Bob Ferrell Email & Phone Number

Bozeman, Mt, Us

• Facilitate the collaboration of cross-functional teams for data integrations. • Lead analysis and solutioning of HL7 routes using Mirth HL7 Interface Engine• Served as SME of HL7 Data integrations and supported multiple implementation teams to integrate data exchanges to and from EHR system.• Responsible for interfacing with business owners to obtain their reporting needs for various Government compliance reports related to tracking Member correspondence, sales performance, and overall membership reporting.• Perform data analysis on existing reporting models and data flows to determine issues with how data is being consumed by various systems and reported.• Solution new reporting data models for reporting requirements as requested by business need.• Assist Program Manager and Product Owner with adoption of SAFe Agile practices to deliver more robust solutions.• Responsible for managing the data, workflows, and applications used in support of annual HEDIS audits.• Responsible for the development of reporting dashboards in both SQL and PowerBI for reporting data load and quality of source data• Responsible for producing and loading Monthly and Annual data extracts to load into Cotiviti Quality Intelligence system.• Served as lead data analyst to the HEDIS annual Audit project team and SME for quality measures for data reported out of Cotiviti Quality Intelligence.• Responsible for managing the data, workflows, and applications used in the CMS Encounter Data, RAPS, and HEDIS analysis. • Identify and help resolve data problem areas in upstream and downstream reporting of health plan operational measures.• Lead team to engage the collaboration within Finance, IT, Claims and Enrollment areas to optimize risk adjustment and quality reporting results.• Accountable for troubleshooting and resolving Internal and external encounter processing errors for both MEDICAID and MEDICARE encounters using Babel and Epic systems for validation and verification.

• Responsible for coordination and vendor delivery of all projects related to transitioning Troy Medicare to a new TPA for 2024.• Facilitate weekly requirement and project deliverable status for each workstream impacted by a TPA transition, lead daily standups with Vendor to address any project blockers.• Responsible for Executive project reporting and escalation of project deliverables. • Lead Troy Medicare workstream leads and Vendor parties in data migration of Member, Provider, Contract and Claim data to new TPA system.• Responsible for overseeing the delivery of 3rd party vendor file integration with new TPA system.• Responsible for coordinating and delivery of rebranding materials for Regulatory and Compliance in Elevance Health. • Lead the coordination of multiple state plans in the delivery of the drafting, approval, and state submission of rebranded UCD (Universal Change Document), Member Letters and Member ID cards.• Manage the delivery of the filing of Health Plan specific legal documents with multiple state entities where Elevance does business.• Responsible for coordinating and delivery of sales strategy, actuarial analysis, and maintaining CMS submission guidelines for a successful bid.• Review and apply all related regulatory requirements related to department activities including: CMS audits, changes in risk adjustment models, changes in submission requirements and HEDIS data validation.• Define analysis and reporting requirements and provide analysis and data-driven recommendations to ‘C-level’ plan executives to support the maximizing of star ratings from CMS and quality measure reporting for commercial employers and State Medicare plans.• Project Executive responsible for planning, staffing and executing ICD10 compliance project throughout the enterprise systems. All aspects of the project included claim risk analysis, testing, certification.

• Responsible for advising the development and execution of processes for requirement intake, refinement and analysis for the Product Line Manager, Product Managers and Scrum teams for the DEAN Product Line. • Provide guidance for developing technical and solution-oriented Epics and User stories so that they can be assessed accurately for development teams to intake.• Served as SME for workflow and cloud base solutions where necessary. • Collaborated with VAEC team to assess cloud storage solutions and map out migration strategies for both AWS and Azure Cloud platforms for cost and risk assessment.• Regularly meet with stakeholders to discuss status and risks among the Benefits Modernization team along with the DEAN Product Line.• Lead several Scrum Teams in implementation of HealthShare and Cerner intergration components for the Veterans Data Integration and Federation initiative. • Responsible for advising the development and execution of processes for requirement intake, refinement and analysis for the Product Line Manager, Product Managers and Scrum teams for the VPR interface team.• Provide guidance for developing technical and solution-oriented Epics and User stories so that they can be assessed accurately for development teams to intake.• Lead and advise the Implementation of SAFe Agile principles to the VDIF Program• Responsible for managing the Implementation, Development and Technical Support teams supporting the prime contractor for implementing the Community Care Referrals and Authorization Solution in the HRSM product implementation.• Prepare and manage staffing plans and draft subcontracts to support Program growth.• Monitor budget and subcontract deliverables• Managed the implementation of Patient Poral with HealthShare.• Responsible for leading client technical, clinical and customer service teams in design of a Patient facing solution and workflow to interface with members and case managers.

• Served as Product Owner for Interoperability features related to Claims Repository and technical integration for Centene’s Interoperability initiative. • Planned and Participated in Product Increment planning for the Interoperability program.• Responsible for Roadmap, user story development and prioritization, Backlog refinement for all integration and development efforts related to the implementation of Interoperability in the Centene infrastructure.• Responsible for solutioning API interfaces to retrieve claim and member data from numerous disparate datalake repositories.• Managed the implementation of Edifecs Interoperability Solution• Functioned as the main POC and SME for the Claims Repository group for EDI, Claims and encounter processing methodologies.• Responsible for leading client technical, clinical and customer service teams in design of a Patient facing solution and workflow to interface with members and case managers.• Responsible for overseeing all InterSystems implementation tasks from building reports using InterSystems Zen, building HL7v2 interfaces, C-CDA document management, to patient identity resolution, to consent filtering, to terminology management.

Bellevue, Wa, Us

Responsible for client services - product implementation and post implementation support for Top Tier customers.Building relationships with all levels within a client, helping to facilitate change, partnership and negotiations when required. Responsible for selling $2 million in Services RevenueAccomplishments• As a services account manager I am responsible for recognizing where a client can use Edifecs services and solutions to both solve multiple business problems with both software but to also assist in improving process and staffing.• Responsible for managing HIPAA 4010 to 5010 Migration Projects and ICD-10 using EDIFECS Product Suite for major Healthcare provider companies.• Manage multiple EDI Gateway implementations with expertise in the Edifecs product suite.• Work with Project and Client executives on defining project scope and objectives. To include writing statements of work and change orders.• As an account delivery manager responsible for the overall account health by insuring product implementation methodologies are defined and followed. This also includes interfacing with Edifecs product development and engineering resources to accommodate any product or implementation escalation.• Responsible for multiple client service projects with annual client service revenue of over $10 million in licensing and services.• Lead geographically diverse delivery teams to build in complex upgrade implementations.• Project delivery including project progress tracking, change control and project governance.

Provide Development team leadership in modern development practices. Lead team in long term technical solutions to address business needs in the healthcare payer space.

Alpharetta, Georgia, Us

Provided team leadership and project management for IT projects with price ranging from $50k to $2.5M ensuring timely completion. Directed and mentored application developers, business analysts and clinical consultants in prototype, design development and implementation of technology solutions in the Medical Management space. Worked directly with clients and firm management to ensure engagement profitability.AccomplishmentsOrganized the development and execution of a medical management implementation methodology that assisted customers and implementation personnel. Enabling them to work through all phases on implementation seamlessly and cost efficiently.Provided technical solution architecture guidance to customers including technical troubleshooting and solution design.Provided advisory services to customers including strategy, software evaluation/selection, gap assessments, full life cycle implementation support and software upgrades.

Responsible for building and managing a team of 30 Developers, QA Engineers, System Analysts and Deployment Resources with a $1.5MM annual resource budget. Ensured Care Advance professional services revenue goals, in achieving team utilization of over 85% utilization were met. Mentored and coached service delivery team members to make sure high levels of performance, quality and on time delivery of custom development. Provided technical leadership and project oversight on several full life cycle custom software implementation projects. Mentored development leads in development solutions by performing code reviews (.net, C#, and C++) and lead technical design sessions.AccomplishmentsDeveloped best practice methodologies, documentation and metrics for implementation services for Care Advance Enterprise.Lead enterprise wide defect and customization request system in Mercury Quality Center.Directed the development and implementation of comprehensive strategies, focusing on one or more specialized disciplines, to meet internal client needs (e.g., Staffing, Learning and Development, and/or Compensation). Developed and monitored the status of solution/program schedules and tracked all funds associated with the contract, program, project, e.g., direct labor, subcontractors, and temporary labor as necessary.Act as liaison to Research and Development and Product Development teams on items that should be placed in the base product as per and implementation team feedback

Responsible for designing, presenting and supporting custom solutions for Client Project teams both in the Pre and Post Sales of Professional Services. Provided strategic and tactical planning, development, evaluation, and coordination for Care Advance Enterprise implementations. Facilitated communication between staff, management, vendors, and other technology resources within the organization. Addressed the needed custom solutions of the client during implementation projects. Lead technical implementation for one of the largest healthcare payers in the country with a total of over $10MM in professional services fees. AccomplishmentsLead technical implementation for one of the largest healthcare payers in the country with a total of over $10MM in professional services fees.Provided technical leadership and direction on multiple implementation projects which contributed to the success of the projects.Managed problems and issue escalations to ensure timely and effective resolutions across multiple project implementations. Oversaw implementation of applicable solutions to ensure client needs were met in a timely manner consistent with the specified budget.Designed and managed technical implementations of Care Advance Enterprise that required custom solutions. These solutions included .NET, AJAX solutions, SSO, integration with external Claims system, SOA frameworks and data migration strategies.Remained over 100% billable due to demand of ability to quickly resolve implementation and project issues.

Responsible for building and managing a team of Performance Architects. The team included DBA, Informatica specialists, Web and middle tier developers as well as Performance testing engineers. The goal of this team was to improve performance, implement performance testing, and to develop best practices on all of client's applications. Coordinated the development of Database of Database and Informatica prototyping projects. The achieved end result was better performing architecture such as Cognos and,VANTAGE data extracts. AccomplishmentsLead tactical performance testing and tuning implementations of Informatica and SQL database load process across enterprise.Direct oversight and responsibility of performance testing and performance prototyping of Siebel implementation, N-tier web systems and Datamart/Dataload applications.Implemented an enterprise performance testing methodology that encompassed multiple project, development and Database development teams. Designed and Developed a Performance Portal in .NET to assist Project teams in understanding application batch windowsImplemented Mercury Performance Center 7.8 as an enterprise wide interface into Performance Testing and tuning.Designed and Implemented Mercury Load Runner architecture for reusability

Designed, Built and Implemented QA testing and Performance strategy for an X-12 Transaction Gateway. Responsible for building and maintaining test suites of EDI specific messages. Lead quality assurance on EDI X-12 Gateway project and responsible for EDI Health Care Transactions: 827i, 837p, U277, 276, 277, 270, 271, 835 and 997 transactions. Accountable of test tracking of all Production releases, including 3rd party application hot fixes, internal design change requests, and Production fixes. aaAccomplishmentsDesigned and Developed automation testing suite in PERL to test validation of enveloping of all supported EDI Transactions.Used of Rhapsody to develop and test enveloping of X-12 transactions Supplied client with internal QA Audit of X-12 project for best QA practices going forward.

Mentored Automation and performance test teams in the build and deploying of reusable automation testing architecture. Created Performance testing guidelines to include gathering of performance requirements, load and performance modeling and building of reusable Load runner scripts. Mentored all test engineers in the standardizing QA Process across projects. Responsible for evaluating and becoming technical proficient in various automation tools to choose the best fit for the supported product base of Client Server and J2EE, these products include; Mercury Winrunner and Quick Test, Rational Robot 2002 and Segue Silk Test 6.0.AccomplishmentsDesigned and Implemented new Quality Assurance standards across 10 software projects with a staff of 20 QA engineersTrained Automation Engineers in the use of Silk Test

Created and Executed Data Base Migration Testing Methodology which included crucial financial information to customer. Created and Executed Performance testing architecture to include gathering of performance requirements, load and performance modeling and maintaining performance test environments to accurately assess performance and load bottle necks.

Amsterdam, Nl

Key contributor in Performance and Automation methodology for Practice. Built automation and performance testing standards for client QA implementation projects across many different business spaces such as Financial Institutions, Telecom, and Insurance

Bachelor'S Degree, Computer Science

Six Sigma