James Mattera

Commack, New York *****

www.linkedin.com/in/jimmattera7gmail

ac1xiw@r.postjobfree.com 631-***-****

Visionary Operations Leader

Improve Operational Service & Client Delivery

Collaborative problem solver who uses financial modeling, process improvement, project management, and negotiation strengths to improve processes. Proficient in identifying root cause of issues and translating complex processes into clear, understandable, and actionable steps. Enthusiastic leader, consistently meeting commitments with integrity.

Demonstrated leadership:

Project Management Strategic & Operational Planning Data Analytics

Encounter Management Quality & Outcomes Measurement Client Reporting

Professional Experience

ANTHEM INC. (merger/acquisition WellPoint Inc.), New York, NY 2012–Present

Anthem Inc. merger/acquisition WellPoint Inc., National managed healthcare company, serving more than 40M members.

Consultant, Health Care Analytics (HCA)

Led project management team, compiling encounter health care utilization and claims data. Analyze results and compile reporting. Develop, design and automate annual and program required presentations.

Decreased medical claims and reduced severity or eliminated claims altogether through life-style change by:

oProviding project program analysis.

oMaking recommendations related to program benefit design.

oDemonstrating program value through periodic presentations.

Improved executive decision making by:

oProviding critical data to operational leaders and coordinating management of multiple related program projects directed toward strategic business and other organizational objectives.

oDelivering timely and efficient reporting on current program, future opportunities, and client issues.

oDefining and identifying projects addressing data quality and performance of upgraded software components.

Enhanced effectiveness of business results or strategic intent by maintaining continuous alignment of project program with strategic business objectives and making project team recommendations to modify program as needed.

Increased team productivity and effectiveness by coaching, mentoring and leading personnel within project program team environment.

HEALTH MANAGEMENT CORP. (HMC) (Acquired by WellPoint), New York, NY 2007–2012

HMC's innovative programs, with an integrated and population-based approach to health care that includes prevention; health and wellness, disease management and complex care, HMC working to build healthier lives and communities.

Health Information Consultant, Clinical Informatics

Provided project team client reporting for measurement of quality improvement, profiling, and utilization of clinical management programs.

Improved quality of decisions by providing business change management input into strategy recommendations for program development and policies.

Performed routine and ad-hoc analysis of clinical data, identifying improvement opportunities and best practices.

Measured effectiveness of services by managing client engagement, solution implementation, and reporting and presentations.

Increased use of strategic performance management methodologies, process assessment work, and application of technologies to business by providing business consulting and knowledge expertise.

Fostered loyalty by ensuring that customers fully utilize program value of solutions and services.

Generated revenue and provided strategic upselling of packaged products and services by maintaining and servicing internal and external customers’ existing HMC program fees.

Raised likelihood of success by:

oStreamlining implementation tasks involving 3rd party vendors as well as providing consultation to clients on system implementation.

oManaging transition of client from Solutions Implementation to Client Support. Manage development and maintenance of implementation portions of project.

EMPIRE BLUECROSSBLUESHIELD (acquired by WellPoint / HMC), New York, NY 2002 – 2007

Consultant, Project Manager

Chief Technical Specialist, Project Management & Reporting

Managed 24/7 Nurse Call Center project programs, business and governmental initiative requirements in-line compliance with National Committee for Quality Assurance (NCQA) accreditation and Healthcare Effectiveness Data and Information Set (HEDIS).

Improved quality by initiating, planning, executing, monitoring, controlling, and closing integration, configurations, and interface to all legacy systems.

Ensured open communications by serving as liaison to internal and external customers; Telecom and software partners, Insource and Outsource consultants.

Created and maintained project departmental coalitions, including financial, claims, and marketing areas for reporting cohesion, ensuring system reliability and competitively superior reporting.

Increased growth value by securing new partners, consulting engagements, and by delivering new projects.

Mentored staff in software program methodology and encouraged best practice in programs project management and project planning.

Built credibility and established rapport by maintaining communication with stakeholders at multiple levels, including those external to organization.

Managed budget for organization, influencing organization's program financial profitability.

Led systems development, implementation, and risk via use of Systems Development Life Cycle (SDLC).

Additional Related Experience

HEALTH INSURANCE PLAN OF GREATER NEW YORK (Acquired by Emblem Health), New York, NY

Manager / Project Manager /Consultant

NIELSEN MEDIA RESEARCH (Merged into Cognizant), New York, NY

Systems Administration, Project Management and Support

CITIBANK, N.A., New York, NY

Management / Corporate Financial Analyst & Branch Operations

Education

Master of Science, Management of Technology (MOT), New York University (NYU / Poly.), New York, NY

Bachelor of Science, Business, State University of New York (SUNY/ESC) New York, NY

Addendum

TECHNICAL/SYSTEMS PROFIENCY & KNOWLEDGE

Anthem data/applications: EDWard, CII (Client Information Insights), Advantage Suite, Large Group Client Reporting System (LGCRS) (including LGDW, MyDataPoint), CS90, WGS, Telecomm Suite, WorkNet, SharePoint, Request IM, LiveMeeting, Anthem Metadata Repository, Care Enhanced Call Center, Crystal Reports, BO/BIS (Anthem’s Business Objects, Business Information System), CRMS.

Microsoft Office Suite; Excel, Word, PowerPoint, SQL, Visio, Project, OutLook.

Enterprise Project Management Methodology (EPMM) Process & Documentation Standards.

Specialized Skills

Technology:

Management of Technology (MOT), MPS, CNE, PMI-PMP candidate

Self-Management:

Leader, OPW, Consultant, Team Leader, Team Member

Communication:

Excellent communication, designated as Point of Contact

People – Leadership / Management:

Project Manager, Project Leader, Staff Management, Team Leader

Numerical:

Data Analysis, Data Analytics, Metadata

Professional Development

PAHM designation, Professional Association of Health Management, AHIP CE

Six Sigma – SkillSoft Challenge Series – ALN

Leadership Development Program

SQL - ALN

Microsoft Certified Product Specialist (MPS), Microsoft, Inc., Seattle, WA

Netware Certified Engineer – CNE, Novell, Inc., Provo, UT

Certified Electronic and Computer Service Technology, Grumman Data Systems Institute, Woodbury, NY

Affiliations / Associations / Memberships

New York University Alumni Association

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