Don Reid Bryant

**** ***** ***** **** • Melbourne, FL 32940 • 919-***-**** • acvykn@r.postjobfree.com

HEALTHCARE TECHNOLOGY & SOFTWARE DEVELOPMENT EXECUTIVE

Strong record of success in providing technology vision and leadership. Extensive experience in developing and implementing pacesetting, robust IT architectures and infrastructures that result in organizational innovation and high performance.

Proven skills in planning and implementing enterprise information systems that support distributed and centralized business operations. Demonstrated success in applying IT solutions to solve business issues while maximizing effectiveness and minimizing cost. Full responsibility for P&L, multi-million dollar budgets and staff management with demonstrated profitability.

CORE EXECUTIVE STRENGTHS

• Strategic Visioning & Planning

• Development & Implementation management

• Planning & Policy Development

• Systems Administration & Reporting

• Project Management / Leadership (PMO)

• Electronic Commerce Strategy (EDI)

• Budgeting & Cost Control

• Staff Management & Development

• Vendor Negotiations & Relations

• Methodologies – SDLC,PMBOK, Agile/Scrum, RUP

• Strong Grasp of Key Business Issues in Healthcare

• Portfolio Management Tools: Clarity, HP PPM

• Proficient in healthcare and business applications (i.e. • Claims, CRM interfaces, Encounters, Membership, Provider Networks, Authorizations, Configuration (product and pricing), Billing, COB, BlueExchange, Blue 2,ITS, FEP.) Medicare, Medicaid (CHIP) and Duals.

• Moderator for LinkedIn Groups:US Sailing,HIPAA 5010 and ICD-10 Network Communities

• Proficient in establishing a PMO infrastructure as well as a tool box. •Basic Support Services, Advanced specialist Services, • Consultancy and advisory Services, Strategic and governance Services.

PROFESSIONAL EXPERIENCE

Independent Living Systems

Sr. Project Manager November 2015 to Present

Converting current claims system Trizetto QNXT to PegaSys claims system. Integration of all internal and external interfaces and extracts.

New client implementation (WellCare) to ILS business model (Membership, Provider Networks, Authorizations, Claims, Financials). Manage staff of 13 in matrixed environment.

Assisted in the development of the PMO program (Agile/PMBOK)

Blue Cross Blue Shield of Tennessee

ICD-10 Sr. Project Manager January 2015 to September 2015

Support Bureau of TennCare state government Medicaid program. Responsibilities include facilitating the ICD-10 program activities. Additional responsibilities include management of Medicare program and all communications as it applies to ICD10 (Web Portals, intranet).

PMO Administrator (SDLC/PMBOK)

Univita (Home Health)

ICD-10 Program Manager February 2014 to November 2014

ICD-10 Program Manager - supported the Enterprise ICD-10 project preparation and implementation activities for the October 1, 2014 (CMS-mandated conversion date) at the time). Works with senior leadership and organizational development to develop and implement standards and new processes impacted by ICD10 (i.e. Pricing and billing). This also includes the implementation of training plans and new data models. Researched and analyzed basic and complex issues surrounding the processes and systems of this organization. Communicated Status, Necessary process changes (EDI) and RAID (Risks, Assumptions, Issues & Dependencies) to senior management. Utilized Agile Scrum methodology and tools (Scrum wise).

PMO Administrator (Agile, SDLC/PMBOK)

PHP, Lansing, MI June 2013 to January 2014

ICD-10 Sr. Project Manager

ICD-10 Project Manager - supported the Enterprise ICD-10 project preparation and implementation activities for the October 1, 2014 CMS-mandated conversion date. Responsible for the implementation of various standardized processes, tools and methodologies to support fundamental project and program management activities. The responsibilities included facilitating the ICD-10 conversion activities and accomplishing goals set forth in the ICD-10 project plan in the following areas: Capital and operating budgets, Compliance and monitoring, Payer readiness to include Medicare and Medicaid, ICD-10 crosswalk strategy and implementation, Work plan development, Management and periodic status reviews, Resource management, Issue management, Risk management, Decision tracking, Change control, Financial tracking, Executive status reporting, Document management and quality assurance. Utilized SDLC and Agile Scrum methodologies(VersionOne).

KEBB Consulting LLC (GEHA, CareMore), Melbourne, FL August 2012 to May 2013

Facets Sr. Project Manager

Facets Project Coordinator, managed all tracks of the installation of Facets 4.8 (Custom Development, Interfaces (membership,billing,EDI,etc.) and Extracts, Conversions, Repots / Correspondence, EDI, Batch, Macess, and Go Live Plan) SDLC/PMBOK

Influence and control matrix project team across multiple functional areas

Manage changes to the project scope, project schedule, and project costs using change management procedures

Managed vendors on behalf of client.(Integration vendor and Trizetto onshore and offshore)

Managed all project plans and consolidated them into the integrated program project plan.

Coordinated all efforts of the program through client System and Integration testing.

Coordinated team meetings and reported status via dash board status format to the client.

United Healthcare, Hartford, CN March 2012 to July 2012

Facets Project Manager

Facets Project Manager for the installation of 4.71 for a new product expansion on their NC River Valley Platform.

Managed all aspects of the project up to installation.

Managed all project plans up to the program integrated project Plan. (SDLC/PMBOK)

CareMore Health Plan, Los Angeles, CA September 2011 to February 2012

Facets Sr. Project Manager

Analyze user and business requirements; to determine appropriate technical approach and develop specifications for implementation of Trizetto Facets 4.71.

Directed Implementation effort of Trizetto Facets 4.71.

Directed data conversion efforts to ensure smooth cutover. (Date of Service cutover).

Directed development and implementation of interfaces to surround systems (i.e. Membership and Billing, Salesforce, Trading Partner interfaces)

Directed first phase implementation of 5010 and started ICD10 assessment. (SDLC/PMBOK)

No World Borders, Newport Beach, CA October 2009 to August 2011

(Regence BCBS and Preferred Care – Miami FL)

Program Manger

Review of HIPAA migration plans to achieve compliance and reduce risk of missed deadlines, over spending, and incorrect processes to meet critical dates.

Review of HIPAA IT technical and business requirements artifacts (TriZetto Facets, BlueExchange, etc).

Creation of mitigation plans that account for the impact of third party software that may not comply by the required dates.

Evaluation of data integration hubs, configuration, data interchange standards, and schemas to aid in the HIPAA 5010 / ICD10 standards implementation.

Review and development of "as is" and "to be" business process models to evaluate changes in processes based on changes to HIPAA transactions such as 997, 837, 835, 834, 820, 278, 277, 276, 271, 270.

Access early the business, IT, and operational / revenue cycle impacts of HIPAA 5010 / ICD10 standards to associated partner plans, provider networks and business associate compliance schedules. (SDLC)

KEBB Consulting, Raleigh NC November 2008 to September 2009

(Horizon BCBS / BCBS RI)

Sr. Project Manager

Trizetto Facets Implementations and EDI Gateway - Analyze user and business requirements; to determine appropriate technical approach and develop specifications for implementation. Participated in cross team meetings with business and IT management in development of goals and objectives as they relate to systems needs and changes. Worked with the Application Architect and Technical Leads to support, design and develop business unit solutions. (SDLC)

Blue Cross & Blue Shield of Rhode Island, Providence, Rhode Island May 2008 to November 2008

Program Manager

Lead the planning, design and implementation of all ITS Association-related products for BCBS/RI. Evaluate, plan, develop, implement and manage operational/technical processes and/or process improvements in support of LRSP/ FACETS. Contributed subject matter expertise.

Direct the implementation of the BCBS Association’s ITS 10.2 and Blue2 3.1 releases.

Implement, configure and support BCBS Association applications and interfaces.

Manage and facilitate the design and strategy for integration into front end, adjudication and back-end processes.

Oversee maintenance and delivery of all project management artifacts. (SDLC)

HMSA Blue Cross and Blue Shield of Hawaii, Honolulu, Hawaii November 2007 to May 2008

Sr. Project Manager

Oversaw day-to-day execution of assigned QNXT projects, including project plans, resources and deliverables. Evaluated, developed and drove new efficiencies and re-engineered internal control processes and practices. Identified and developed management policies and procedures for key QNXT systems. Managed $3.5 million budget and 40-person staff. (SDLC)

Identified, planned, developed and managed infrastructure enhancements to support initial production, ongoing maintenance and reporting protocols and tools for EDI transactions.

Managed the migration of core transactions to HIPAA-compliant formats and maintained smooth transaction flow as formats changed over time (BlueExchange, NPI, EDI).

Analyzed and defined business goals, objectives, needs, processes and requirements for various system changes

Recommended system enhancements, new system developments and business process changes as appropriate.

WellCare Health Plans, Tampa, Florida June 2007 to November 2007 Medicare Program Manager

Provided executive leadership to WellCare’s Medicare HMO program. Directed all strategic IT analysis, planning and implementations. Engineered turnaround of IT performance and service levels, successfully transforming IT into a strategic business unit. Managed multiple large-scale projects on-time and within budget. Oversaw budgeting, design and support of all technology for the Medicare program. Managed $2.5 million budget and 60-person staff.

Served on leadership team that evaluated and implemented technology standards for full HIPAA compliance.

Directed tech support, software development, Internet and Oracle operations for WellCare’s largest business unit.

Solved week-long average help desk backlog by attaining 90% responsiveness within the same day.

Implemented and managed new technologies successfully, including Internet and extranet sites for customers.

Established, communicated and monitored enterprise-wide portfolio and project management processes.

Managed SOX compliance, MMC audit processes, and delivery and responses to RFP’s and RFI’s.

Increased productivity through application re-engineering, development and deployment. (SDLC)

Blue Cross & Blue Shield of North Carolina, Durham, N.C. September 2004 to May 2007

Sr. Project Consultant

Managed delivery of all HIPAA and NPI projects. Provided project leadership to assess and determine impact of HIPAA and BCBS Association mandates (Blue Exchange) on existing systems. Managed technical design, development and implementation of HIPAA changes to legacy systems to comply with EDI requirements. Oversaw $2 million budget and 20-person staff. (SDLC)

Identified, planned, developed and implemented a number of new services; applied industry best practices in providing high-quality IT services to the organization.

Designed and implemented a knowledge management function to improve leveraging of intellectual capital.

Established a web asset steering committee to define technology standards and branding standards for all client-facing, non-participant web assets.

Kaiser Permanente, Dallas, Texas July 2004–September 2004

Solutions Design Consultant

Directed the prioritization of deliverables for customer solutions in accordance with CDP (Comprehensive Delivery Framework). Oversaw delivery of the Electronic Data Management Project (EDM) Kaiser’s automated enrollment process improvement project Managed $4 million budget and 10-person staff.

Performed primary oversight of EDI portion of the EDM project (Ansi x12 834 820).

Facilitated delivery of the Recon Tracking System (Kaiser’s group bill reconciliation process improvement project).

Managed the reconciliation portion of the Recon Tracking System from a solutions design perspective. (SDLC)

SeeBeyond, Redwood Shores, California June 2002–June 2004

Director of Business System Development-Consulting

Coordinated and led multi-disciplinary technical teams using current project management methodologies and tools to ensure successful on-time application implementation. Assisted clients and vendors with implementing processes such as Just In Time (JIT) delivery and flow management of electronic transactions (EBFM Electronic Business Flow Management). Managed 20-person staff and $4 million budget. (SDLC)

Navigate complexities of EDI implementation in assisting clients with defining trading partner relationships and data integration with supporting business application systems.

Assisted clients (AT&T, IBM, Oracle) with negotiating contracts for obtaining software, hardware and services.

Assisted clients with control and management of both inbound and outbound information flow through an EDI mechanism, using Value Added Networks (VAN) and IP Internet communications.

Played key role in creating training center management elements to improve business development/sales training; these included a user manual, training policies, seminars, demos and business presentations.

Coordinated with clients on key objectives concerning systems integration (EAI) projects (CRM, Healthcare and HIPAA-related projects).

Advised clients on impacts of HHS regulatory developments and HIPAA Privacy and Security rules and projects.

Facilitated project management/status meetings with executive management, QA, end users and development teams.

Blue Cross Blue Shield Association, Chicago, Illinois July 2000 to June 2002

Director of Applied Technologies

Spearheaded the delivery of BlueExchange and Blue Cross Blue Shield Associations’s B2B Infrastructure service. Oversaw BCBSA membership and billing system migration from IBM mainframe to Sun client server environment. Managed $30 million budget and 120-person staff. (SDLC)

Implemented project management processes and controls along with quality assurance standards for HIPAA projects.

Monitored and evaluated impact of regulatory developments (HHS) and HIPAA Security/Privacy rules on projects.

Planned, developed and implemented a national e-logistics strategy for all Blue Cross Blue Shield Licensees.

Managed negotiations and contracts with key partners, including AT&T, IBM, Oracle and Vitria.

Recruiting all technical staff and conducted performance and compensation reviews

Blue Cross & Blue Shield of Florida/Georgia/Nebraska July 1991 to June 2000

Senior Systems Management Consultant (SDLC)

Directed activities of senior and mid-level staff in developing and implementing corporate business systems. Managed $4 million budget and 10-person staff.

Oversaw several large project budgets; performed cost benefit analyses.

Planned, developed, implemented and managed several healthcare business systems.

Facilitated project management status meetings with end users and development teams.

Recruited staff and conducted performance and compensation reviews.

EDUCATION / CERTIFICATIONS

Bachelor of Science Degree, Information Technology, University of Georgia, Athens, Georgia, 1985.

PMP Certification – Expected August 2016.

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