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Yyyyyy x. yyyyyy In Process of Relocating to Nashville, TN

Xxxxxx, XXXXXX xxxxxx (xxx-xxx-xxxx



Qualifications for Business IT Project Manager

Results-Generating Professional Specializing in Healthcare Project Management & Program Administration


Multi-Project Management Program Administration Strategic Implementation

Fiscal Management Performance Measurement Interdepartmental Communications

Strategic Analysis / Planning Trends Tracking Procurement Stakeholder Relations

Multimillion-Dollar Budget Control Process Improvement Technical Business Writing

Contract Negotiations Risk Mitigation / Management Scheduling / Logistics Compliance


Highly Accomplished Leader who achieves multimillion-dollar project success while demonstrating expertise in goverxxxxxxent programs such as Medicare, Medicaid, CMS, and Long-Term Care, as well as Quality and Regulations. Top Performer who sees the big picture at all times, and who maintains up-to-date knowledge of industry trends to align with a company s vision, value, and goals. Ambitious Self-Starter who rises above challenges to attain winning outcomes, including quickly adapting to evolving scenarios to accomplish projects through stakeholder involvement, policy development, and strategic planning. Excellent Communicator who builds collaborative relationships with cross-geographical decision-makers, and who leads teams by example and with integrity.


Career Highlights Include:

  Designing and developing solutions-generating process and procedure improvements.

  Excelling in all facets of leadership, project management, and technical business writing.

  Expertly initializing, planning, executing, monitoring, controlling, and closing key projects.

  Consistently achieving recognition for critical thinking prowess and problem-solving tenacity.

  Skillfully analyzing and coordinating processes, mitigating risk, and negotiating vendor contracts.


Professional Synopsis


Presbyterian Health Plan, Xxxxxx, XXXXXX 2015 Present

Robert Half Technology, Xxxxxx, XXXXXX 2014 2015


Project Manager Business IT Relationship Manager

Lead enterprise business-centric IT projects to reduce ED visits and opiate abuse and assign PCPs to Medicaid members, and complete the project 3 months early. Direct strategic planning sessions for expansion in NC. Develop execution-ready business IT proposals and cases for Goverxxxxxxent Programs (Medicare / Medicaid) and System Services to support leadership initiatives and programs, including Medicare Social Security Replacement Number, Electronic Visit Verification, and Medicaid Co-Pay, D-SNP, Data Breach Tracking Tool, Identity and Access Management, and Remote Staff IT Support Program. Manage large-scale Goverxxxxxxent Programs portfolio.


  Pursued Executive Governance Committee approval, as well as capital and operating funding requests.

  Completed the second highest-profile project in the company s history, and reduced outstanding Medicaid healthcare assessments from 132,000 to 18,000 within a 6-month period.

  Quickly led the turnaround of a failing high-profile IT EDI Re-Architecture project within a 7-week period to achieve a 10% reduction in outstanding vendor FTP conversions.

  Developed business proposals encompassing cross-departmental discovery, planning, scheduling, budgeting, ROI, and implementation costs and total cost of ownership.


Lovelace Health Plan, Xxxxxx, XXXXXX 2010 2014


Quality Program Manager Regional Sales Operations Manager Business Proposal Manager

Strategically steered key planning focused on improving quality measures by developing data analysis reports for HEDIS, STARS, and NCQA measurements. Served as lead project manager for multimillion-dollar enterprise RFP submissions, sales operations, and quality improvement programs to ensure on-time, in-budget completion. Increased sales based on competitor weaknesses by gathering information and compiling measurement data analysis for Medicare and Commercial markets. Prepared and managed a Sales Department s $2-million budget, along with executing and managing vendor contracts and renewals via critical negotiations and product sourcing.



Yyyyyy x. yyyyyy Page Two (xxx-xxx-xxxx


Lovelace Health Plan, Xxxxxx, XXXXXX (continued) 2010 2014


Quality Program Manager Regional Sales Operations Manager Business Proposal Manager


  Achieved PMP certification and led sales teams in completing 100% of tasks on-schedule.

  Drafted and managed multimillion-dollar health insurance business proposals to meet deadlines.

  Streamlined sales and boosted efficiency via the development of new process improvement projects.

  Ensured compliance with company and goverxxxxxxent policies by comprehensively writing and administering P&Ps and SOPs for Commercial and Medicare lines of business.

  Improved year-end scores by developing a HEDIS project team encompassing Wellness, Pharmacy, Care Management, and Medicare Risk Adjustment.


City of Sandusky, Sandusky, OH 2008 2010


Grants Administrator

Utilized broad scope of industry knowledge toward writing and awarding grants, including a $800,000 Weed & Seed Grant from the Department of Justice and a U.S. Department of Housing & Urban Development (HUD) Community Development Block Grant (CDBG) for $4.1 million over a 5-year period to save $30,000 in funds. Spearheaded project and financial reporting requirements overhaul by documenting monthly results and budget expenditures through the Federal Reporting Database System. Coordinated and led 10 Community Advisory Committees to develop need assessments, strategies, and goals for city-wide development plans and projects.


  Successfully implemented financial accountability processes for core expenditures.

  Monitored reviews to reveal misuse of CDBG funds reporting non-compliance issues.

  Managed $2.5-million in grant projects by administering 25 contracts and subcontracts.

  Reduced $2 million in federal project timeline findings by $1 million in a 9-month period.

  Completed a bike path project on-schedule and in-budget using a $133,000 natural resource grant.


Columbus Hospitality Management MFS Events, Columbus, OH 2007 2008


Event Planner

Spearheaded cost-effective event planning initiatives by aggressively establishing budgetary constraints for sourcing products and vendors, including negotiating with vendors to secure optimal pricing for services and handling contracts. Recruited, trained, mentored, and managed a details-focused staff. Conducted risk assessments to ensure events were successful, and developed efficient backup plans used on an as-needed basis.


  Designed comprehensive events, including menu, entertaixxxxxxent, seating, and travel logistics.

  Successfully planned events from start to finish for groups ranging from 20 to 4,000 attendees.


Ohio Department of Aging, Columbus, OH 1998 2007


Grants Administrator Assistant Division Chief Assistant Program Director

Collaborated with multi-industry professionals (i.e. Ohio Departments of Job & Family Services, Development & Mental Retardation, Developmental Disabilities, Ohio Olmstead Consumer Task Force, CMS, and Administration on Aging) to connect community services and programs for people with disabilities. Expertly administered and obtained grants. Led targeted project planning, including liaising among Ohio-based federal, state and local agencies and community-based organizations to facilitate and execute strategic project planning.


  Wrote, negotiated, and implemented key contracts, policies, and procedures.

  Expanded educational outreach and provided highly valuable community services.

  Drafted memorandums of understandings and agreements for public- / private-sector agencies.


Education & Professional Development


Master of Business Administration (Executive Business Management Emphasis) Xxxxxx University

Bachelor of Arts in Business Management Marketing University of Mount Union

Associate of Applied Science in Hospitality Management Columbus State Community College


Project Management Professional Certification (PMP No. xxxxxx92) Project Management Institute

ITIL Foundation IT Service Management (License No. 00198145) BCS: The Chartered Institute for IT


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