Sr. Project Manager on the Clinical Affordability team, Clinical Services Group. The team looks for opportunities to drive out unwanted variation in healthcare by working internally within UCS, with the lines of business (LOB), and other department/teams within UnitedHealthcare. The team also is responsible for clinical program oversight for the Optum Health relationship working closely with the Finance and the Vendor management team for a unified collaborative approach to improving the health and well-being for our customers. We also monitor, and continuously perform strategic visioning for, potential solutions to identified outpatient trends.

• Sr. project manager for three projects under the Operations Model Transformation (OMT) enterprise program, which is migrating all claims processing operations to a third-party host (Highmark Health Solutions, HMHS).
• Currently on the Vendor Integration project, overseeing the integration of pharmacy benefit management (PBM) and medical banking vendors with Highmark.
• Recently completed the project to develop the program dashboard to monitor the conversion and migration of Group Market accounts (1.4M members) to Highmark.
• First project was managing the Codes Editing track of the OMT project, where all medical diagnosis and procedure code edits (CPT, HCPCS) including modifiers were converted to HMHS’ coding system.
• Applying project management best practices in the oversight and management of project teams.
• Collaborate with third-party project managers to coordinate deliverables across cross-functional teams within the enterprise.
• Prepare status reports and presentations for senior leadership and governance to provide risk, issue and dependency updates.

• Member of the Managed Solutions Group of Incepture which provides professional services and consulting for IT and business transformation projects across various industries (health care, health insurance, financial services and banking).
• Primary role is project manager lead on enterprise-wide projects. Currently managing two large projects for Florida Blue (Jacksonville, FL): Transition to ICD-10 (diagnosis and procedure code set) and their corporate Contract Management system (McKesson product).
• Manage project budgets of over $2.5M combined. Directly manage a mix of cross-functional project teams totaling more than 50 resources.

Member of the Enterprise Project Office for the largest health insurer in the state of Hawaii, an independent licensee of Blue Cross Blue Shield Association.

• Hired to assist with developing standards and policies for the newly created PMO. Provided guidance to clients on project management rigor by utilizing corporate standards and best practices in gathering system requirements, analysis and design, integrated system testing and implementation of key strategic and tactical solutions.
• Responsible for all aspects of managing enterprise changes through the program management of a portfolio of large projects across all lines of business. Directly managed all project teams, both business and technical, including external vendors/consultants, in a matrix environment composed of 50+ team members, including project managers, across several functional areas. Overall accountable for project budget, scope and schedule.
• Projects include applications/ technologies such as QNXT claims processing system, SQL server/Oracle databases, Informatica ETL tool, and MicroStrategy business intelligence platform. Managed two large multi-year projects: HIPAA 5010 and ICD-10.
  

• Member of one of the core consulting teams that deployed to major clients.
• Typically managed a consulting team of 8-12 system architects, business analysts, data analysts, developers and testing specialists.
• Successfully completed projects included:

1. Technical assessment and subsequent project planning for an internally-developed J2EE application that enabled group enrollment, maintenance and renewal functionality for small- to mid-sized group accounts;
2. Data integration effort involving the data extraction (using Ab Initio) of pharmacy claims (from a Teradata database) and subsequent submission of this data to a national data warehouse.
3. Successfully completed a project for a large health insurance client in New York involving the migration and deployment of an Oracle-based Enterprise Data Warehouse and ETL application (Informatica) to an outsourced managed host environment.

• One of the original team members of the Enterprise Project Management Office within the IT division. Hired to assist in the setup and growth of the enterprise PMO.
• Primary responsibility was to manage large enterprise-wide initiatives that involve information technology.
• Performed all functions of a senior level project manager, leading project teams with over 50 team members and project budgets over $7M.
• Successful projects included web-based applications (J2EE) and systems integration for health insurance products, an enterprise call routing system, computer telephony integration (CTI) system, and hardware upgrade of the enterprise Wide Area Network and the development of a web-based e-billing application which included the foundational infrastructure to process credit card transactions