Yyyyyy x. yyyyyy

Project Manager / Senior Business Analyst

Project Coordination ~ Business & Data Analysis ~ Systems Testing & Implementation

Vendor Management ~ Systems Analysis ~ Technical Documentation ~ Client Relations

         Possess strong project management experience with the ability to identify requirements, allocate resources, and facilitate delivery within stringent timeline, scope and financial parameters.

         Demonstrated strengths throughout the complete SDLC and extremely well-versed in PMI methodologies, cost-benefit analysis, requirements clarification, system design, testing, and quality assurance.

         Adept at developing influential and user-friendly training documentation for internal staff.

         Effective at managing both onshore and offshore personnel and resources to achieve project objectives.

         Able to build and nurture client relationships that result in significant revenue and profitability growth.

         Specialization in healthcare industry including patient accounting and patient financial services, revenue cycle, medical necessity, coding, and clinical applications and processes.

         Advanced skills in ICD-9, ICD-10, EDI, HIPAA ANSI X12 transaction formats, ADT, and HL7 message formats.

Apex Systems Inc., Nashville, TN, 10/13 to 02/16

Project Manager / Project Lead / Project Coordinator Community Health Systems (CHS), Franklin, TN

         Championed Valence Health Vision HIE population management tool implementation across five CHS markets for corporate physicians and specialty systems team; oversaw data acquisition and integration of crosswalks and data feeds including LOINC and health maintenance crosswalks, claims (institutional and professional), clinical lab results, ADT, and EMR.

         Spearheaded full-scope project management including testing as vital member of CHS Corporate IS Financial and Information Systems ICD-10 Readiness Team.

         Orchestrated corporate CHS ICD-10 unit and integration testing of cutting-edge hospital systems encompassing 3M, MedHost, MediTech, McKesson, Cerner, Siemens Clinicals, and AthenaNet/Allscripts.

         Fostered and maintained productive relationships with external vendors to facilitate and accelerate issue and problem identification and resolution.

         Steered all corporate ICD-10 end to end testing with Centers for Medicare and Medicaid Services FIs.

         Strategically managed projects to achieve on-time, on-budget delivery including developing, maintaining and monitoring schedules, milestones, deliverables, risks, and ongoing issues.

         Ensured products were ICD-10 compliant and teamed with individual facilities to implement upgrades as required.

Software Professionals, Medford, NJ, 03/09 to 07/13

Senior IT Consultant Highmark Blue Cross Blue Shield Delaware (BCBSD)

         Functioned as Senior Technical Project Lead and Business Advisor for BCBSD / Highmark claims, membership, eligibility, financial and payment systems, and ensured unified project efforts during merger.

         Contributed to numerous remediation and development activities in support of HIPAA EDI 5010 project.

         Played a pivotal role in engineering one-time and ongoing claims history data load for new clinical editing vendor (Bloodhound) to capture $4M in annual savings.

         Collaboratively instituted new DB2 reconciliation process to support Bloodhound Clinical Editing project.

RCG Information Technology, Edison, NJ, 04/08 to 12/08

Senior Project Manager Transcontinental Direct (Fulfillment Processing)

         Partnered with CEO in company re-structuring, holding full accountability for revamping Fulfillment SOPs and leading major migration of TCD clients from legacy systems to new SQL Server 2005 and ERP platform.

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         Aligned and mobilized offshore and outsourced vendors as well as internal technical and business staff throughout development and testing activities.

         Served as integral member of Transcontinental Direct Program Management Office (PMO).

Keystone Mercy Health Plan, Philadelphia, PA, 04/02 to 02/06

Project Manager / Project Leader / Technical Manager for HIPAA PMO

         Contributed to development and administration of project budgets up to $15M and recruited, managed, coordinated, and supervised IT professionals throughout four major company-wide implementations.

         Diligently communicated project status to leadership team via dashboard reports, risk matrices and RACI charts.

         Directed QA testing and production migrations to ensure project completion within expected timelines.

         Project-managed iHealth Clinical Editing initiative requiring development of new inbound and inbound claim adjudication and reconciliation processes, successfully forecasting $20M in post-implementation revenue growth.

         Deployed government-mandated HIPAA-compliant EDI program in flawless cooperation with subcontractors, affiliated MCO plans and state agencies in five states.

         Project-managed implementation of state PROMISe claims processing and management information system.

         Successfully accomplished timely implementation of all KMHP transactions, reports, and files affected by VISTA and Public Works Department requirements.

Software Professionals, Medford, NJ, 03/97 to 04/02

Senior IT Consultant Care First / Blue Cross Blue Shield of Delaware

         Generated almost $1M in annual savings by delivering extensive modifications to financial legacy systems as senior member of HIPAA EDI implementation team.

Senior IT Consultant Astra Zeneca Pharmaceuticals

         Served as Project Lead for multiple phases of EDI project to divide Zeneca Ag Products I/T systems from Astra Zeneca Pharmaceuticals I/T systems and migrate systems to new mainframe in Bristol, UK.

         Prepared all technical documentation, performed comprehensive LPAR production parallel testing, conducted in-depth technical and business analysis, and prepared system documentation.

Senior Programmer/Analyst Care First Blue Cross Blue Shield of Delaware

         Performed analysis, coding, extensive modifications, and testing of existing programs and JCL job streams across numerous systems, while supervising junior staff in analysis, remediation, and debugging for Y2K conversion.

Prior Background:

Programmer Analyst II, Computer People (Delmarva Power & Light; State of Delaware), Wilmington, DE, 04/96 to 03/97

Programmer/Analyst, E. I. DuPont, Wilmington, DE, 1993 to 1996

Diploma in Computer Analysis and Program Design, The Chubb Institute, Springfield, PA

A.A.S. Degree in Electrical Engineering Technology, Jamestown College, Jamestown, NY

Professional Development:

PMI Foundations in Project Management & PMP Certification Test Preparation, Villanova University

Insync, Dumpmaster, Tracemaster, Highmark Blue Cross Blue Shield DE

Vendor Applications & Software: Daptiv PPM, MS Project, MS Office (Word, PowerPoint, Excel, Outlook, Access, Visio), SharePoint, 3M Coding, FACETS, Oracle, Sybase, FTM/Tidal protocol, Data Ager, Time Warp, Hyperstation, Xpediter, PGP Encryption, Value Added Networks, Connect Direct, Connect Mailbox, System Vision, Paperfree (ECMAP), Gentran, Librarian, Changeman, MedHost, MedHost EDIS, MediTech, McKesson, Cerner, AthenaNet/Allscripts, Siemens, iHealth, Bloodhound, SSI Group Claims Processing/Medical Clearinghouse, 3M - CAC, 3M/360 Encompass

Development Tools: CICS, DB2, COBOL, SQL, Visual Basic, QMF, SPUFI, TSO, IMS DB/DC, Eztrieve, FILEAID, Assembler, Boole, Baggage

Operating Systems: Windows, AS400, UNIX, SQL Server, Mainframe MVS/OS