Resume

1. Ronald Sommer
Tampa, FL 33647
 (813) 388-5235 (h)  (813) 523-3765 (c)
rsommer608@yahoo.com
http://www.linkedin.com/in/rsommerflbi
SUMMARY
Highly motivated Business Intelligence professional; previous experience includes
inventive Systems Integrator, computer operator, programmer and 8 years of Application
Development Management. Intimate knowledge of healthcare industry allowing effective
integration of IT systems including 12+ years Managed HealthCare experience utilizing
Amisys, Facets, and Diamond claims payment systems. Skills include departmental and
project leadership, team building, systems analysis/design, application development,
implementation and training. A United States Air Force veteran.
TECHNICAL SKILLS
Microsoft Technologies:
SQL Server 2005 Integration Services, SQL Server 2005 Analysis Services, SQL Server 2005
Reporting Services, Microsoft Office SharePoint Server 2007, Microsoft Performance Point
Server, Microsoft Visio
Databases:
MS SQL Server 2005
Software:
SQL Server Business Intelligence Development Studio, AMISYS, Diamond, Facets, MS Office,
PeopleSoft, SQL 2000/2005, Visual Studio 2003
Query Languages:
T-SQL, MDX
Programming Languages:
SQL, VB.NET, Visual Basic, COBOL, Microfocus COBOL
SetFocus, LLC. Tampa, FL 01/10 – 03/10
Business Intelligence Master’s Program
• Implemented a Labor Analysis Business Intelligence solution for a national
construction company.
• Existing data from diverse data sources were consolidated into a uniform SQL Server
2005 database. ETL capabilities of SSIS were used to define imports of data, build
scheduling packages, define integration flow, log data error exceptions and orphaned
data and to define Database Maintenance Plans and send emails.
• Created cubes, dimensions, and business critical KPIs using SSAS representing
aggregations in different ways - hierarchically and using custom groupings, that the
company will use to analyze performance. Created MDX queries according to
business requirements.
• Developed detail and summary reports, line and pie charts, trend analysis reports
and sub-reports according to business requirements using SSRS.
• Implemented Business Intelligence dashboards using MOSS 2007 Report Center and
Excel Services producing different summary results based on user view and role
membership.
• Created score cards using MS Office Performance Point Server 2007 Dashboard
Designer that feature executive summary measures for revenue, overhead costs,
material purchases, labor and profitability trends for a construction company

2. rsommer608@yahoo.com
extracting data from SQL Server 2005 OLAP data source and deployed to SharePoint
sites. The dashboards also contain pages to view performance by employee, by
region, and by quarter enabling end-users to make filter selections.
• Key product areas utilized also include data modeling, SSRS report subscriptions and
data driven subscriptions, SSAS analysis services processing tasks, cube processing
options and roles.
• Studied and reviewed application of Kimball data warehouse methodology across
various industries. Worked with data-handling scenarios, such as multiple
hierarchies, data-driven KPI goals, sourced either from dimension attributes or fact
tables, handling Type-2 slowly changing dimensions.
PROFESSIONAL EXPERIENCE
WellCare Health Plan Tampa, FL 11/07 – 5/09
Manager, Application Development
2.5 MM for-profit Medicare/Medicaid Managed health care organization with oversight of
production support for CRMS/HEDIS, EDI and IT Operations.
• Expanded Encounters reporting teams after identifying that only 30% of Encounters
data was being reported to the states; this change resulted in an increase of 60%
additional data being reported.
• Oversaw conversion of member eligibility data files from a variety of proprietary
formats to industry standard X12 834 format. This resulted in a simplified new partner
on-boarding process which allowed reallocation of 60% of the support staff to other
duties.
Affinity Health Plan Bronx, NY 1/05 – 11/07
Manager, Operational Services
A 200,000-member non-profit organization with software development responsibilities for:
Claims, Compliance, EDI, Finance, Human Resources, Membership, Enrollment, Public
Affairs, Provider Contracting/Networking and Regulatory Affairs.
• Project Manager to lead software development effort in support of adding Medicare as
a new line of business for the health plan.
• Established measurement tools to evaluate team’s performance in the areas of on-time
delivery, adherence to standards, first-time quality versus rework, and customer
satisfaction levels, which resulted in a 30% reduction of rework and 100% of jobs
being automated.
• Recommended configuration changes which resulted in annual savings of 2.6% in
claims payments.
• Implemented a Vendor Management System which standardized vendor data submittal
format and tracked all rejected encounter data from delegated vendors to ensure it
was corrected and returned by the vendor, resulting in an 8% increase in
reimbursement rates.
• Recovered $32m by automating the rebilling of membership and recovery of prior
years funds which increased revenue over 7%.
• Key member of Corporate Disaster Recovery/Business Continuity staff conducting
quarterly reviews/updates to IT Application Development plans.

3. rsommer608@yahoo.com
US Dept of Health & Human Services Baltimore, MD 08/04 – 01/05
Director, Transitions & Testing – Medicare
Responsible for all system transitions, software & hardware, as well as requests from
contractors that are seeking to terminate company data center operations.
• Participated in renegotiation of a series of contracts with net savings of a minimum of
$10M for a 14-month period of time.
QualChoice Inc Cleveland, OH 07/01 – 08/04
Manager, Application Services
A 200,000-member Medicare, Medicaid, and Commercial health plan organization.
• Ensured consistently responsive software support which contributed to the
organization achieving NCQA 'Excellent' rating in all categories for its HMO and POS
products.
• Designed and managed development of a web-based individual health product
application which resulted in over $1M in new policies to be written without adding
marketing staff.
• Oversaw data analysis of encounter data submitted to the state which resulted in the
return of over $1 million in fines from the state of Ohio.
• Oversaw development of a data reporting system that ensured all encounter/claim
data was reported to appropriate state/federal agencies resulting in maximum
reimbursement rates to the health plan.
H/P Technologies, Inc Phoenix, AZ 04/99 – 06/01
Technical Director
A national healthcare consulting organization.
• Managed EDI efforts with electronic clearinghouses for Blue Cross/Blue Shield of Utica.
• Developed and implemented a HIPAA compliant EDI solution for the Wellness Plan of
North Carolina (with multiple interfaces to other commercial healthcare applications).
Project resulted in a 1st pass automatic payment of 85% of inbound claims.
EDUCATION
University of Phoenix Jersey City, NJ
Bachelors of Science, Information Technology - Overall GPA 3.46
Anticipated Graduation 11/10
COMMUNITY SERVICE
• Member – Heritage Isle Covenants Committee
• Advisor – Heritage Isles Community Development District
• Advisor – Heritage Isles Home Owner’s Association