Middle Project Manager

PROJECT MANAGER

Industry Preference: Technology, Business Operations, and Finance

QUALIFICATIONS PROFILE

Highly organized, performance-driven, and goal-oriented professional, offering progressive experience in all facets of project management within diverse industries. Exemplify proven expertise in identifying challenges and providing applicable resolutions to drive organizational development and success. Possess excellent critical thinking, problem-solving, and decision-making capabilities, coupled the ability to accomplish corporate goals and objectives. Display exceptional interpersonal and communication skills in cultivating relationships with various groups and individuals.

AREAS OF EXPERTISE

Team Leadership Process Improvement Business Development

Documentation and Testing Management Quality Control and Quality Assurance Administration

Strategic Planning and Implementation Risk Assessment Statistical Analysis and Modeling

RELEVANT EXPERIENCE

AultCare Insurance Company, Canton, OH

Data Analyst Dec 2014–Present

Function as principal data analyst for the development and improvement of value plan or the diabetic member engagement chartered program project, which involve six AultCare’s functional departments that would aid diabetics manage their health and reduce overall insurance risk

Provide strong leadership capabilities in handling the following functions:

–Lead developer to work with external partner CCS;

–Lead programmer and main contact regarding Alegeus Health Reimbursement Account (HRA) for pharmacy drug costs to the involved diabetic members; and

–Lead analyst for new member attribution logic development

Serve as principal analyst for the integration and application of LexisNexis product planning and management (PPM) product, including the following functions:

–Provision of earlier adopter feedback to LexisNexis Development Team; and

–Partnership with the Development Team in addressing and providing solution that would support providers in attaining anticipated population; as well as obtaining additional elements to the PPM product including quality and utilization metrics

Utilize the following to carry out tasks with regard to reports and requests:

–SQL for querying various audit reports across all functions of the business;

–SSRS and ACMS for converting oracle codes to SQL stored procedures and creating user report generator environment, allowing convenience with the user in running reports; and

–Over five different servers and all subsequent tables that generated queries for unique ad hoc daily requests

Conduct genetic testing cost analysis based on historical data that were used to bill fee schedules for all genetic testing procedure codes

Take full charge of performing healthcare effectiveness data and information set (HEDIS) analysis for the Quality and Accreditation Department for three months

Design and apply a process to query and confirm fee schedule loads to the new claims processing system

Generate reports utilized in analyzing the company’s financial standings and executing operational functions, future planning, department oversight, quality control, and quality assurance

Deal with new SQL-coded reports creation and capital flow or numerous payment monitoring of providers, groups, product line categories, provider specialties, and other classified groups

Project Manager Dec 2015–Jan 2017

Determined a project need and provided presentation to a five-person group of executives

Established an advisory board of 10 directors and supervisors across Technical, Operational, Compliance, and Client Relations departments

Initiated the design and preparation of project charter, from scratch through strategic planning

Managed the development of statement of work (SOW) in Microsoft Project to be used in monitoring the schedule of the project

Used temps to confirm provider ID relationships between the old and new claims processing system, as well as for cross-walking providers for historical deliberations

Formulated and implemented quality control (QC) procedures to guarantee the accuracy of encoded data and non-violation of major key constraints in the operational system and supporting tables

Handled the research, drafting, and presentation of a wide range of solution options to be considered by executives including the following:

–Principal option 1: To customize the new system to enable a 4th provider matching layer, which could maintain AultCare’s existing process; and

–Principal option 2: To change business model in alignment with industry standards

Notable Accomplishments:

Applied project management methodologies in implementing a project to verify and enhance provider information prior to the launch of AultCare’s new claims processing system for commercial lines that established the foundation of using project management methodologies on future projects

Took part in assigning a specialty code to all nurse practitioners and physician assistance to allow a copay for them based on type of specialty services executed, which led to a net savings for AultCare

Played an integral role in identifying new primary issue which contributed on AultCare’s provider contracting business model with new systems capabilities

J. F. Safe Harbor Trust, Minerva, OH

Senior Investment Property Manager Jul 2010–Dec 2014

Rendered expert oversight to investments and land productivity activities, including research and contract negotiation, and financial assessments

Served as the program director for various construction projects which included $120K budget for capital asset acquisition and $245K for building update and improvement project on seven outbuildings, which involved negotiation and coordination with the proper governmental agencies

Notable Accomplishment:

Succeeded in negotiating a $500K long-term lease guarantee for oil and natural gas mineral rights with final agreement of 250% higher than the initial offer

Oakhill Life Care Center, Louisville, OH

Independent Software Contractor Dec 2010–May 2011

Facilitated the configuration of a child’s Apple iPad app to boost communications for a nonverbal stroke victim of 30 years, while training the individual in utilizing the new program

Conducted research with regard to available commercial software for nonverbal stroke victims

Created a common communication tree and parameterized software to provide support to logical mapping of the tree structure

Dealt with recording and uploading of verbal statements and images that supported several branches and leaves of the tree

Led quality control testing on parameterization for ease of use with accuracy

OTHER EXPERIENCE

Career and Technology Centers of Licking County, Newark, OH

Classroom Instructor Sep 2007–May 2008

EDUCATION

Master of Project Management, 2014 GPA: 4.0 Graduated with Distinction

DeVry University, Keller Graduate School of Management, Downers Grove, IL (Online)

Bachelor of Science in Decision Science, 2010

Miami University, Oxford, OH

CERTIFICATION

Certified Associate in Project Management (CAPM), Valid Until: Apr 2023

Project Management Institute (PMI)

ACTIVITIES

Basketball Statistician and Baseball Scoreboard Operator, Miami University

Member/Executive Officer, Pi Kappa Phi Fraternity

Construction Volunteer, Build America

Volunteer, Fairfield Center

Youth Mentor, 4-H Projects

TECHNICAL ACUMEN

SQL SAS Visual Basic (VB.NET) SSRS Report Creation Minitab Oracle Crystal Ball

Microsoft Office Applications (Word, Excel, PowerPoint, Outlook, and Access) Visio, and Project Tableau

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