Duncan Glenday Email & Phone Number

Frederick, Md, Us

Managed, led, or participated in numerous large-scale projects including:* Conversion to Facets for a Blue Cross / Blue Shield* Project-managed a full web portal system for a mid-west Blue-Cross / Blue-Shield* Managed, analyzed, and designed Medicare Part-D implementation* Managed two HIPAA 5010 EDI upgrades* Managed and architected the technical interface to Bluecard (ITS) system for a large Taft/Hartley labor fund* Project managed several large-scale system implementation projects* Complex client/server application for Medicaid premium reconciliations* Enterprise-wide reporting re-engineering for a large (3-state) Blue-Cross / Blue-Shield payer* Managed all quality assurance activities for an extremely large Blue Cross / Blue Shield implementation* Managed Medicare conversion for a very large payer, and re-engineered the provider capitation system for Medicare* Manager and senior analyst for one of the largest Blue-Cross / Blue-Shield payers with conversions from various applications onto AMISYS data warehouse redesign for a million-plus member Medicaid payer* Managed all production issues for a mid-sized health plan while a system conversion was underway. Managed Diamond, CCMS, CRMS (HEDIS reporting), RiskSmart, MEDecision, complaints, appeals & grievances, and all government programs applications (Medicare, Medicaid, CHIP).* Designed and project managed AXIOM's HIPAA-enabling product * Designed and co-wrote cap-settlement and revenue analysis systems (COBOL and Allbase)* Installed fully comprehensive HEDIS reporting system* Wrote a complex provider search for AMISYS, using Quick and COBOL* Conducted full regression testing of a new claim system’s premium-billing system prior to rollout

While with CCSC - contracted to AMISYS for 2 years, then to a small managed care-consulting house (STG) for one year.Work at STG:• Developed enhancements to the Monument claim system for a large regional payer*** Allowed the client to extend the life of the legacy system by several years before a system replacement became necessary.• Presented public Oracle, SQL*Plus and PL/SQL training courses

While with CCSC - contracted to AMISYS for 2 years, then to a small managed care-consulting house (STG) for one year.Work at AMISYS:• Wrote enhancements to the AMISYS claims management system’s Correspondence Generator (CG) and the provider credentialing logic, and expanded the syntax for provider, member, auth and claim searches*** Expanded the functionality of the AMISYS product• Project managed, architected and developed Geographical Information Systems (GIS) provider search in PowerHouse, VisualBasic, MapInfo, MapBasic and Reflection Basic*** Enabled the client to do geographical searches for providers, display maps, and fax maps to members. Also became a key marketing tool for the client.• Wrote customized add-ins to enhance AMISYS to address behavioral care payer needs*** The changes enabled AMISYS to sell the product to one of the biggest behavioral care payers in the USA