TONY SNIDER

Cell Phone: 281-***-****

Houston, TX

Email Address: ad0liv@r.postjobfree.com

PROFESSIONAL SUMMARY:

Senior-level program manager with outstanding record of achievement in system/software implementations, project management, business requirements gathering, quality control, vendor management, and process improvement. Proven leadership skills working collaboratively with steering committees, to drive portfolio of projects impacting Operations, Compliance, Finance, and Healthcare Information Technology departments. Bilingual in English and French.

Specialties: SDLC (Agile and Waterfall), System Integration, Legacy Systems, Quality Assurance, System Integration Testing Lead, Project Finance Management, Software Testing, Team Facilitation, Risk Management, Knowledge Transfer, Strategic Planning, RFP Response

PROFESSIONAL EXPERIENCE:

Tegria 2021 - 2023

Managing Consultant

Responsible for managing client services, quality, and vendors for DC Medicaid rebid

Responsible for leading the participating and non-participating providers project to ensure compliance for the 2022 covered year for Medicare Advantage participants

Managed the secure provider portal to ensure compliance for the 2022 covered year for Medicare Advantage participants

Provided support for a Medicaid RFP response upon award for the state of Indiana

Managed the Heathcare Management, Grievances and Appeals, and Quality workstreams for the Indiana Medicaid Project.

Managed project plan using MS Project and tracked progress monitoring JIRA tickets

Bright Health (Client) 2021 - 2021

Program Manager (Senior Consultant/Contractor)

Responsible for supporting Bright Health’s Enrollment and Finance teams transition to a third-party administrator

Documented current-state process flows

Collaborated with third-party administrator to obtain future-state process flows

Developed and maintained a project plan

Developed and maintained a RAID log

Proje

Blue Cross Blue Shield of Louisiana (Client) 2020 - 2020

Sr. IT Project Manager

Responsible for leading a team of IT and Marketing to deliver two projects - annual product enhancements and summary of benefit changes.

Documented BRDs, decision memos, and change requests.

Created and monitored a project plan for each project.

Worked with IT teams to determine the number of hours estimated to complete build, unit test, and QA of code.

Tracked hourly burn rate in ServiceNow.

Delivered weekly status reports, using ServiceNow.

Delivered monthly executive status report, using ServiceNow.

Managed to deliver ahead of schedule for the Summary of Benefits Project (SBC) projects.

Worked as a Sr Business Analyst and Sr Project Manager for two large projects.

Facilitated weekly status report meetings with 185 attendees.

Managed 11 IT teams.

Managed QA onshore and offshore resources.

Worked with the Marketing Team to ensure UAT was performed and on track and schedule.

eDocumentIT

Premera Blue Cross (Client) 2019 - 2019

Senior IT Project Manager (Senior Consultant/Contractor)

Responsible for working with delegated provider groups and vendors to outsource enrollment, claims processing, medical management, and providers.

Tracked weekly expenses.

Developed bi-directional traceability matrix.

Documented UAT test cases.

Documented BRDs for provider groups and EDI transactions to prepare for the annual enrollment period (AEP).

Facilitated weekly meetings with UAT testing team.

Presbyterian Health Services (Client) 2019 - 2019

Senior IT Project Manager (Senior Consultant/Contractor)

Responsible for technical teams of solution architects, Facets, System Integration, NetworX Config, and SIT.

Tracked weekly time/travel expenses of consultants.

Created and tracked project plan.

Developed bi-directional traceability matrix.

Led weekly project meetings.

Facilitated daily meetings with solution architects to develop architecture diagrams to ensure EDI transactions and encounters with third-party trading partners were accounted for.

Tracked weekly burn-down charts to ensure development, SIT, and UAT are on track.

Facilitated JAD session to prepare for implementation.

Emblem Health/ConnectiCare (Client) 2018 – 2019

Senior IT Project Manager (Senior Consultant/Contractor)

Managed technical team of solution architects, Facets SI, Legacy SI, Facets/CAE/NetworX Config, and SIT teams

Led daily stand-up meetings for all phases of project.

Facilitated daily stand-up meetings to phase the creation/testing/deployment of EDI transactions in preparation for the annual enrollment period (AEP) for dual eligible subscribers.

Facilitated meetings with solutions architects to ensure creation and maintenance of architecture diagrams and interface catalogs through course of project to drive approval from the Architecture Review Board (ARB).

Facilitated technical calls between services corporation and client (health plan).

Tracked progress of design/development/SIT, using weekly burn-down charts.

WPS Health Care (Client) 2018 – 2018

Program Manager (Senior Consultant/Contractor)

Managed team of Product Owners and Senior Software Architects to design, develop, and implement a provider management software solution.

Led daily JAD sessions with client.

Created expense cost (design vs. development) based on JAD sessions.

Facilitated development of client solution assessment.

Led 30-day sprints of software implementation.

Tracked EPICs and User Stories, using JIRA.

Tracked project budget versus actual spend and review team’s billable versus non-billable hours, using Replicon.

Reviewed weekly project status with executive leadership team.

Managed expectations/communications with client.

Scott & White Health Plan (Client) 2016 – 2017

Project Manager (Consultant/Contractor)

Managed team of writers responsible for responding to an RFP for Texas CHIP.

Managed Medicare Advantage Annual Enrollment Period (MA AEP) preparation project for Enrollment, Recon, and Billing departments.

Wrote policies for Enrollment and Recon and corresponding process flows.

Wrote BRDs for CMS required enhancements.

Tracked internal Corrective Action Plans (CAPs) for Enrollment, Recon, and Billing.

Oversaw development of Medicare Advantage letters.

Created RFP score card.

Reviewed vendor selections for recon automation tool.

Led UAT for enrollment system enhancements.

Memorial Hermann Health Solutions (Client) 2014 – 2016

Project Manager (Consultant/Contractor)

Managed PBM conversion for 144 distinct commercial products.

Performed carrier/account/group (CAG) data audit of 144 distinct commercial products with legacy PBM, resulting in a 65% correction rate.

Managed implementation of ICD10.

Led a Commercial LOB through a system conversion for Utilization Management from legacy System to Facets and Pharmacy Legacy System to RxClaims.

Led Facets implementation for Utilization Management and Pharmacy for Medicare Advantage

Managed a suite of programs for Medicare Advantage, including software implementations for Facets, WiPro A&G360, and Advisory Board Crimson Care Management for Case Management.

Implemented a new PBM (Envision) for Medicare Advantage.

Accomplished development of a new CMS STARs program.

Universal American Corporation

Program Manager STARs Performance Improvement 2012 – 2014

Created and managed programs to move two Medicare Advantage contracts from a 3.5 Star to a 4 Star rating, resulting in a $22 million bonus payment from CMS.

Responsible for executing strategic initiatives that improve outcomes across health management, analytics, provider network and contracting, claims, consumerism, and quality management-related solutions for the STARs Program.

Built quality program into vendor selection criteria, holding vendors accountable for SOW.

Managed portfolio of 10 programs.

Onboarded/mentored/developed new Program Managers.

Project Manager 2008 – 2012

Managed care management system conversion from TriZetto CareAdvance (CAE) to internal purchased solution, resulting in a $23.2 Million savings.

Implemented purchased LOB into the Universal American northeast book of business, resulting in a $2 Million savings.

Facilitated PBM integration from MEDCO to CVS with focus on risk mitigation.

Documented scope of work by Gorman Health Group for Valencia software implementation and managed project scope and finance.

Accountable for communications to C-Suite and senior management on project status, overruns, timeline adjustments, and budgets.

Evaluated resources and costs required in making project decisions and presents to management for decisions.

Managed TriZetto Facets claims-payer system conversions and upgrades for Enrollment, Recon, and Billing.

Developed testing documentation, exit criteria lead integration testing and UAT for Billing, Reconciliation, and Billing teams.

Managed data and system conversion project to return vendor-managed book of business in house, saving the company $880,000.00 per month.

Managed offshore vendor relationship in Noida, India.

EDUCATION:

Master of Arts – University of Houston

Bachelor of Arts – Texas State University

TECHNICAL SKILLS:

JIRA – EPICs, User Stories, and Issue Tracking Software

Replicon – Time Tracking and Expense Management Software

MS Office Suite, Visio, Project, Outlook, Excel, Word

SharePoint

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