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Manager Project

Location:
Goodlettsville, Tennessee, 37072, United States
Posted:
May 30, 2018

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Resume:

Donald Lee (Don) Oaks

Greater Nashville TN Area

615-***-****

ac5os9@r.postjobfree.com

www.linkedin.com/in/don-oaks-682069138

SUMMARY:

Innovative, effective, coach, manager and director with 20+ years of project manager and business analysis experience that gets results yielding savings to my work organization. Implementation management specialist for the design, business relationships, data gathering/handling/transformation processes, security, project management and business community interfaces that result in successful systems that meet or exceed organization and project needs while saving money. Expert in building quality data that uses or builds standards supported by streamlined automation resulting in significant savings in labor costs, operating costs and reduced end user frustration. Expert in cross-functional teambuilding, coaching, technical staff mentoring, verbal and written communications, multiple SDLC processes including agile, iterative and waterfall, and the usage of multiple technical tools for data storage, ETL, business reporting, design tools, etc.

TECHNICAL SKILLS:

Implementation Management

Project Manager

User Interfacing

Teambuilding and Coaching

Business and Systems Analysis

Product Development

Migration Manager

Data Testing – Planning and Execution

Communications – verbal, written and presentation

EDI process automation

X12, NCPDP, HL7 transaction formats

Data Requirements Gathering and Design (JAD)

Active listening

MS Office Suite

Broad Software Toolkit

Claims Processing Methodology

Eligibility/Enrollment Expert

Managed Care Expert

PROFESSIONAL EXPERIENCE:

Oaks Solutions: Project Manager Consultant Nov 2017 to current

Manage multiple small projects from conception to completion while looking for my next full time position.

State of Tennessee, Division of TennCare: Jan 1997 to Oct 2017

Information Systems Technology Consultant 2017

EDI Manager 2009 – 2016

Data Systems Manager 2004 -2009

Information Systems Consultant 1997 - 2004

Recognized system implementation, EDI, healthcare data and managed care expert who testified twice before the NCHVS, delivered multiple presentations at MESC and WEDI, and works with CMS on innovative ideas for Medicaid data standards, modularity and cost saving efficiencies.

Started and built the Tennessee Medicaid (TennCare) EDI department into an enterprise model that is emulated by several states and recognized as superb by the federal government. Effective and efficient EDI processes and business relationships took claims from a first pass clean claim rate of 27% to over 99% saving millions for Tennessee taxpayers and providers in reprocessing costs.

Train Project Managers and Business Analysis to assist with Project Management Office (PMO) setup and SLDC maturity processes to save money by yielding better initial system results.

Established department focused workgroups to create and maintain open direct communications with management and key users in each functional area resulting in faster project conception to completion times, quicker issue resolution and significant savings for development and support.

Implementation Project Manager for multiple business usage systems (claims processing, finance, fraud and abuse, provider relations, eligibility/enrollment, network management, business/management reporting, infrastructure data management, etc.). Activities included building business user relations, database and format designs, coding design/review, useful testing, project management, user interfaces, disaster recovery/business continuity plans, etc.

Built and managed all EDI activities including business data handling of proprietary, X12, NCPDP and HL7 transactions. Activities include design, documentation, useful testing, coaching, team supervision, ETL processing, management consultation, technical problem solving, project management, user interfaces, and data storage/handling processes.

Created batch SFTP, real-time web interfaces and WAN/LAN/VAN/ESB networks with fully automated processing for data storage/acquisition/quality review/user reporting/purge and email notifications resulting in better efficiency, significant savings in support personnel, enhanced trading partner usage and better quality data resulting in significant savings of time and resources.

Implemented data usage and statistical reporting initiatives to provide all internal and external stakeholders with enhanced interfaces and reporting for quality monitoring.

Managed the migration of multiple cross-function systems (hardware, business software and operating systems) to new environments including all phases of data/database updates, revised documentation, training (support staff and business users), reporting, disaster recovery, business continuity, support SLAs, etc.

EDUCATION:

M.S., Public Administration Management, Cumberland University, 2002; B.S., Mathematics and Biochemistry, Lipscomb University, 1979; Numerous professional courses, seminars and certifications including Mentoring, Certified Project Manager (expired), JAD, DBA, Business Analyst, Teambuilding, Active Listening, Toastmasters, COPE, Coaching, etc.

TECHNICAL THOUGHTS:

Don has a broad background with a willingness to share knowledge so he will be an asset to any organization. Don has experience with multiple environments and software tools and is an expert in managing the implementation of quality systems that meet business needs along with the management of business and external trading partner users He is specialized in healthcare and EDI related activities and innovation with an excellent understanding of privacy and security requirements.

Organizations, standards and business needs change and IT systems, processes, etc. must be flexible enough to absorb or be modified to handle change.

Standards should be used where they can be applied, saving time, resources and minimizing the need for proprietary files.

Data is the backbone of an organization and must be governed to ensure quality, timeliness and reusability. Eliminate garbage in for quality internal and outward.

Processes should be effective, automated, scheduled and streamlined with routine scheduled reviews for issue review and improvement identification.

File/data handling acquisition and delivery processes web/batch/ESB/etc. should be automated with appropriate acceptance/error notifications for seamless operations.

Internal and external users both business and technical should be treated with respect and an attitude of no question is a stupid question and all questions deserve a responsive answer.

All team members should be empowered to do their jobs with management and cross-trained team member support.

REFERENCES:

Erik Bock, TennCare Enterprise Architect, ac5os9@r.postjobfree.com

David Hinson, CMS Southeast Region IMS Specialist, ac5os9@r.postjobfree.com

Jim Gorman, CMS Innovation Coordinator, ac5os9@r.postjobfree.com

Max Arnold, TennCare Chief Technology Officer, ac5os9@r.postjobfree.com

Rick Wells, TennCare Auditor, ac5os9@r.postjobfree.com

Paul Nodjak State of TN STS Project Manager ac5os9@r.postjobfree.com

John Hugie Edifecs Technical Manager ac5os9@r.postjobfree.com

Toni Kirk DXC Sr. Project Manager ac5os9@r.postjobfree.com



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