Jim Delaware Email & Phone Number

Portsmouth, New Hampshire, United States

Strategize the planning and development of PCG TPA (third party administrator) with internal and external customers.Manage team responsible for all EDI/System functions: * Production cycle * Eligibility loads * Check Run Process * 837 Claims Loads * 835 Payment Files * System Configuration * Void and Reissue checksWork closely with Project Managers who.

Woburn, MA

• Regional Operations Manager for Northeast Region in charge of client support and project management covering clients in the Northeast region.
• Work collaboratively with internal teams (Product, Development, IT, Claims, EDI, Account Partnership, Provider Relations, Compliance, Legal, Audit, Reporting..), as well as clients in the Northeast, assuming overall.
• Manage projects in a proactive fashion to be ready for the inevitable changes and challenges, and pivot as internal and external conditions dictate.
• Clone project team resources via cross-training and shadowing (i.e. having a back-up for each team resource, ensuring projects don’t stall due to primary resource not being available).
• Excellent client reviews on all client projects managed and issues handled, for both response time and results delivered.

• Led the Client Production Operations & Customer Support department, encompassing 3 teams: Production Operations, Production QA and Customer Support.
• Accountable for all aspects of production customer support for three of McKesson’s SaaS solutions.
• Led overall strategic approach to customer issue resolution. At a high-level this consisted of: (Stop-Bleeding, Short-term Solution, Root Cause Analysis, Design & Develop & Implement long-term solution with a goal of.
• Main operational liaison between Clients, Production, Support, Client Services, Product, Analytics, R&D and DevOps, to ensure production client satisfaction and drive E2E operational efficiencies to meet/beat client.
• Ensured timely and accurate execution of entire production data refresh cycle of McKesson’s population health SaaS solutions, as well as the associated customer support for these solutions.
• Created, implemented and enforced internal & external SLAs and SOPs.

• Managed the Production Operations department, consisting of 3 teams (Production Operations, Production Customer Support, Production QA). Oversaw the ongoing production data processing, production customer issues.
• Responsible for client data reception, data quality checks, ETL and data aggregation into SAS and Oracle DBs.
• Responsible for all processing to create Health Outreach Campaign datasets that were ultimately loaded into Seibel (CRM) for subsequent Health Coaches (RNs) to perform member and provider outreach.
• Program & Project Manager, converting a manual production processing operation environment to a fully automated, end-to-end operations environment, for both upstream SAS processing as well as downstream Oracle.
• Created all associated internal and external SLAs & SOPs to support the data processing operational environment.
• Accountable for the implementation, mapping, setup and ongoing support of all Tidal Enterprise Job Scheduler job streams and overall application.

• Lead a 24 x 5 Operations & Production Control team responsible for: staging, executing, monitoring and producing all weekly, semi-monthly and annual output for US & Canadian Payroll, HR and Benefits from a Global.
• Directed and maintained security controls for payroll check printing, direct deposit file transmissions and all subsidiary interfaces.
• Produced an annual production processing calendar that is distributed to 200+ users/vendors of our PeopleSoft HRIS System.
• Produced Annual Budget for Operations Dept. (Approx. $1 million Budget).
• Implemented Tidal Job Scheduling application to work with PeopleSoft System.
• Developed programs for MMC Risk Department’s Errors and Omissions Systems; The Public Affairs Department’s Matching Gifts System; and the Payroll Department’s Payroll System, utilizing FOCUS & Cobol programming.

• May 1988– July 1992 (4 years 3 months)Responsible for programming, report writing, and support of the following systems:
• E & O Management System - Risk Management/Legal Department, written in FOCUS under VM/CMS.
• Match Gifts Systems - Public Affairs, written in FOCUS under VM/CMS.
• Genesys Human Resources, Payroll and Benefits Systems, programmed internal Interfaces, written in COBOL and FOCUS under MVS/ESA for entire Genesys System, programmed in the following languages: COBOL, FOCUS.

• March 1986– May 1988 (2 years 3 months)
• Responsible for installation of IBM PC's and related hardware, Wang VS terminals, and mainframe terminals.
• Provided support for various PC software including: Windows 95/98/NT/ME, DOS, Lotus, WordPerfect, CC Mail, LotusNotes, Procomm, Word,Rumba/Irma, Irma file transfer, FTP, and many; software packages.
• Set-up PC-based systems with user-friendly menu systems and performed one-on-one training with users.
• Programmed and supported the Xerox 4090 Laser Printing System, including FDL programming for all forms, JDL for all batch print jobs for Payroll, Human Resources, and the Tax department.
• Supported a 3com LAN.

Serviced as a 3rd class Petty Officer on the USS Kalamazo as on part of the Nimitz Battle Group for 4 years. I was part of the supply department and worked on the computerized inventory system of this AOR class ship (supply ship). In charge of 25 Supply Department personnel.

Continuing Education Courses While Working At Mmc, Business Administration And Management, General

•Worked toward degree in Applied Science & Business Administration while employed at Marsh & McLennan Companies

Certificate, Programming And Operations

2 year curriculum covering: Data Operation Concepts Hardware and Software Architecture Programming languages covered:(Cobol, RPG - II.