Our candidate is a seasoned Healthcare Project Manager with over 10 years of consulting & FTE experiences. He has an excellent background in supporting and managing Healthcare projects, and brings an extensive understanding of the tools, processes and technologies in use in the Healthcare vertical. He recently worked at a medical company where he worked on their Claims system and provided training for Xcelys and developed the price rules configured in the Xcelys database. He has extensive experience gathering and documenting clinical, financial, technical and business requirements, through JAD sessions and has significant clinical knowledge and experience.
This candidate is currently based on the East Coast and is available to work anywhere in the Continental U.S. for direct hire, consulting and contract to hire.
Interested in meeting this candidate? Email us at marketing@staffsmart.net
Achievements
- Achieved Financial Strategic Goal Providing Company $ 50 Million integrations of CMMI level 2 compliance standards and MMIS subsystems standards for Government RFP State Insurance Database Structure build. Created the Rational ReqPro Enterprise Insurance Product Data bases storage structures for Global Management, Member Management, Provider Management, Operations Management, Program Management and Securities Management for Blue Cross Blue Shields of GA insurance stakeholders.
- Established Managed Maintained Medicaid Management Information System (MMIS) managed care and fee-for-service policies support also provided 3M 360 duel coding ICD-10, CPT/C4 and other coding standards support.
- Provided Medicaid and CHIP program policy, requirements, including complete end-to-end lifecycle (data flow) of eligibility, enrollment, claims, payment, and post-payments.