Rick Simmons Email and Phone Number

As Healthcare Practice Leader and Senior Executive Consultant Manage the Healthcare Consulting Practice that serves BlueCross BlueShield Health Plans and Commercial Healthcare clients. Our focus is to deliver value to our clients and partners on every assignment. Consulting services include system evaluations and planning, executive leadership coaching and mentoring, strategic evaluations and development, architectural reviews, organizational assessments, program management, Merger & Acquisition (M&A) support, Executive Information System (EIS) development and interim management. Including expertise in cloud based self-service solutions, remote access capabilities, mobile technologies and wireless networks.

As CEO provide relevant Information Technology Services to the Healthcare, Financial and Technology Industries. Services include system assessments and roadmap development, leadership coaching and mentoring, organizational design, program and project management, Merger & Acquisition (M&A) integration support, Executive Information System (EIS) design and development and enterprise architecture governance services. Clients include Blue Cross Blue Shield Plans, Commercial Carriers, National Financial Institutions and Global Technology Companies.

Verbum Dei is a private High School that has served the South Central Los Angeles communities for over 50 years. As board members our goal is to provide the Gentleman at Verbum Dei High School with the resources necessary to prepare them for college and the corporate workplace through the Cristo Rey Network Internship College Prep Programs. As a result the past 5 years, 100% of all graduating students have been accepted in colleges and universities across the nation.

As Chairman of the Company Evaluation Committee we selected 20+ startup companies annually for investment consideration by the membership. As an active board member of the Pasadena Angeles and venture capital investor in early stage companies we lead investment transactions in high tech companies while providing leadership coaching and mentoring to the entrepreneurial and academic communities in Southern California.

As CIO had responsibilities for all information technology functions, including, strategy planning, applications development, telecommunication networks, data center infrastructure, security, architecture, compliance, project management office and disaster recovery planning. Budgetary responsibilities included $130 million annual expense budget and $50 million capital budget with 800 associates reporting through eight (8) vice presidents. Led major initiatives including consolidation of operations over seven (7) year period to reduce the annual expense budgets by $50 million annually through the reduction of systems and merging of data centers to a single footprint in Northern California. During this period we implemented an Executive Information System to improve visibility of key performance indicators and negotiated staff augmentation and offshore outsourcing contracts with IBM and Cognizant to reduce staffing levels by 20% while improving associate survey result by 13%. This was accomplished by engaging associates at every level of the organization to improve outcomes. Additionally, service levels were improved during this period by nearly 5% to achieve 99.9% system availability. This was accomplished by implementing best practice desktop refresh programs, strengthening infrastructure capacity and implementing management practices that improved quality and reduced outages. Also, developed outsourcing strategy to further reduce costs and improve organizational performance.

Responsible for all information technology functions supporting Health Net’s New York, New Jersey, Connecticut and Arizona Health Plans. Including membership and billing processing for over 1 million members and adjudication of over 12 million claims annually. Budgetary responsibilities were over $15 million annually while managing over 150 associates reporting through nine (9) Directors. As a member of the executive management team led thirty-five (35) revenue generating and cost reduction projects that were completed in six (6) months. These initiatives contributed $35 million annually to the P&L.

Responsible for all information technology functions supporting Health Net’s California and Oregon Health Plans. This included membership and billing, eServices, provider, benefits, claims, capitation, underwriting, pharmacy, Interactive Voice Response (IVR) and sales systems. These systems supported processing of over 2 million members, including $1.9 billion in HMO provider payments and adjudication of over 6 million claims annually. Budgetary responsibilities were over $13 million annually while managing over 130 associates reporting through nine (9) Directors. Developed and delivered new HMO capitation system that improved payment accuracy to providers and reduced processing time by over 50%.

Responsible for all information technology functions, including software engineering, telecommunications and data center functions. Reporting to the CEO and a member of the executive management team was also responsible for all technology recommendations to the board of directors in support of the business and investment strategies. Developed and presented technology strategies to the board of directors for approval. During this period 15 web product releases were delivered including the initial provider contracting product release on schedule and budget. Also, obtained eBusiness certification and co-branding partnership with IBM, engaged Paragon Solutions as our off-shore engineering partner and negotiated data center contract with IBM to increase web site utilization by 200% while reducing costs by 50%. As a member of the executive team we secured investment funding from SAIC, Three Arch Partners, Versant Ventures and Mobis Venture Capital firms. Additionally, supported the product sales process for Sutter Health and led the successful implementation of this flagship account.

Over 10 year period had responsibilities for a variety of information technology functions, including Corporate Systems, Executive Information System, Managed Care Systems, Data Center Operations, Technical Services, Support Services and Technical Architectural functions. Responsible for a staff of over 140-information technology associates who reported through five (5) Directors with budgetary responsibilities of over $25 million annually. Additional responsibilities included leading the Program Management Office (PMO) and successful Y2K certification efforts for all WellPoint companies and subsidiaries assets. Working directly with the executive leadership team led all technology aspects of the John Hancock, Massachusetts Mutual, Rush Prudential and Blue Cross Blue Shield of Georgia Merger & Acquisition technology integration activities. Responsibilities included the consolidation of the John Hancock data center operations into WellPoint’s infrastructure, resulting in an annual $19 million run-rate savings to the P&L. Implemented process improvements to strengthen data center performance to achieve 99.5% systems availability and successfully implemented all HIPAA electronic transactions in support of the Public California Healthcare Interchange Network (CHIN).

Responsible for all Corporate System functions, including the Executive Information System, Marketing Systems, Decision Support and Loan Origination Systems. Developed and delivered systems that supported the Chief Economist Office to evaluate market trends and indicators; improved the mortgage loan originations cycle times with new on-line processing features; and implemented (at the time) a first of its kind marketing customer information system to target market products and services to customers and prospects.

Served in active duty for three (3) years and was honorably discharged. Supported the Emergency Deployment Communications Network (EDCN). This network provided voice, data and cryptography telecommunications capabilities supporting the command and control infrastructure in Europe. Infrastructure included: High Frequency Radio, Microwave Radio, Pulse Code Modulation (PCM) Carrier, Cryptography and Teletype telecommunications equipment. Assignment required a secret clearance throughout military career.