Management Manager
Resume:
KENNETH R. BONI
Clifton Park, New York 12065
*******@*****.***
QUALIFICATIONS SUMMARY
Accomplished Medicaid Management Information System (MMIS) Project and Systems Manager with 20+ years Technical, Analytical, and Management Skills.
Proficient at delivering highly critical projects on time, under budget, and in scope as is evidenced by the Louisiana HIPAA project
Overall management for implementing all HIPAA-mandated initiatives for the Louisiana MMIS. Under his management, Louisiana achieved prestigious CMS “Top 5” State standing for HIPAA and was used as CMS approved HIPAA EDI “Best Practices” which served as a guideline for other states
Successful in managing large staff of 80 + and coordinating projects spanning multiple technical platforms and operational teams and stakeholders
Adept at applying innovative solutions to complex Medicaid Management Information System (MMIS) issues and problems by identifying root cause of deficiencies
Highly skilled written and oral communication skills to a diverse range of audiences from system programmers to executive board members
Adept at minimizing impact to ongoing operations and external interfaces/dependencies during the reengineering of highly complex and integrated systems
Proficient in large-scale systems development
Expertise in all aspects of Medicaid management including proposal preparation, requirements analysis, general system design, detail system design, development and testing, accepting testing, systems implementation, and ongoing operations and maintenance.
WORK EXPERIENCE
Molina Healthcare Corporation, Baton Rouge LA: May 2012 – March 2016
Independent Consultant/Mainframe Developer: Louisiana Medicaid Management Information System ICD-10 Conversion Project. Hands on responsibility for requirements, analysis, coding/testing, implementation and post implementation support. On-boarded several new managed care organizations including Magellan, Aetna and United Healthcare. Responsible for requirements, analysis, coding/testing, implementation and post implementation support for all FFS claims/MCO encounter processing to facilitate compliance to HIPAA regulations. Also remained responsible for the maintenance and enhancements for all X12N EDI transactions. Utilized COBOL II, DB2 SQL, command level CICS, VSAM, TSO/ISPF, Fileaid, JCL, Endevor, Syncsort, Eztreve Plus, Idcams and Jobtracs.
Molina Healthcare Corporation, Baton Rouge LA: May 2010 – April 2012
Independent ConsultantMainframe Developer: Louisiana Medicaid Management Information System 5010 Conversion Project. Hands on responsibility for the development/implementation of enhancements required by the DHH for conversion from 4010 to 5010 for all X12 transactions, including 837I, 837P, 837D, 835, 270, 271, 276, 277, 820 and NCPDP D.0. These responsibilities include all coding and testing of enhancements to FFS claims/MCO encounter processing, pharmacy claims processing, remittance advise generation, claims status inquiry and recipient member eligibility inquiry. Utilized COBOL II, DB2 SQL, command level CICS, VSAM, TSO/ISPF, Fileaid, JCL, Endevor, Syncsort, Eztreve Plus, Idcams and Jobtracs.
Unisys Corporation, Baton Rouge LA: May 2004 - 2010
Independent Consultant/Mainframe Developer: Louisiana Medicaid Management Information System Enhancement Project Manager. Hands on responsibility for the development/implementation of enhancements required by the Unisys successful rebid of the LMMIS. Responsible for the successful impklementation of Mckesson ClaimCheck. Responsible for coding/testing of all impacted systems including claims processing, recipient eligibility, provider enrollment and MARS data warehouse. Also remained responsible for the maintenance and enhancements for all X12N EDI transactions. Responsible for maintenance and elimination of all production assembler modules. Utilized IBM Assembler, COBOL II, DB2 SQL, command level CICS, VSAM, TSO/ISPF, Fileaid, JCL, Endevor, Syncsort, Eztreve Plus, Idcams and Jobtracs.
Unisys Corporation, Baton Rouge LA: 2001 - 2004
Independent Consultant: Louisiana Medicaid Management Information System HIPAA Project Director. Responsible for managing a team of 80+ technical and operational staff. The team was responsible for requirements, coding, testing implementation and post implementation support. Successfully completed a series of 56 phased implementations to achieve HIPAA compliance through full legacy claims processing systems remediation. Implementations spanned multiple platforms and included all HIPAA mandated X12N EDI transactions (837I, 837P, 837D, 835, 270, 271, 276, 277, 820) and the elimination of all “Local Codes”. Project was deemed “top 5” by CMS, 14 of 18 CMS HIPAA “Best Practices” were derived from the CMS review of the Louisiana HIPAA project. Utilized COBOL II, DB2 SQL, command level CICS, VSAM, TSO/ISPF, Fileaid, JCL, Endevor, Syncsort, Eztreve Plus, Idcams and Jobtracs.
SPIEGEL GROUP, Newport News, VA: 2000 - 2001
Independent Consultant: Analysis, design, coding and testing in a MVS environment utilizing Cobol II, DB2 and command level CICS. Developed a quarterly reconciliation module between the Spiegel Group Customer Credit database and the First Consumers National Bank master files. Utilized COBOL II, Oracle SQL, command level CICS, VSAM, TSO/ISPF, Fileaid, JCL, Endevor, Syncsort, Eztreve, Idcams and CA-7.
UNISYS CORPORATION, Glen Allen, VA: 1997 - 1999
Independent Consultant: Kentucky Medicaid Management Information System. Analysis, design, coding and testing for the conversion of the claims processing system from "Fee For Service" to "Managed Care" utilizing command level CICS and COBOL II. Responsible for Claims Processing System modifications.
CAPITAL ONE, Glen Allen, VA: 1994 - 1997
Independent Consultant: Analysis, design, coding and testing in a multi-platform/IBM mainframe environment utilizing COBOL II, DB2 SQL and command level CICS. Completed development of a Real Time Online Automated Credit Application Processing System, utilizing command level CICS, COBOL II and DB2.
FIRST HEALTH SERVICES, Glen Allen, VA: 1984 - 1992
Senior Director Medicaid Systems Group, 1991-1992: Responsible for a team of 90 technical staff performing maintenance and enhancements of 4 Medicaid Management Information Systems (MMIS); including Alaska, New Mexico, District of Columbia and West Virginia. Responsible for the development and implementation of the State of Louisiana Medicaid Early Periodic Screening Diagnosis and Treatment Tracking System (Kid-Med) and responsible for the coding, testing and implementation of the Massachusetts Medicaid Mental Health Services Tracking System. Job duties included full fiscal responsibility.
Director, Maintenance and Ongoing Development, 1987-1991: Responsible for the maintenance and enhancements to the Alaska, West Virginia, District of Columbia and Delaware Medicaid Management Systems. Developed system schedules, resource and cost requirements and monitored progress of projects. Supervised a staff of 30 people including; programmer analysts, system analysts and project managers.
Systems Manager, 1984-1987: Responsible for design, development, acceptance testing, implementation and ongoing operations of the Georgia Medicaid System. Served as claims processing team lead during the development phase of the project and as systems manager during the operational phase. Responsible for the processing of 260,000 Medicaid claims per week, including an extensive CICS on-line system. Staff of 30.
EDUCATION
State University of New York
Concentration of study: Computer Science, Mathematics
TECHNICAL COMPETENCIES
Software: Z/OS, DB2, COBOL, CICS, VSAM, TSO/ISPF, JCL, ENDEVOR, EZTRIEVE PLUS, CA-7, SYNCSORT, EXPEDITER, IEBGENER, JES 2, MICROSOFT OFFICE SUITE, MICROSOFT WINDOWS, IBM ASSEMBLER, UNIVAC ASSEMBLER, IBM ASSEMBLER, ORACLE SQL, 6502 ASSEMBLER, BASIC, FORTRAN, DYL260, PANVALET, ROSCOE, VBASIC 5.0
Hardware: IBM 9000, IBM 3090, IBM 3081, IBM 370/155, AMDAHL V6, IBM PC, UNIVAC 1110, UNIVAC 70/46
Office Automation: Microsoft Office Suite, Microsoft Visio, Microsoft Access, Microsoft Project
References Available Upon Request
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