John Mandujano, PMP CPHIMS

*** ********* ***** ***** ** 33771 s 727-***-**** s acvbcf@r.postjobfree.com

SUMMARY OF QUALIFICATIONS:

A professional with eight years project management experience in a variety of industries but primarily in the healthcare arena. Proven abilities with attention to detail and able to work in a fast paced environment. Recognized as a superior communicator and leader.

CERTIFICATIONS:

Project Management Professional (PMP), Certification #1407712, from the Project Management Institute (PMI).

Certified Professional in Healthcare Information and Management Systems (CPHIMS), Certification #2058, from The Healthcare Information and Management Systems Society (HIMSS).

PROFESSIONAL EXPERIENCE:

10/2013 – present PROJECT MANAGER

Mandujano Consulting LLC Largo, Florida

Mr. Mandujano served as the Project Manager. He designed and managed the implementation of SaaS applications leveraging behavioral economics to improve voter turnout and another SaaS application to provide a finance portal for high-end automobile dealerships.

IDC Technologies (PriceWaterhouse Coopers) Tampa, Florida

Mr. Mandujano assisted in the network management of a webinar featuring the CIO of PWC North America. Activities included monitoring and adjusting network traffic, monitoring connect times and tracking the number of connections. He also managed the rollout of an SCCM release to over 40,000 desktops and laptops in preparation of a rollout of Windows 10.

WellCare Health Plans Tampa, Florida

Mr. Mandujano managed ICD-10 testing with clearinghouses like Relay Health, providers, ancillary vendors and state Medicaid programs to ensure a smooth application implementation affecting Medicare and Medicaid managed care subscribers in seven states. He was also responsible for updating all policies and procedures referencing diagnosis codes. Recognized for his expertise, Mr. Mandujano participated as a panelist with other managed care organizations in webinars for rural healthcare providers in Georgia. In addition, he coordinated internal communication professionals to create training programs on ICD-10.

Blue Cross Blue Shield of Michigan Detroit, Michigan

Mr. Mandujano managed the ICD-10 Program which included provider outreach, internal and external training programs, updating operating policies and procedures, supervising contracts with outside vendors, managing a 3.4 million dollar budget, creation of a social media site, external testing with healthcare providers, manipulating 837I and 837P EDI transactions to create HIPAA compliant ICD-10 test claims, internal enterprise testing and implementation of an Informatica Master Data Management (MDM) system.

Insurance Administrative Solutions Largo, Florida

Mr. Mandujano managed the analysis of the effort bring a potential client into a new whole life insurance system.

04/2013 – 10/2013 PROJECT MANAGER

PharMerica Tampa, Florida

Mr. Mandujano managed the transition from ICD-9 to ICD-10 concentrating on order entry and claim adjudication application implementation affecting processing all across the United States. The implementation allowed acceptance of ICD-9 and ICD-10 diagnosis codes. The acceptance and processing of ICD-10 codes was based on a variable implementation date. Since PharMerica had multiple implementation releases throughout the year, the ICD-10 remediation used Agile methods. Mr. Mandujano also managed a project to update billing hierarchies and another project that coordinated corporate updates to pharmacy satellite operations.

10/2007 – 04/2013 APPLICATIONS ANALYST / PROJECT MANAGER

Adventist Health Systems - Information Services (AHS-IS)

Florida Hospital Tampa / University Community Hospital

Tampa, Florida

Test and implement software to accommodate ICD-10 changes in Siemens Patient Accounting (Revenue Cycle) and McKesson’s Horizon Home Health and Hospice Care.

Mr. Mandujano managed the EDI 5010 remediation revenue cycle project as well as the implementations of Studer’s Patient Call Manager and Discharge Call Manager. He also maintained and enhanced Siemens Invision Patient Accounting and Patient Management Systems. He implemented changes to billing interface files from ancillary systems using HL7, Easytrieve, REXX and COBOL. As part of the 5010 remediation project, he gave a presentation to the IT Steering Committee on the importance of the V5010 837I EDI transaction. Recognized for his communication skills and knowledge, he gave two presentations to the Office Manager’s Council: one on cooperation, competition and productivity and another presentation on managing stress. Mr. Mandujano also taught newly hired clinical staff on how to use software applications including Quantros, CACTUS, GE Centricity and Siemens Patient Management.

03/2006 – 08/2007 IT CONSULTANT

Pinellas County Government Clearwater, Florida

Maintain and modify software (COBOL and Easytrieve), assist staff in system maintenance projects and develop enhancements mandated by customer business requirements and statutes.

03/2005 – 03/2006 IT CONSULTANT / PROJECT MANAGER

Health Plan Services Tampa, Florida

Production Support Project Manager for the Finance Team. Responsibilities included supervising up to ten programmers, initial diagnosis of errors, project planning using traditional waterfall methods, interacting with external and internal clients to determine requirements, scheduling resources, and review and test corrective measures.

Maintain and created COBOL programs and MVS JCL in a DB2/CICS environment. Systems included enrollment, commissions, EFT processing, policy maintenance and billing.

Assisted in the configuration, customization and installation of new carriers.

02/2003 – 12/2004 PROJECT MANAGER / SYSTEMS ENGINEER

Medicaid Systems for the State of South Carolina

Using EDS’ SDLC methodologies, analyzed, designed, and implemented HIPAA compliant EDI 270/271 transactions including supervising business analysts, EDI engineers and programmers, requirements gathering with end-users, writing requirements documentation, creating technical design specifications, supervising and assisting business analysts in the creation of test cases, budgeting the coordinated efforts and scheduling all efforts.

Assisted in the development of Companion Guides to enhance project communications with outside vendors as a part of a larger SOP update.

Worked closely with representatives of the State of South Carolina’s Department of Health and Human Services, Clemson University and the U.S. Department of Defense Enrollment Eligibility Reporting System.

Coordinated certification procedures for CLAREDI.

Developed Requirements, Technical Design, Test Cases and Turnover Documentation using MS Project, Excel, Visio and Word.

Programmed and tested 837 Institutional Claims, 837P Professional claims, 820 Payment Order and 834 Benefit Enrollment and Maintenance transactions.

Taught an IDMS class to system engineers.

10/2002 – 12/2002 IT CONSULTANT

CareMedic St Petersburg, Florida

Designed a relational database for HIPAA EDI health care claims processing including 837 Institutional, 837 Professional 837 Dental and 835 Remittance Advice transactions.

10/1998 – 10/2002 PROJECT LEADER

Progress Energy St. Petersburg, Florida

Project Leader for conversion projects between Oracle and legacy systems.

Project Manager for Florida Power Y2K remediation team. Responsible for supervising five programmers, project planning, scheduling resources, performing and directing Y2K integration and system testing, assisted production support and problem resolution.

EDUCATION:

PMI-ACP (Agile Certified Practitioner) Training

Building a Project Schedule in Microsoft 2010

Tracking and Managing Projects in Microsoft Project 2010

Customizing and Sharing Projects in Microsoft Project 2010

Intermediate Skills in Microsoft Access 2010

Setting Up Projects in Microsoft Project 2010

Designing a SQL Server 2005 Security Policy to Integrate with Systems Infrastructure

An Introduction to Transact-SQL in Microsoft SQL Server 2008

Querying and Filtering Data in Microsoft SQL Server 2008

Managing Microsoft SQL Server 2005 Supporting Services

Cerner Overview

Introduction to the Centricity Enterprise Database

Centricity Enterprise Core Concepts

B.A. Excelsior College – SUNY – Albany, New York

Boston College, Chestnut Hill, Massachusetts

AWARDS:

Team Information Services Consultant of the Year 2000.

CTG 1996 Achievement Forum Attendee.

3rd Place Leonard Persuasive Speaking Collegiate Contest

Alternate to the U.S. International Discussion and Debate Collegiate Team

New England Debate Collegiate Champion

Top Freshman Debater of Boston College

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