Michael L. Hébert Email & Phone Number

Lake St. Louis, Mo

Dallas/Fort Worth Area

Provided primary and specialty support and compliance services for healthcare clients nationally. Services included work for health systems/districts and health plans including commercial and Medicaid, including Texas Medicaid.• Responsible for interacting with Texas state agencies, such as the Texas Department of Health and the Texas Health Quality Alliance, regarding state Medicaid plan requirements and new state initiatives such as Compass 21 (a Medicaid Management Information System) and the Children’s Health Insurance Program (CHIP).• Developed financial and utilization reports at multiple client sites, including Medicaid and HEDIS reporting as required by Texas Medicaid.• Developed procedures for extracting financial data for the generation of provider 1099s.• Developed and maintained several claims, eligibility and enrollment EDI processes for both Medicaid and commercial clients in several EDI formats including HIPAA formats X12 837, X12 834, X12 835, X12 276/277, X12 270/271.• Involved in several healthcare-related EDI projects mapping client proprietary formats to various inbound and outbound HIPAA-compliant EDI transaction sets including X12 837. Also provided enhancement of existing client maps.• Provided custom enhancements and support functions for various clients of Dell/Perot System’s healthcare management software solution, including EDI, data warehousing ETL processes in Microsoft environments, UNIX, and enterprise reporting.• Implemented Dell/Perot System’s DDS EDI software. This included the enhancement of several EDI maps, installation of various 3rd party software, and testing with several trading partners.• Clients have included but are not limited to: Seton Health Plan, MetroWest/JPS Health Plan, MediFax, etc.

Greater St. Louis Area, Dallas/Fort Worth Area

Worked for a national healthcare consulting company initially in a technical role and quickly moved into a healthcare specific requirement and solution delivery. Key participant in a Texas Medicaid health plan startup and also for other Texas Medicaid health plans.• Involved in the implementation and customized enhancement of HSD’s healthcare management and EDI software solutions for various health plan clients.• Involved in HIPAA gap analysis identifying deficiencies in clients’ information systems in meeting HIPAA Administrative Simplification standards.• Using Sybase/Neon/Paperfree mapping software, mapped HIPAA-compliant claims EDI transaction sets into modified NSF, UB92, and various proprietary file formats.• Enhanced the Diamond software solution with several custom modules written. These included Flex Spending, Usual & Customary Pricing imports, Texas Medicaid Fee Schedule imports, and Provider Network data imports.Business & Systems Analyst • Developed and modified several EDI interfaces. EDI formats included X12 837, NSF, UB92, and proprietary formats.• Set up ETL processes for enterprise data warehousing and master data management repositories in Microsoft environments at various client sites. This involved the use of the FTP scripting, ODBC drivers, VBA programming, and task scheduling software.• Provided UNIX support functions for various clients.• Client work included but not limited to: Mercy Health Plan, Seton Health Plan, Kaiser Permanente and MetroWest Health Plan.

Urbana-Champaign, Illinois Area

While attending college for my BS in Psychology and BA in History, maintained a series of jobs including part-time independent consulting, co-management of a home healthcare business and various other jobs. • Coursework in computer science included C++ programming, SAS statistical programming, and Scheme programming.

Greater St. Louis Area

Key designer and developer of the Labor Union Management System (LUMS) software solution which handled many labor union management functions including membership, dues, benefits and health claims processing (Taft-Hartley 1975 amendment). He also led the efforts in enhancement design, configuration and implementation for the Medical Management System (MMS) software solution for provider groups of 10 to hundreds of physicians. Work also developed an automotive inventory and accounts management software system.• Managed the implementation and customization of LUMS at several midwest labor unions and district councils.• Implemented and enhanced the MMS at several midwest regional medical groups. This software package provided accounts receivable health claims adjudication and associated functions.• Developed and installed an inventory and accounts management package at a St. Louis automotive parts warehouse. This software tracked inventory, handled automatic purchasing, and maintained customer accounts.

Bs In Psychology, Ba In History, Additional Studies In Computer Science

• Besides coursework related to degrees, additional coursework in computer science included C++ programming, SAS statistical programming.

Pahm Certification, Healthcare Management

• Coursework: An Introduction, Governance and Regulation and Health Plan Finance and Risk Management.

Computer Programming Certification

• Coursework included several progamming languages such as Basic, RPG, COBOL, Fortran and Assembly.