• Advise investors in Health IT (specialties: cloud, mHealth, claims processing / revenue cycle management, electronic health records, SaaS based analytics, Accountable Care, Value Based Care, Medicare Advantage, healthcare economics diligence) • Advise legal teams in healthcare economics, clinical data and new regulations, structures (expert witness, reasonable and customary costs, pricing, diagnostic imaging (MRI, CPT, etc. anti-trust matters for Federal Trade Commission landmark case in clinical data, ICD-10, reimbursement economics, computer assisted coding, revenue cycle management)• Advise health plans and hospital systems (ICD-10, EDI, ACOs, EHR, Meaningful use, Revenue Cycle, CORE Operating Rules, Affordable Care Act, Medical Loss Ratio)• Advise Health IT companies in mHealth, Cloud, SaaS, BigData, Analytics, 510k diagnostics, social media and healthcare• Presided over explosive growth of a Health IT firm - $50 million in enterprise deals, high profile clients• P&L experience - startup to $50 million to $350 million; managing teams up to 200• Diligence on $4 billion in healthcare M&A with leading payor / provider / HIT target companies• Extensive clinician software usability and workflow expertise, large IT systems migration experience• Filing of three patents in healthcare informatics, mHealth and Cloud focused clinical data and process• Quoted in Wall Street Journal, regular speaker, published works as expert in the field• Manager, largest social media group of its kind on LinkedIn focused on Accountable CareExpert opinions - care claims reimbursement; fraud; HIPAA privacy and security; medical record & billing documentation; ICD & CPT coding for orthopedics, obstetrics and cardiology; Medicare, Medicaid Insurance. Lead of team with MD, RN, RD, MPH, RHIT, CCHIT, CPC credentials bringing more than 30 years of experience in coding, regulatory affairs, population health Medicare Advantage and Medicare Shared Savings Plan (MSSP) ACOs.

Chair, Compensation Committee, Member, Audit Committee, Chair, Cybersecurity Subcommittee for this publicly traded (NASDAQ: LIFW) Medicare Secondary Payer recovery leader. For more about some of the recent wins for MSP Recovery, see: https://www.jdsupra.com/legalnews/11th-circuit-upholds-rights-of-medicare-60018/

Leadership position to discuss the impact of legislative updates and legislative forecasts for the healthcare industry. Track updated guidance for federal state and commercial coverage determinations of medically necessary care, independent review organizations (IROs), and independent dispute resolution entities (IDRE); Workers' Compensation Utilization Management (WCUM) standards; InterQual / Milliman Guideline updates; quality Standards from URAC and Compliance Standards.

Advisor to Independent Diagnostic Testing Facility business in propriety of medical coding approaches, fair market value physician advisory board compensation, presentation of new code to American Medical Association, market research regarding new innovations and their impact on health care economics in the EEG with video telemetry / telemedicine for this HIPAA Covered Entity / health care provider.

Focusing on Strategic Financial Management for C-Level Executives in Healthcare Providers and Value Based Care Payors. HFMA is the premier professional association for over 40,000 financial executives in healthcare.Key topics I am interested in:Case studies about reducing the cost of care, cost of operations, cost of delivering care, or avoidance of regulatory risk and therefore cost Bond ratings, revenue cycle management, physician hires, unionization, tax exempt financingsValue based care, cost of care delivery changes in reimbursement under the Affordable Care Act, analytics, risk adjustment, capitationRisk avoidance: Best practices in HIPAA privacy and security e.g. sharing patient data in patient portals connected to E.H.R.s, breach avoidance, policies and procedures, information safeguardsRisk avoidance: avoiding failed audits - RAC, False Claims Act risk in Meaningful Use Attestations, risk adjustment audits

Executing go to market strategy for healthcare based version of innovative SaaS, Cloud Based technology that measures worker productivity using RFID, Real-Time Location Services (RTLS) and a visual workplace. Hospital systems, home care and other markets leveraging indoor spatial location systems Near Field Communication (NFC) technology from Broadcom and Qualcomm Snapdragon platform, including iZat location platform and NFC tags.App prototypes - User Interface (UI) and User Experience (UX).

Writer for Government Health IT News on Mobile Health (mHealth) Patient Protection and Affordable Care Act, American Recovery and Reinvestment / HITECH Act / Meaningful Use, and the International Classification of Diseases, version 10 (ICD-10).

Accountable Care Strategy; Patient Protection and Affordable Care Act (PPACA). Optimize clinical documentation, coding and billing for inpatient / acute care as well as physician group / outpatient across multiple specialties including primary care, orthopedics, cardiology, obstetrics, oncology and other specialties. ICD-10 Informatics - Study of complex systems, information and computation using applied mathematics, electrical engineering and software engineering techniques. Lead team to review physician informatics for E.H.R. with respect to clinical workflow, clinical quality measures (CQMs), SOAP notes, specificity of documentation for ICD-10 support, revenue cycle impacts prior to the acquisition of a rural health system by on of the largest academic medical centers in the U.S.

Clinical data, interoperability, and Health IT for one of largest publicly traded healthcare IT firm in the U.S. ICD-9, ICD-10, DRGs, Electronic Health Records, Affordable Care Act, computer assisted coding. Testimony preparation for hearing before Federal Trade Commission. Impacts: Durable Medical Equipment (DME), medical diagnosis, medical procedures for inpatient and outpatient procedures, fraud waste and abuse reviews, clinical documentation and medical and billing codes used for reimbursement, national economic impacts.

Lead management consultant to improve Utilization Management processes using BPM, IT solutions, training and regulatory experience to decrease claim UM queue times and improve service to the provider network. Build executive dashboards to provide insight into financial incentives and alignment with physicians in the provider network. ICD-9 diagnosis and HCC code risk adjustment, capitated payments, CSSC Operations (Palmetto) integration, risk corridors. utilization management. Impacts: Durable Medical Equipment (DME), medical diagnosis, medical procedures for inpatient and outpatient procedures, fraud waste and abuse reviews.

Hospital interoperability, HIPAA transactions, Meaningful Use of Electronic Health Records, ICD-10 process, clinical documentation, medical coding, revenue cycle management

Macroeconomic models for reimbursement under ICD-9 and ICD-10. Opine on the importance of data liberation and interoperability as an anti-trust issue and a matter of national economic importance.

Evaluated company strategy and made recommendations regarding upcomming HIPAA, ARRA, PPACA mandates including HIPAA 5010, ICD-10, and related people, business process, legal and compliance issues.

Evaluated investment opportunities in Healthcare IT including Medicare Advantage and Accountable Care Organization Businesses, SaaS, Cloud Computing, social media in healthcare, IPA, health plan, healthcare analytics, electronic medical records, interoperability and service oriented architecture integration

Largest data company in the world. Responsible for initiative to integrate siloed businesses and IT platforms into one. Managed consulting team to assist enterprise sales in winning and business with top 20 financial institutions. Led effort designed to streamline internet based lending. Assisted in securing strategic marketing relationships and major contracts with JP Morgan Chase, Wells Fargo, Bank of America, GMAC, Suntrust, Navy Federal and other clients.Built successful teams and eCommerce solutions for loan origination, closing, securitization and capital markets, loan portfolio analysis, valuation services including AVMs, documents, tax data, flood certifications, title insurance, default, loss mitigation, final disposition, sale of REO properties.Executed Sarbanes Oxley audit under Section 404 of the Sarbanes Oxley Act. Board-level and audit committee-level quarterly presentations. COBIT / COSO compliance. Results: on time, on budget & eventually successful completion a favorable audit by PWC / Price Waterhouse Coopers.

Optical, Cardiac medical device, pharmaceuticals emphasisBusiness process improvementFDA Adverse Event solutionsCRM integrationInterface to Regulatory AffairsCAPA (corrective action preventative action)21 CFR Part 11 and related regulationsI led a complex engagement for Abbott Laboratories regarding medical devices and pharmaceuticals as well as pharmacovigilance in 2002 - 2004. This covered optical, cardiac devices and pharmaceuticals. This engagement focused on the markets, regulatory, compliance, process and systems necessary to support Abbott's business and it interfaced with Regulatory Affairs, IT, Financial areas.

Built web Services team to link the financial and technology assets of $multi-billion Fidelity lines of business. Managed one of the most profitable P&Ls for the company. Clients included Bank of America, JP Morgan.

Recruited by board of directors to grow a software as a services (Saas) provider of Internet, wireless, and medical and enterprise billing, provisioning systems. Leveraged Java and XML Web Services technology market lead to attract strategic investor Citrix Systems, Paymentech (largest processor of Internet credit card data in the world). Grew company from $200k in revenue in to $10 million run rate and profitable with less than $3 million in equity funding in 18 months.

Founded LeadersOnline, an early social networking venture for $400 million executive search firm and launched it in less than 18 months. Positioned company for $20 million in revenue in second year. Created partnership with www.businessweek.com new media and careers. Venture added approximately $100 million to the market capitalization of parent company Heidrick at the time of its IPO on the NASDAQ in May 1999 according to underwriters Lehman Brothers and Goldman Sachs. Clients included WAMU (Washington Mutual), Goldman Sachs, VISA. Left after IPO, merger of company.

Advised two companies on their strategy around Internet content, first with Oracle in a venture that combined database search technology with CNN Interactive to form Oracle Custom News Server for Corporate Clients leveraging content from CNN interactive, Thomson and other companies.

Guided Symantec in setting their LiveUpdate OEM strategy with clients such as Intel, and licensing and acquisitions related to electronic software distribution, security software, and acquisitions due diligence.

Reviewed and advised HP on its early Web Services strategy for senior management-worked directly with Chief Scientist at HP on competitive and execution issues around the strategy.

Member of management team that helped grow company from $3 million in revenue to $50 million acquisition within two years. Left after acquisition by publicly traded competitor. (multiple acquisitions - Digitalk acquired by ParcPlace Systems, who was merged into ObjectShare, later acquired by Cincom Systems).

Launched first PC database interfaces to Sybase and Microsoft SQL Server. Re-launched Ashton-Tate and dBASE IV Version 1.1. Held P&L responsibility for $250 million product line; $15 million + marketing budget. Profits and market share increased until purchase of the company by Borland. Returned database products to profitability; successful launch of Ashton-Tate's cross platform strategy, product line on five versions of UNIX. Started as Product Manager for new innovative, easy to use consumer information management product, RapidFile which was a hit in Europe (UK, France, Germany, Netherlands) and Latin America and changed the way the company thought about user interface development and design for its flagship database software.