Mark Scott Email & Phone Number

Palm Beach County, Florida, United States

I am currently building and nurturing a proficient, transparent, and efficient IT organization that delivers high-quality service and support—partnered directly with the Chief Operation Officer (COO) and CFO to offer leadership and counsel on information technology strategies, fostering the advancement of PBACO's success. Responsible for infrastructure, budget, vendor management, and cost optimization. Some highlights include:•Salesforce CRM Implementation: Successfully led the end-to-end implementation of Salesforce CRM, specifically tailored to handle credentialing and provider outreach programs. Used by 40 field agents and supervisors, the PAAS replaced an outdated ACT CRM software. Collaborated with cross-functional teams to customize Salesforce to fit the organization's needs, focusing on provider outreach, reporting, and supervisor workflows. •Call Center Relocation: Successfully led the relocation of a 25-agent call center to a new facility, overseeing the seamless transfer of technology, peripherals, and logistics, such as seating arrangements and ergonomic improvements. Implemented new optimized call workflows and powerBI reporting to track real-time results. The combined efforts resulted in a 227% increase in productivity, including call volume and scheduling of patients. This project was completed in 3 weeks during the year-end holidays. •Office 365 Cloud Migration: Led the effort to migrate to a hybrid Active directory environment with over 190 users. Followed by a seamless transition to Office 365, OneDrive, and Teams. This effort also allowed using tools such as Microsoft Intune and Altera for device management and enterprise deployments. My wide range of responsibilities:—Developing and implementing IT policies and procedures—Managing IT budgets—Hiring and managing IT staff—Overseeing the procurement of IT hardware and software—Evaluating and implementing new IT technologies—Ensuring the security of IT systems and data

Greater New York City Area

Overall accountability for centralized data management/engineering functions for $1.5B health plan. Recommend and implement an approach for collection, storage, protection and delivery of application usage data, ensuring it meets the data quality needs of the organization. Strategically supported and improved the infrastructure which enabled an elevated BI team with the ability to provide clinical informatics and statistical modeling to a strategic and value-add discipline to enable business outcomes in the Medicaid, Medicare and Commercial/Exchange lines of business including Quality Health Plan (QHP) and Essentials Plan (EP). Provide leadership to 20+ internal FTEs and contracted offshore staff made up of Business Intelligence Analysts, Report Writers and ETL DevelopersProject Highlights include: ♦ CMS Edge Server: Spearheaded an Enterprise Risk Adjustment Performance Monitoring & Evaluation team, including managing activities and staff conducting analyses related to the Medicare Advantage (MA) and Affordable Care Act (ACA) Risk Adjustment programs.• Coordinated all data Inbound & Outbound extracts• Analyze enrollment and claims data to identify coding gaps,• Supplied documentation and coding improvement opportunities • Creation of target lists for remediation• Forecast Risk Adjustment scores and payments and providing reports to leadership• Improved Risk Adjustment score by multiple basis points, resulting in 1 Million+ dollar in savings • Coordinate government audit of risk adjustment data (RADV Audit)♦ Population Health initiatives: Provide analytic insight to Population Health initiatives including risk stratification, quality/care gap management and value-based purchasing agreements with hospitals and primary care groups♦ Enterprise-wide Data Quality Program: Drove the definition and implementation of data governance initiatives. Formulated and managed the improvements of over 100 process to encourage and pledge enterprise-wide data quality

Greater New York City Area

Responsible for leading the internal and contracted off shore staff of Business Analysts and Developers who support the IT functions of Affinity’s Medicare, Managed Long-Term Care and New York State Health Insurance Exchange products. This included the design, development, and implementation of custom and turn-key operational support and e-commerce applications. Lead technical teams in supporting TriZetto’s Facets versions 4.x to 5.x, including enterprise-wide product upgrades, Extensions design and development, systems integration of external vendor interfaces and HIPAA Gateway EDI 5010 and 4010 transaction code sets (834, 270/271, 277/276, 837P, 837I, 997, 999, 835. Project Highlights include:♦Qualified Health Plan (QHP) Implementation: Compiled and documented Electronic Data Interchange (EDI) implementation requirements necessary for Affinity participation as a Qualified Health Plan (QHP) in New York State HIX - Covered New York. Led the evaluation and execution of system changes for enrollment management involving Trizetto Facets, Trizetto HIPAA Gateway, 40+ custom SQL Databases, HPN submission, EOB and letters, billing, banking, Federal APTC (820) and authorizations. Ongoing work member of CMS Registration and Technical Assistance Portal (REGTAP) with primary focus on enrollment, financial transactions and EDI. Active participant in the WEDI HIX workgroup.♦NYS APD Encounter Submission Implementation: Oversaw Affinity's internal resources, outside vendors, business partners to change encounter submission process from MEDS 3 to new 837 EDI layouts for professional, institutional and dental transactions and NCPDP 4.2 layout for pharmacy.♦Enterprise Billing and Reconciliation System Support: Led, improved and supported a full range of billing and reconciliation IT processes which enabled the Affinity organization to bill and receive more than $500 million dollars in revenue annually from New York State Department of Health.

Greater New York City Area

During this period held several IT leadership positions with increased degrees of responsibility that provided knowledge-based, content or technical expertise for the development and implementation of custom applications or turn-key vendor solutions. Provided leadership over end-to-end process of IT deliverables and multiple components. Project highlights include:♦Altruista GuidingCare SaaS Implementation: Spearheaded the IT integration of heterogeneous systems in a seamless manner and minimized the development effort by writing common business objects pluggable to systems irrespective of platform & architecture.♦TFS Implementation Policies & Procedures: Implemented Team Foundation Server for enterprise source control, data collection, reporting, and project tracking management. Trained and managed onsite and offsite development teams. Wrote polices around source control naming conventions standards, directory structures, branching and merging.

Greater New York City Area

Hired to lead and manage database-related tasks during the implementation of TriZetto’s Facets enterprise-wide software solution. Projects included supporting several custom development efforts related to the implementation, requiring knowledge of and compliance to the Health Insurance Portability & Accountability Act (HIPAA) and Sarbanes-Oxley (SOX) regulations. Instrumental in converting and migrating data from existing AMISYS 3000 systems.Project highlights include:• Designed a replicated production server to perform overnight batch jobs—reducing the day-to-day load by 60%.• Implemented SSIS Naming Conventions and T-SQL Coding Standards• Spearheaded the development of IVR systems integration with Facets’ SQL database. Integrated claim and eligibility data.• Spearheaded McKesson‘s CCMS upgrade and training process from versions 3.1 to 5.2. • Implemented a secured Crystal Reports Server for enterprise reporting and design.

Greater New York City Area

Charged with designing and building a high-profile Sponsored Event Fundraising System (SEFS) for the March of Dimes to provide an external system for volunteers and partners to track fundraising information, as well as internal data warehouse and reporting systems to profile events. Responsibilities included, but were not limited to, providing a written analysis of client’s current data warehousing strategy, structure and procedures as well as providing a written data migration strategy detailing the following subjects:○ Migration Timelines○ Migration Scope○ Migration Testing ○ Cut-over Methodology○ Roll Back/Recovery Plan○ Migration Requirements○ Post-Migration○ Results Reporting○ Data cleansing Responsible for writing over 60+ EDI processes to migrate over 43 million rows of data and binary objects. Served as subject matter expert on data-warehouse decisions. Initially lead data warehousing efforts. Used SQL Server Integration Services as the primary EDI tool.

Greater New York City Area

Hand selected to manage all database-related tasks during the implementation of Sunrise Clinical Manager (SCM) a $43 million project consisting of over 30,000 users across the nation's 4th largest non-profit, secular healthcare system. In preparation of a Very Large Database (VLDB), spearheaded the following discussions and implementations:• Performance Monitoring /Capacity Planning - Expected data growth of 1.3+ TB per year• Downtime / Business Continuity / Disaster Recovery via Geographically Dispersed Clustered and SAN Replication (EMC SRDF). • Application Support Model - via Eclipsys call center using CA UniCenter products.

Greater New York City Area

Responsible for the overall management of infrastructure, strategic planning and data migration.Staff of 6 programmers and technicians. Researched and implemented new hardware and software solutions. Managed a Windows 2003 network with 100+ users located over multiple floors. Acted as liaison between vendors, IT staff and department managers on all major projects. • Negotiated all new contracts with vendors for support and maintenance services and consistently reduced costs during annual review of all telecom and support contracts.• Implemented policies to comply with HIPAA privacy, EDI and security regulations.• Redesigned the data center: upgraded power, cabling, physical layout and upgraded backbone to fiber. • Conducted periodic security audits and drafted computer use policies.• Developed and implemented Anti-Spam solution.• Managed the upgraded PBA Network from a NT 4.0 and Novell to Windows 2003.• Directed the upgrade from Exchange 5.5 to Exchange 2003.In April 2005, was asked to accept the additional responsibility of the Records Management department, consisting of 9 staff members. During a 7-month period, achieved the following goals:• Designed and implemented new workflows between the Claims and Records Management • Increased access to critical information used to provide a higher level of service.• Increased workflow efficiency of the claims process by implementing a barcode and scanning• Complied with Industry and Government regulations such as HIPAA Act.• Reduced physical document storage costs by 59%• Increased department productivity by 36%.

Greater New York City Area

Greater New York City Area

Education record

Computer And Information Sciences And Support Services