KGO Consulting, LLC is a technical consulting company. Areas of expertise include: Business Intelligence and Reporting, Data Architecture, Data Integration, Database Administration, Data Security, SharePoint, Cloud Design and Migration, EDI Integration, Disaster Recovery, and Enterprise Architecture Planning.

Our team is contracted to implement multiple inbound and outbound X12 EDI interfaces relating to membership, claims, capitation, and remittances. Our framework also allows easy implementation of proprietary healthcare data formats.

Our team developed and implemented many business intelligence processes (ETL, Data Warehouse, OLAP Cubes, and Reporting) that interface with EPIC, Clarity, and Caboodle. We also implemented additional data marts in Caboodle and a separate EDW from non-EPIC sources such as Lawson GL, Talant Managent, Active Directory, and more. Currently, we are enhancing the Balanced Scorecard application which is used to create objective reviews for employees manager level and above .

Designed and developed a dynamic web-based billing system currently used for over 300 clients. Built a reporting system able to report in aggregate for all products and services across a sharded back-end design. Upgraded database servers with over 300 databases from SQL Server 2005 to SQL Server 2008 R2 and later to SQL Server 2012. Setup Active/Passive failover clusters and Always-On Availability Groups. Built custom backup and restore procedures. Devised solutions and implementations for removing performance problems. Troubleshooting of network issues, SAN issues, and database performance issues. Implemented new queries and indexes to improve database performance.

Devised architecture and built a batch processing system for Medicaid benefits verification. The process uses SQL Server Integration Services to create and send EDI X12 270 requests and receive EDI X12 999 and 271 responses. Benefits history is then created from the data.Currently working on improving database infrastructure and reliability.

Architected, developed, and implemented a new membership management system based on EDI files from health plans and internal data collected by staff. This directly affected the company’s net income by reducing claims payments to ineligible members, increasing the number of auto-adjudicated claims, and enhancing accuracy of encounter data. Setup database mirroring and Availability Groups for both local redundancy and disaster recovery. Implemented self-service BI through server based tabular models. Worked with SAN and VM administrators to improve performance and reliability of core systems. Reduced the number of servers and licensing costs by consolidating database servers while improving performance. Worked with security teams to implement full data and security auditing. Optimized data access to improve performance and load capacity.

Reported directly to the CIO for 90% of the job. Developed and managed new teams responsible for data management, reporting, and business analytics. These teams are in charge of data security, data integrity, internal and external client reporting, state reporting, risk management reporting, self-service business analytics tools, and SharePoint Server. The work output from these teams directly increased compliance ratios, accuracy of claims payment, precision of eligibility information, and the resiliency of core systems. These changes provided cost savings including lower PMPM costs.Prototyped changes to core applications to use Redis improving performance by 900% with minimal cost increases.

Managed a client roster of high net worth individuals. Designed, developed, and implemented an investment club management system and stock option analysis system using custom built trading and management software. The trading software evaluated 100,000+ options and their respective stocks in near real-time to find appropriate hedging strategies. Both systems retrieve data from various web services and store it in collocated servers and cloud-based platforms.

Built and managed a team of business intelligence developers and database administrators. The team successfully designed and implemented a new data warehouse, SQL Server Reporting Services, SQL Server Analysis Services OLAP cubes, Proclarity analytics tools, and SharePoint Server. As a result, process automation was increased, productivity was improved, reporting accuracy was increased, and staffing needs were reduced. These accomplishments resulted in reduced costs, increased compliance ratios, and improved precision of actuarial algorithms.

Created and managed a team of business intelligence developers. The team implemented a real-time data warehouse for use with both internal and external clients. The data warehouse also allowed for near real-time fraud detection processing. The work output reduced the cost of fraud and increased the accuracy and ease of internal and external reporting.Team Lead of Transaction ProcessingOne of two teams that designed, developed, and implemented the core transaction processing system. The two teams worked together to build a highly scalable multi-tier transaction processing system. The system was designed to handle approximately fifty times the current load. Personally built a multithreaded recurring billing system that was responsible for more than 80% of revenue. Systems were built using Visual Basic, SQL Server Message Queuing, and COM+ (Microsoft Transaction Server).IVR Programmer (Concerto)Designed and implemented an IVR based on Concerto that handled 13 different languages. This IVR communicated with many transaction processing components and enabled customers to look up and cancel subscriptions.

Developed secure n-tier web applications for clinical trials. This was one of the first clinical trial web applications.. This software was developed with HTML, JavaScript, VBScript, ASP, and COM (custom DLLs). The software was completely data driven and was administered by a non-programmer.Application DeveloperDeveloped a custom rules-based engine COM Server (DLL) and editor that analyzed data entered by neonatologists to determine the proper billing codes based in physician input. The DLL was completely dynamic at corporate and static at each site. The editor was designed for non-programmers to build new DLLs.SQL SpecialistDeveloped financial reports that gathered and formatted data from multiple systems, including Claris Financials, GPMS, and Pediatrix's custom financial database.