Management Consultant, Program Manager, Project Manager
Independent Consultant
Total years of experience :36 years, 0 Months
Specializing in Management and IT Consulting services - domain includes business process improvement, information technology, strategy/analysis, and program governance. My experience is largely centered on the healthcare industry and health insurance in particular. Experience includes the implementation of enterprise-wide projects relating to functional areas (Claims, Providers, Member, web strategies, EDI) and regulatory implementations such as HIPAA and CORE. Some major projects included:
Assisting a health Co-Op in Oregon establish full range of operations and services to execute a health insurance business using emerging and established cloud based technologies, Internet services, and outsourced back office processing
Leading an Oregon private-public partnership workgroup that strives to develop statewide rules to facilitate consistent health care EDI transactions across the state of Oregon.
Assisted largest US third party employee benefit administrator in the implementation of a highly automated health claims and data management system. Scope included business process, system development, vendor management, business intelligence to clients & their consultants/brokers, and mentoring client team. Project used Agile methodology.
Worked with a healthcare delivery company to leverage & expand successful pilot to fully scalable operational processes that substantially reduced hospitalization costs by providing critical care in a home setting, in partnership with hospitals.
Executed numerous major projects & programs for the largest multi-state health insurer in the Pacific Northwest over a period of 7 years. Projects included:
• Developed a business case and design to implement comprehensive network performance management & contracting processes for Provider Services
• Teamed with top management & operational departments to help define the strategy for consumer engagement.
• Successfully led a Medicare Advantage PPO product development & implementation effort including product development, go to market strategies, sales administration, business process changes, regulatory compliance, systems, & operations.
• Managed the HIPAA Transactions & Codes Sets implementation. Managed projects to develop infrastructure & applications to enable Internet EDI & web portals; aligned business processes with technology.
• Established the HIPAA PMO. Assisted client in aligning program with HIPAA related goals. Defined the processes, governance, organization, & approach to manage a multi-million, 3 yearlong effort that included EDI, Security & Privacy.
• Provided impetus & guidance on key ebusiness and Internet related initiatives to top level IT & business management.
Conducted ebusiness strategy engagements for iPlanet and Sun Microsystems accounts worldwide. Advised global Fortune 1000 corporations and educated their top executives on the impact of the net economy on their businesses. Developed complete ebusiness strategic plans for clients including the vision, specific net economy goals, ebusiness model, identification of key stakeholders, value proposition, financial projections, architectural framework, ebusiness roadmap, implementation plan. Worked with major iPlanet and Sun accounts on ebusiness strategy. Customer contact included strategy consulting, executive round table discussions, industry and client forums, authored current interest white papers. Teamed with account managers to nurture key client relationships and set strategy for major corporate accounts.
Established and directed the Pacific Northwest ebusiness implementation consulting practice for Netscape. Managed all aspects of the practice including business development, resource management, recruiting, implementation planning and approach, wrote consulting proposals, defined and estimated projects, nurtured client relationships, resolved issues, provided guidance to Netscape consulting teams in project planning and execution, delivery quality assurance, and other practice related responsibilities. Mentored and coached team members. Established annualized presence of $4.6 M in the region and directly responsible for regional practice growth, sales targets, alliances/partnerships, and practice profitability.
Netscape multi-tier architecture incorporated Oracle DBMS, J2EE, XML, SSL, LDAP, PKI, EAI, Netegrity.
Key responsibilities included Management consulting and IT related project delivery for multiple clients (focus on health insurance and financial services) on the West Coast, USA. Managed major consulting accounts and multiple full lifecycle business and IT projects. On going responsibility for business development/expansion, definition and estimation of consulting efforts, project profitability, recruiting, resource development, and nurturing strategic client relationships.
Developed consulting market strategy for the Asia-Pacific region. On assignment as country manager Japan with additional responsibility for Hong Kong from May 1998 to February 1999. Worked with Indian team to establish an offshore outsourcing IT development center in the Philippines.
Technology platforms included IBM Legacy, Oracle DBMS, Wintel/Sun client server.
Provided project management, business analysis, re-engineering, and system development consulting services to a major power generating utility in the Pacific Northwest and other clients. Managed full lifecycle analysis and mainframe & client server development projects. Assignments included the development of an executive information system, reengineering & implementation of the purchasing and financial processes and systems, and development of a client-server energy billing system. Participated in business development worldwide.
Technology platforms included IBM Legacy and Wintel/Sun client server.
Provided IT and Management consulting services to businesses and government agencies. Initial career focus was technical development and DBA in legacy environments leading to business analysis and development team leadership opportunities. Engagements included leading teams responsible for IT area restructuring in a major business process reengineering effort, and corporate acquisition due diligence at a prominent Boston based insurer; redesign of sales administration and logistic services for a major software company; development of the Massachusetts Tax system among others. Extensively used structured life cycle methodologies and CASE tools.
Technology platforms included IBM and Unisys Legacy, and Wintel/Sun client server.
Masters in Business Administration
Bachelor of Arts in Economics (Honors)