Working with Mphasis on the Migration and Support of a new customer moving to #Javelina.

Independant Consultant Assisting Health Insurance Payers with the following: System Migration and Implementation Program and Project Management, Process and Change Management, Data Migration and System Quality Assurance.

Javelina Implementation Project Program Director tasked with providing leadership, direction and project governance for #Javelina System Implementation / Upgrade Project.

Javelina Implementation Project Program Director for #Javelina System Implementation Project.

miBenefits Javelina Project Program Manager responsible for all aspects of the GBAS to Javelina System Implementation/Migration Project deliverables, as well as providing Project oversight and governance for the implementation of EBMS New Groups to Javelina. Developed and drove the team to a new project timeline for the Javelina Implementation project which was stalled and 2+ years behind schedule. Lead the successful implementation and migration of the EBMS’s first 3 Phases (20 groups) and New Groups (30 groups) to the Javelina Software platform, in 2018. Set program objectives, project deliverable timelines and an appropriate and successful project governance structure. Continue to plan future migration phases, work with Vendors on software and integration deliverables and help transform an organization to support business growth projections.

Interim Sr. Director of IT and acting IT Program Manager for the Children’s Medical Center Health Plan QNXT Implementation. Responsible for the QNXT System IT deliverables for the Star Kids program. In addition, tasks involved in standing up a new Health Plan include, but not limited to enacting, setting and implementing IT departmental policies, procedures, roles and responsibilities. Children’s Medical Center Health Plan (CMCHP) will cover seven counties: Collin, Dallas, Ellis, Hunt, Kaufman, Navarro, and Rockwall counties. CMCHP’s goal is to serve the Medicaid and CHIP population in these areas, covering children and adults that participate in these programs.

Program Manager/QNXT SME responsible for the implementation of the Cal MediConnect (Medicare/MediCal Duals) Program onto the QNXT Platform. As a QNXT Functionality SME, assisted with Configuration and Workflow development.Developed and ran auditing procedures, data cleanup, and QNXT data mining/reporting, to support different SCFHP departments. These included, EDI Member, Provider, Claims Customer Service and UM. Documented the data mapping between the Altruista (UM) system and QNXT and provided QNXT scheme knowledge to the IT teams.Worked on process improvement by developing business and technical solutions to support the QNXT implementation.

Assisting with the implementation of the Cal Medi Connect (CMC), or Duals Implementation. Also, providing QNXT Functionality and Schema knowledge to the CORE project Team.

Responsible for the overall QNXT system implementation from MP/MHC to QNXT, for all HealthSpring Markets. HealthSpring currently owns and operates Medicare Advantage plans in Alabama, Delaware, Florida, Georgia, Illinois, Maryland, Mississippi, New Jersey, Pennsylvania, Tennessee, Texas, and Washington, D.C., as well as a national stand-alone Medicare prescription drug plan.Transitioned to the role Director of QNXT Configuration.

Providing valuable post go-live QNXT data, schema and software knowledge to solve issues. Troubleshoot configuration problems and make recommended solutions. Mine data necessary to take correction action in fixing claims, membership, providers, configuration and most anything system related.Provided many temporary workarounds to system/setup issues.

Consultant

Conversion Lead, Implementation of QNXT, for the State of Maine, Medicaid System.

I'm currently assisting Molina (Formerly Unisys) with its State of Maine QNXT Project.

Project Manager, Senior Business and Senior Technical Analysis roles. Clients include; BCBS of New Jersey (Horizon), Dental Dental of Missouri, Schaller-Anderson, Altius,