Printing tool Download PDF

Work experience

Jul 2009Present

Project Management Consultant

HealthPlan Services

HealthPlan Services is the largest Business Process Outsourcer of sales, distribution, benefits administration and customer service and retention solutions to the insurance and managed care industries.

Program Manager for Healthcare Reform large Fortune 500 and Medicaid Carrier Implementation's with projected annual revenue in excess of $10MM. Scope of Program includes both IT work and Business process outsourcing. Responsible for program management and coordination of the following work streams: printing/fulfillment vendor, 5 enrollment interface vendors, PeopleSoft General Ledger interface, Financial Reporting, 22 data file exchanges, actuarial rate processing, call center for billing and enrollment, and claims processing.

Day to Day responsibilities include the following: Effectively leads and facilitates meetings involving carrier client and internal resources from diverse functional areas, Provides recommendations to management regarding resources (people, financial, tools, etc.) required to complete projects, Supervise and Mentor Junior and Mid-Level Project Managers and Business Analysts, assisting and facilitating their successful performance and achievement of project tasks and deliverables, Develops proposals for internal process improvements, Manages the day-to-day relationship with carrier client personnel: Project Managers, Directors, V.P.'s and Business Analysts, Ensure project team members have the knowledge and information required to perform their tasks, Organizes and coordinates cross-functional teams of resources to meet project and program objectives, Develops and manages deployment of processes and tools for management and control of projects, Proactively evaluates alternatives, recommends actions, and develops strategies to maximize project success, Identifies project risks and issues, develops solutions and mitigation strategies for issues and risks, Establishes project timelines and project plans, Prepares weekly internal and external project status reports and presentations. 


Consultant: Sr. Project Manager

PriceWaterhouse Coopers

 Independence and Compliance Portfolio                                                                                                                             Internal Firm Services

Lead a team of 15 resources consisting of project managers, business analysts and test analysts, including PwCi offshore resources. The team supported all regulatory applications within the firm to ensure compliance with the Securities and Exchange Commission (SEC) and Sarbanes Oxley legislation. Supported and oversaw all projects within the portfolio including the development new applications and maintenance projects. Established a strong rapport and trust with senior - level partners of the firm and cohesively created future IT roadmaps which increased business sponsor and IT synergy. Portfolio Value $10MM. 


Consultant: Sr. Technical Project Manager


GA and FL Medicaid Implementation Project:

Responsible for leading the application development of the entire H.I.P.A.A. transaction suite for the GA and FL Medicaid Implementation Projects: 834, 837 (I, P, D) 835, 270/271, 276/277, 277U/275, 820 & 278 and utilizing a Web Portal front end, Biz Talk 2004 with HIPAA accelerator, C # adapter for calling Stored Procedures from the E 2.4 Paradigm (Oracle 9i) data base. Developed a Pharmacy Web Portal for the switching of NCPDP 5.1 transactions for GA pharmacies. Developed Architectural Proof of Concepts with Oracle iWay Adapter and Oracle Attunity Adapter for BT 2004 to increase performance of batch transactions and decrease time degradation. Attended daily meetings with ACS (fiscal agent for State of GA) other CMOs and the State of GA to iron out proprietary formats for first data delivery. Manage 4 Business Analysts, 8 developers and 4 testers. Report status to Program Manager. Projected ROI for WellCare $ 1.7B.


Business Process Consultant

Blue Cross Blue Shield of FL

Mentored 40+ Business Operations Analysts to create current and future state business process maps based on Six Sigma DMAIC. Utilized the Business Analysis Model (BAM) Methodology and rational tool set. Instructed workshops on how to define and measure the effectiveness of current business processes and re-engineer inefficient business processes. Created comprehensive training material that was deployed to all process improvement business units to communicate new analysis and quality management plan.


Project Manager


Oversaw the development, testing and deployment for WebMD/Envoy Products and HIPAA compliance Medicaid/Medicare payer and submitter migrations. Managed an Enterprise-wide Siebel CRM integration project. Project scope consisted of Call Center, Inside Sales, Field Sales, Contract Administration and Account Management Modules. Oversaw the Implementation of Business Objects 2000 (Crystal Reports) (SQL Server Backend). Identified data Universe and worked with the same Siebel Sales and Account Management team to help define customized sales, prospecting, and ROI management reports.  


Business Analyst


Elicited and documented requirements using business process descriptions, use cases, scenarios, task and workflow analysis for various healthcare business applications.




Project Management Professional (PMP)

Project Management Institute


Subject Matter Expert in Healthcare Carrier IT and Business Processes, including:

  • Healthcare Reform
  • Commercial Carrier Implementation
  • Medicaid (CMS) Implementation
  • Enrollment
  • Billing
  • PeopleSoft GL 
  • Commissions
  • Case Issuance
  • Claims
  • Fulfillment
  • Data Warehousing
  • Reporting