1. SKILLS
Leadership/Management Skills
Strategic Planning
Technology Architecture & SOA
Project Management & Planning
Product Solutions & Development
Goal & Customer Oriented
Change & Risk Management
Agile Methodology & Delivery
Continuous Process Improvement
Critical thinking
People Skills & Team Building
Mentoring & Coaching
Strong Interpersonal Skills
Communication and Collaboration
Complex Problem Solving
Self-Motivated
ACCOMPLISHMENTS
Delivered new Application Products (Spending Account Application, Automated Metadata
Management, PEGA Systems) into HMHS Enterprise environment in the last 4 years
supporting all clients (Highmark, IBC, BCBSMN)
Delivered Spending Account Capabilities and Migration in a matrix environment that had
close to 400 resources working across the organization
Migrated Legacy Consumer Driver Health Plan System to Acclaris Spending Account Vendor
Platform, integrating to Highmark enterprise Platforms including Client, Membership,
Claims, eBusiness, Billing, Customer Service, Operations, Sales, Finance. Platform
encompass 24 applications across the enterprise.
Stood up New Application SAA (Spending Account Application) to support Near Time Claims
Processing as centralized hub for data between OSCAR Claims /RENO Payments to Acclaris
Vendor Platform
Stood up PEGA EWS Application to track file processing errors between Acclaris and HMHS
Application (360 Files every month to Acclaris, 70 File from Acclaris)
Delivery of over 160 business processes and successful deployment of over 300
enhancements and defect resolutions for Spending Account Platform
Increased stability and tighter processes allowed for addition of approximately 300 new
clients through the year and the successful mass migration in October 2012 of over 2,600
clients and 160,000 members onto the platform.
Over 3,000 clients and 450,000 members are now processing successfully on the Spending
platform for Highmark, IBC
Migrated IBC, Highmark and Delaware Members onto Spending Account Platform
Delivered Transparency Project that includes Highmark "Portal " to move into Web Service
based model from vendor Acclaris and implemented UX layer in Portal (Enterprise Services
and Data Power) for all Clients in the platform - Uniform Member Experience
2. Delivered Near Real Time Claims Processing for Spending Account HRA Auto Submit Claims
with Acclaris (Acknowledgement in 3 Sec and Response in 30 Minutes).
Integrated 3 key Spending Accounts Application to PEGA EWS for Real Time Error
Resolution.
Stood Up Automated Document Factory Application Team, built the Operating Model,
Operational Support and transitioned to Output Services Platform to support the printing
services across Highmark Health.
Led Team to deliver Enrollment Real Time Project within an aggressive timeline (4 Months,
14K Hrs.) with to reduce Sync Errors between Membership and Billing Product by 40% for
Highmark, IBC Clients
Migration of IBC, BCBSMN Clients into Billing Platform for HCR, MediGAP line of Business
Migration of IBC Members for Medicare Individual, Group and CHIP Business into CATS
Billing
Successful Capability and migration of AmeriHealth New Jersey Client for HCR and Non HCR
Line of Business to Billing
Leading a team to deliver Medicare Individual, Medicare Group, Split Billing Capability for
HMK and IBC with roadmap to complete migration from Legacy systems to Billing Platform
in 2017
Migrated 300K MediGAP Members from CATS Billing to Enterprise Billing Platform.
Accountable for Billing Platform Roadmap Delivery from year 2014