Experience

MOLINA HEALTHCARE INC

• United States
• Hospitals and Health Care
• 100 - 200 Employee

• Sr. Project Manager

  • Jun 2017 - Present

  Columbus, Ohio Area Responsible for Project Management of multiple large and medium scale projects (5-8 projects avg. in open status at all times) intended to improve performance of critical business processes and meet government regulatory requirements. Responsible for project leadership, project plans, issue management, and status reporting, Responsible for all phases of project execution and team leadership, facilitation of all project meetings including agendas and follow-up items. I also perform Business… Show more Responsible for Project Management of multiple large and medium scale projects (5-8 projects avg. in open status at all times) intended to improve performance of critical business processes and meet government regulatory requirements. Responsible for project leadership, project plans, issue management, and status reporting, Responsible for all phases of project execution and team leadership, facilitation of all project meetings including agendas and follow-up items. I also perform Business Analyst responsibilities including: business requirements definition documentation and current/to-be workflow design. Significant role is working liaison between Corporate IT teams and Business Owners to ensure IT development met requirements, including testing, business feedback and logic change. Highlighted projects: - Data and Systems Lead for new 2023 fiscal year Ohio Medicaid contract readiness review. Workstream PM for the Encounters implementation team including Molina and our three primary delegates for vision, dental, and transportation claims. Business fluent in EDI transaction sets that support the new 2023 Ohio Medicaid contract. Currently managing readiness for two clinical delegates performing UM and CM functions on specific populations. I have managed implementation for following delegation clients: Clear Coverage (radiology authorizations), Evicore (UM), Progeny (UM/CM), Pure Health Care (CM), AccordantCare (CM), SkyGen (dental), March Vision, Access2Care (transportation). Responsible for all delegate communications associated with new contract. - I have managed projects in Care Management, Utilization Management, Encounters, Health Information Exchange, Appeals and Grievances, State Appeals, Quality, Call Center, and more. - PMP/PMI membership, Six Sigma Green Belt certified. Show less



Molina Healthcare

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Project Manager

  • Jun 2010 - May 2017

  Columbus, Ohio Area Molina Healthcare of Ohio: Project Manager with experience leading multiple project teams with representatives from the following functional areas: IT, Utilization Management (UM), Case Management (CM), Care Transitions, Communications, Provider Contracting, Reporting and Analytics, Government Contracts, Compliance, Medical Affairs, A&G. - CM Transition Projects: Led two managed care redesigns. Project teams included 10-15 core team members and 10-12 person extended team. Responsible for… Show more Molina Healthcare of Ohio: Project Manager with experience leading multiple project teams with representatives from the following functional areas: IT, Utilization Management (UM), Case Management (CM), Care Transitions, Communications, Provider Contracting, Reporting and Analytics, Government Contracts, Compliance, Medical Affairs, A&G. - CM Transition Projects: Led two managed care redesigns. Project teams included 10-15 core team members and 10-12 person extended team. Responsible for all Sr. Mgmt. status reporting, project planning and monitoring, IT requirements collection and testing. - Partners for Kids (PFK) and Health Network by Cincinnati Children’s (HNCC) Delegation Projects (2012-2013): The objective of these two similar projects was to formally delegate CM, UM, and Care Coordination functions for PFK/HNCC members. - McKesson Clear Coverage Implementation Project: Software integration of a provider facing web based service authorization package. Managed 12 person team through software configuration and workflow development, acceptance testing, provider rollout, staff training, - Collected detailed requirements then worked with business and IT to develop these new reports - UMTD, CM quarterly files and HRA. UMTD and CM reports required very complex logical design which demanded iterations of BRDs and IT reviews. My role was to manage the requirements and business soli solicitation and IT oversight/communication. - Show less



Deloitte

• Business Consulting and Services
• 700 & Above Employee

• Manager

  • May 2009 - Sep 2010

  - Assisted a major New Jersey health plan development of a comprehensive plan for implementing a cost reduction and quality improvement initiative. My deliverables scope focused on Case Management restructuring from individual CM to pod CM. - Assigned to a major Minnesota health plan to implement a focused improvement project in the Utilization Management area. Improvement suggestions included streamlining workflows, automating manual processes, improving inter/intra departmental… Show more - Assisted a major New Jersey health plan development of a comprehensive plan for implementing a cost reduction and quality improvement initiative. My deliverables scope focused on Case Management restructuring from individual CM to pod CM. - Assigned to a major Minnesota health plan to implement a focused improvement project in the Utilization Management area. Improvement suggestions included streamlining workflows, automating manual processes, improving inter/intra departmental communications, establishing performance metrics, and improved reporting procedures. o Observation, interviewing, and relationship building skills, uncovered process inefficiencies and encouraged workers to openly speak about issues and improvement ideas. Show less



Capgemini

• France
• IT Services and IT Consulting
• 700 & Above Employee

• Manager

  • May 1994 - Sep 2003

  Coordinated establishment of an SAP Automotive Center of Excellence (COE) in the Detroit CGEY Advanced Development Center. - Team Leader for a financial reengineering project at a Japanese automotive manufacturer. o Demonstrated ability to coordinate data collection resources at ten production facilities on three continents and synthesize the data into a cohesive current state assessment and gap analysis. - Project manager of a twenty person Enterprise Resource Planning (ERP)… Show more Coordinated establishment of an SAP Automotive Center of Excellence (COE) in the Detroit CGEY Advanced Development Center. - Team Leader for a financial reengineering project at a Japanese automotive manufacturer. o Demonstrated ability to coordinate data collection resources at ten production facilities on three continents and synthesize the data into a cohesive current state assessment and gap analysis. - Project manager of a twenty person Enterprise Resource Planning (ERP) system implementation project. Areas in project scope included manufacturing, distribution, purchasing, sales, engineering, finance, and inventory management. Managed third party vendor relationships, expectations, and timelines that accelerated functional design readiness by two months. - Team leader on a multi-million dollar ERP system implementation project for a division of a tier one automotive supplier. Demonstrated team leadership skills and helped advance project goals in multiple business areas, and resolved functional design issues amongst a diverse set of stakeholders. - Team leader and process improvement workshop facilitator/trainer for a big three auto company. Personally responsible for planning, coordinating and conducting process improvement workshops at 15 plant and administrative facilities. Show less