Managing the Health Choice core production systems with a talented team. The core systems supported are our claims adjudication system, Med/MC, and our care management system, CareRadius. This team is also responsible for development of internal applications, vendor data exchanges, EDI, reporting design and delivery, and more. Functions coordinated within our group include design and testing of claims adjudication system change, customization and maintenance of the care management solution, vendor management, relationship building, resource coordination and collaboration, EDI activities from inbound claims to outbound encounters, growth initiatives and implementation strategy, and audit management with numerous entities and focus areas. Evaluate product direction, manage core maintenance and support teams, deliver process solutions to support our internal and external customers. Focus on member experience, claims, care management systems, affiliated products, and reporting.

Managing the Health Plan Information Systems core production systems with a talented team. The core systems supported are our claims adjudication system, Med/MC, and our care management system, CareRadius. This team is also responsible for development of internal applications, vendor data exchanges, EDI, reporting design and delivery, and more. Functions coordinated within our group include design and testing of claims adjudication system change, customization and maintenance of the care management solution, vendor management, relationship building, resource coordination and collaboration, EDI activities from inbound claims to outbound encounters, growth initiatives and implementation strategy, policy development, and audit management with numerous entities and focus areas. Evaluate product direction, manage core maintenance and support teams, deliver process solutions to support our internal and external customers for both Health Plans and Accountable Care Organizations. Focus on member experience, claims, care management systems, affiliated products, and reporting.

Manage a dynamic team of 12. Responsible for core systems development, testing, maintenance and system integration including the billing, document management and financial systems. Responsible for maintaining compliance matters related to HIPAA, PCI and previously Sarbanes-Oxley within the Information Technology group.