Jack Joseph

*** ******* *****

Westerville, Ohio 43082

Professional Summary

Mr. Joseph is a Senior Management Consultant with over thirty (30) years of experience managing large, mission critical information technology programs/projects in the state/local government and healthcare industries – including budgets in excess of $100M and geographically dispersed cross-functional teams. His professional consulting career has encompassed working with government programs, including Health & Human Services (HHS), Medicaid, Medicare, Veterans Health Administration, Workers Compensation, Public Health, and Mental Health, as well as state and local e-commerce and public university based academic medical centers. He has worked with top tier clients on strategy development, requirements analysis, business/systems design, systems implementation, full lifecycle testing and operational deployment. He is well versed in multiple technical areas including business/data modeling, Business Intelligence (BI)/Data Warehousing, Service Oriented Architecture (SOA), ITIL (Information Technology Infrastructure Library), Medicaid Information Technology Architecture (MITA) and Electronic Data Interchange (EDI). He has served in trusted advisory roles for Federal/State agencies and private sector companies, working effectively throughout the organizations from the C-Suite to line staff.

In addition, he is a Subject Matter Expert (SME) in the areas of Medicaid, Medicare, Patient Protection and Affordable Care Act (PPACA), Health Information Technology for Economic and Clinical Health Act (HITECH), Healthcare Insurance Portability and Accountability Act (HIPAA), and Health Information Exchanges (HIE)/Regional Health Information Organizations (RHIO). More specifically, he has led custom software development, BI and packaged implementations, including multiple health care claims management systems and Medicaid Management Information Systems (MMIS).

Experience

Advocate Solutions 11/2014 – Present

Lead/Project Manager, Ohio Health and Human Services Business Intelligence Solution

Leading the strategic planning and implementation of a statewide health and human services business intelligence solution, including multiple source data integration, data cleansing/governance and systems architecture to support advanced reporting and analytics.

Responsible for balancing business priorities, developing delivery models, creating resource models, budget management and maintaining quality.

Provide project management, serve as subject matter expert and manage the business analysis for the State of Ohio’s implementation of an enterprise-wide health and human services (HHS) business intelligence system.

Coordinate multiple vendors to design and deploy a robust and flexible business intelligence technical architecture; integrate multiple data sources and provide advanced reporting/data analytics.

Directing a comprehensive Data Management program, including Data Governance, Data Quality, Metadata Management, Release Management and interface with Master Data Management.

Directing the design and implementation of using Agile/Scrum approach to source to target mapping; extract, transformation and loading (ETL) processes; creation of multi-tiered Relational, Data Vault and Dimensional data models; design and implementation of data marts and implementation of pre-defined and ad hoc reporting.

Integrating data from key operational systems, including the Ohio Medicaid Management Information System (MMIS), Pharmacy Benefits Manager (PBM), Integrated Eligibility, Medicare, Home Healthcare Electronic Visit Verification (EVV), Medical Management, Financial Management and other State agency/commercial data sources, into relational and dimensional data models.

Supporting transition to healthcare value-based reimbursement for the Ohio Medicaid program.

PricewaterhouseCoopers LLP 09/2009 – 10/2014

Manager, Washington Federal and Health Industries Advisory Practices

Managed business/information systems projects and served as Subject Matter Expert (SME) for large healthcare organizations.

Provided project management and technical leadership to leading large healthcare organizations implementing the Patient Protection and Affordable Care Act (PPACA) and the Healthcare Insurance Portability and Accountability Act (HIPAA) requirements.

Responsibilities included planning information systems consolidations, full lifecycle testing of ICD-10 application systems modifications, Senior Project Manager for large health plan implementation of the Medicare/Medicaid Dual Eligible Demonstration and served as a HIPAA transactions/EDI technical Subject Matter Expert (SME), Solutions Architect and Senior Project Manager for a large government payer organization.

Key clients included:

Anthem Blue Cross Blue Shield

Excellus Blue Cross Blue Shield

Health Care Service Corporation (HCSC)

Health Net

Harvard Pilgrim Health Plan

EmblemHealth

Department of Veterans Affairs, Veterans Health Administration (national provider and payer organizations)

Hewlett-Packard (HP)/Electronic Data Systems (EDS) 09/2006 – 09/2009

Technical Delivery Leader and Project Manager

State/Local Healthcare and Information Management Practice

Led business and technical analysis, as well as provided project management for healthcare organizations implementing state-of-the-art claims processing, EDI and business intelligence/data warehouse systems.

Directed delivery of an advanced highly customized Medicaid Management Information System (MMIS), with responsibility for client acceptance and satisfaction.

Directed a large team of over 200 Systems Managers, Team Leaders, Business Analysts, and Systems Engineers;

Solution included Service Oriented Architecture (SOA)/Enterprise Service Bus (ESB-TIBCO);

Commercial Off The Shelf (COTS) product integration;

Extract, Transformation and Loading (ETL-Informatica) tools;

Data warehousing/decision support functionality;

Standards based Electronic Data Interchange (EDI); and,

Customer self-service Web portals.

Responsible for leading large healthcare organizations implementing advanced information management, business intelligence and data warehouse solutions.

Documented business requirements and data sources for data warehouse implementations.

Developed testing strategy and led the test case development, as well as the test execution of an enterprise-wide membership Operational Data Store (ODS).

Key clients included:

Ohio Department of Jobs and Family Services (ODJFS)

Health Care Service Corporation (HCSC – Blue Cross Blue Shield of Illinois, Texas, Oklahoma and New Mexico)

Dean Health Plan

PricewaterhouseCoopers, LLP 08/2001 – 09/2006

Manager, Healthcare Advisory and Washington Federal Practices

Managed critical information systems projects and served as Subject Matter Expert (SME) for large healthcare organizations.

Led large healthcare organizations in the implementation of advanced electronic commerce and data management applications, including compliance with the Healthcare Insurance Portability and Accountability Act (HIPAA) requirements.

Key clients included:

Department of Veterans Affairs, Veterans Health Administration

The Ohio State University

Commonwealth of Puerto Rico

CIGNA

Michigan Education Special Service Association

Group Health Incorporated

Covansys (Formally CBSI) 02/2001 -08/2001

Senior Manager

Managed the Healthcare Insurance Portability and Accountability Act (HIPAA) compliance projects for healthcare providers, integrated delivery networks and clearinghouses.

Developed HIPAA 4010 standard electronic transaction implementation strategies, including technology architecture and vendor partnering.

Completed detailed data element mapping to implement automated coordination of benefits processing for national provider network.

Key clients included:

Mt. Clemens Health Systems

WebMD

eGovNet 01/2000 – 02/2001

Chief Technology Officer (CTO)

Built a technology delivery organization from the ground up to deliver state of the art, fully integrated e-Commerce applications for state/local governments.

Responsible for defining and managing project scope, budgets, constraints, schedules and client deliverables.

Completed requirements analysis, systems design/architecture and testing of custom software.

Directed the development of Web portals incorporating e-Commerce applications.

Directed the development and operations of a state of the art, secured data facility for application hosting, software development and internal network/office automation management.

Key clients included:

Ohio Bureau of Motor Vehicles (OPLATES)

City and County of Honolulu

Florida Department of Management Services

Cambridge Integrated Services Group/Managed CARE Services 04/1998 – 01/2000

Technology Services Manager

Directed all aspects of $54M outsourcing project of the Ohio Bureau of Workers Compensation (BWC) Health Partnership Program; responsible for all aspects of project management, including budget management, scope management, risk/issues management and client communications.

Project included facilities management; customized software development and support; electronic commerce development and operations, as well as customer service and consulting.

Responsible for directing the activities of a state of the art data center including customized software development; data warehouse implementations; systems administration; database administration; network administration; EDI implementation; and, disaster recovery planning.

Responsible for Year 2000 compliance and vendor liaisons.

Claremont Technology Group 08/1997 – 04/1998

Manager, Development Center of Excellence

Managed the custom development and implementation of the Kentucky Childcare Management Information System.

Documented client specific requirements, completed high-level and detailed design, supervised application customization, and coordinated testing, as well as production implementation.

Managed the Development Center of Excellence, providing custom programming and production operations support.

Coordinated first statewide deployment of the childcare management information system.

Ohio Department of Human Services 05/1988 – 08/1997

Section Chief, Applications Development

Managed Systems Analysts, Programmer Supervisors and Programmer Analysts supporting the complex, highly customized Ohio Medicaid Management Information System (MMIS).

Led the transition from implementation vendor to State staff support.

Chaired interagency information technology committee responsible for planning for the information systems impact of a major statewide health reform initiative; the committee included Departments of Mental Health, Mental Retardation/Developmental Disabilities, Health, Aging and Alcohol and Drug Abuse Services.

Led the software enhancements projects to support major policy initiatives, including managed care, long term care, drug rebate, home and community based waivers and eligibility system interfaces.

Responsible for supporting Federal audit activities.

Led procurement efforts for major projects, including Pharmacy Point of Service and Medicaid Decision Support System.

Responsible for full systems lifecycle, including documenting business requirements, developing high-level design/solutions architecture, developing and validating detailed design, supervising programming, planning and conducting testing and coordinating production migration.

Community Mutual Blue Cross and Blue Shield 05/1985 – 05/1988

Advisory Business Analyst

Served as Project Leader responsible for a major component of a large IBM mainframe medical claims processing system, writing proposals, negotiating with vendors, developing budgets and participating in all phases of systems development.

Collected and documented claims pricing and adjudication business requirements, developed high-level systems design documents, including data exchange specifications, coordinated with external systems integration vendor to complete detailed design and programming, developed test cases/scripts and conducted automated testing to validate requirements implementation.

Education, Training and Certifications

Professional Scrum Master 1 (PSM1) Scrum.Org

Master of Arts, Clinical Child Psychology The Ohio State University

Bachelor of Science, Psychology/Pre-medicine University of Pittsburgh

Technical Capabilities

Extensive experiencing managing traditional and iterative/agile software development implementations, service oriented architectures, business intelligence/data warehousing, electronic commerce, electronic data interchange, information system security, and disaster recovery planning.

Speaking, Testimony and Publications

"Preparations for a Successful Deployment of the 5010: Are we there yet?", 4th WEDI 5010, ICD-10 Implementation Forum, January, 2011

Preparation of Veterans Health Administration provider organization testimony to the National Committee on Vital and Health Statistics (NCVHS) on National Health Plan Identifier and Operating Rules (July, 2010), Electronic Funds Transfer (EFT) and Remittance Advice (RA) (December, 2010), and HIPAA Transaction Acknowledgments (April, 2011).

Business Development

Led sales of new and add-on work for projects up to $4M, with average sales of $1.4M/year.

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