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Project Manager Clinical Operations

Location:
Louisa, VA
Posted:
December 11, 2023

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Resume:

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

Louisa, Va *****

Avid Bruce Napier

www.linkedin.com/in/avid-bruce-napier-b02636139

Home Phone: 540-***-****

Email: ad1vkj@r.postjobfree.com

PAGE 1 OF 6

Summary

A highly motivated, goals oriented, self-starter with an extremely diverse background, I have been referred to as a Swiss Army Knife of technical and business skills. I am comfortable in fast paced, hectic environments where my organizing skills enable me to perform exceptionally well. Positions that require significant multi-tasking while filling multiple roles are enjoyable to me. Very adept at getting struggling efforts back on track while keeping them moving at the same time. Health Care

18.3 yrs

Transportation

12.5 yrs

Manufacturing

8.1 yrs

Banking

2.0 yrs

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460 Ridgemont Drive

Louisa, Va 23093

Avid Bruce Napier

www.linkedin.com/in/avid-bruce-napier-b02636139

Home Phone: 540-***-****

Email: ad1vkj@r.postjobfree.com

PAGE 2 OF 6

Professional Experience

Anthem / Elevance Jan 2021 – Oct 2023

Title: FTE; Initiative Project Leader, Commercial Clinical Operations Skills: ELT Liasion; SLT Liasion; Compliance Liasion; IT Liasion; Program Mgmt; Project Mgmt; Mentor; Enterprise Systems Change Mgmt; Enterprise Systems Architecture; Cost/Benefit Analysis; Agile/Scrum; Waterfall; Requirements Mgmt; Business Analysis; Systems Analysis; Process Improvement; Process Engineering; Test Case Approval; Tools: MS Office; MS Project; MS Access; MS Visio; MS Teams; SharePoint; Jira; Confluence; SNOW; Webex; Overview: Program manager overseeing the work to address the findings from the 2020 California DMHC audit of Anthem’s Commercial Clinical Operations.

Led the completion of over 400 deliverables along with the documentation, training materials and compliance artifacts.

Wrote the clinical operations playbook for handling provider terminations which was also adopted by the Medicare and Medicaid divisions.

Became the department’s sole liaison to the Compliance department

Served as the department’s primary contact for legislative impact assessments and managed any resulting process, procedure and/or system changes needed to ensure compliance. Anthem May 2020 – Dec 2020

Title: FTE; Strategy Director, Care Management Operations Solutions, Digital Team Skills: ELT Representative; SLT Representative; Program Mgmt; Project Mgmt; Enterprise Systems Change Mgmt; Enterprise Systems Architecture; Cost/Benefit Analysis; Agile/Scrum; Waterfall; Requirements Mgmt; Business Analysis; Systems Analysis; Process Improvement; Process Engineering; Test Case Approval; Tools: MS Office; MS Project; MS Access; MS Visio; MS Teams; SharePoint; Jira; Confluence; SNOW; Webex; Overview: Upon transferring into this group, I was “temporarily” assigned to Commercial Clinical Operations to manage a failing project to address the 2020 California DMHC audit findings.

Because of my performance, this turned into a permanent position and promotion to “Initiative Project Leader”. WellPoint / Anthem Dec 2012 – May 2020

Title: FTE; Business Change Director, Care Management Operational Support Skills: Project Mgmt; Budget Mgmt; Change Mgmt; Business Analysis; Systems Analysis; Mentor; Epics & User Stories; Agile/Scrum; Kanban; Waterfall; Process Engineering; Process Improvement; Test Case Definition; Testing Approval;

Tools: MS Office; MS Visio; MS Access; MS Project; Jira; Confluence; SQL Server; SNOW; Skype; Webex Overview: As a member of the CMOS team, we acted as the business representative in the agile software development process. We were also responsible for acquiring and documenting the business requirements and creating user stories.

Acted as a liaison between IT and the business for requirements definition and user story creation

Helped to improve, refine, formalize and document inter-departmental processes.

Acted as the business SME for numerous enterprise systems, business processes and system processes

Built and managed many focused SharePoint sites. 460 Ridgemont Drive

Louisa, Va 23093

Avid Bruce Napier

www.linkedin.com/in/avid-bruce-napier-b02636139

Home Phone: 540-***-****

Email: ad1vkj@r.postjobfree.com

PAGE 3 OF 6

Health Management Corp (HMC) Sep 2006 – Dec 2012

Roles: IT contractor via MaconIT; Senior Technical Lead, Systems Analyst, Senior DBA Skills: Project Mgmt; Mentor; Change Mgmt; Business Analysis; Systems Analysis; User Stories; Agile/Scrum; Waterfall; Process Engineering; Process Improvement; Team Foundation Server; Test Case Definition; Test Case Review & Approval;

Tools: MS Office; MS Visio; MS Access; MS Project; SQL Server; Overview: I was brought in to address process problems within the company’s home-grown disease & condition management system Healthy Returns System (HRS).

Led a team of 10 to 25 technical resources for the Program Eligibility Notification Delivery System (PENDS) project that completely reworked the major feeds from the enterprise into HRS. End result was an increase in the data accuracy from 50% to 99%.

Single handedly revamped the business processes around the Nurse Team Assignment process.

Author of the Enterprise Reportable Segment (ERS) demographic attributes from existing data.

I took the initiative to personally design, develop and deploy a custom tool, the HRS Group Finder, that enabled the user to view how the customers and their members were loaded into the HRS system.

I took the initiative to personally design, develop and implement a custom client/server application, called the Load Rules Tool (LRT), that housed the rules for loading and/or updating incoming data from the enterprise into the HRS database structure. This replaced a manual process run from a spreadsheet that had significant accuracy and timeliness issues.

Capital One – US Card Division Apr 2006 – Sep 2006 Roles: IT contractor via Strategic Staffing Solutions (S3); Business Systems Analyst, Master Level - Application Decommissioning Program

Skills: Business Analysis; Systems Analysis; BRD Review; RTM Review; Tools: MS Office; MS Access; SQL Server;

Overview: My job was to determine the overall plan for the retirement of 46 legacy systems as a result of rollout of a new system. At the same time, I was responsible for determining which servers could be retired by shifting remaining applications onto other servers.

Built a custom tool that performed the analysis of shifting applications to other servers.

Helped to recoup $50 million to the business via server decommissioning.

Worked with the various technical teams to ensure the decommissioning solution was both viable, accurate and in line with the overall plan.

Philip Morris USA - Information Technology Division Sep 2005 – Apr 2006 Roles: IT contractor via Xperts Inc; Facilitator, Senior Technical Writer, Business Analyst Skills: Meeting Facilitation & Documentation; Task Tracking; Process Review; Business Analysis; Systems Analysis; Technical Writing; Risk Mgmt; Issue Mgmt;

Tools: MS Office; MS Visio;

Overview: I was responsible for the definition and documentation of the new processes for the NOC as a result of a new out-sourcing vendor.

Facilitated meetings of high-level management with the new NOC vendor representatives

Created and managed numerous status reports, dashboards and trackers.

Helped to define new internal and interface processes. Created process and procedure documentation.

Compared existing processes against proposed new processes, identified gaps and issues; proposed solutions Capital One - Information Technology Division Apr 2005 – Sep 2005 Roles: IT contractor via Prism Inc; Senior Project Manager, Enterprise Integration Layer / Real Time Messaging Program (EIL-RTM) Program

Skills: Program Mgmt; Change Mgmt; BRD Review & Approval; RTM Review & Approval; Schedule Review & Approval; Budget Administration

Tools: MS Office; MS Visio; MS Access; MS Project; Overview: I was responsible for the overall management of the redesign of the communications layer for real time data inquiries and transfers from two ELT platforms to one.

Managed the $1.3 million dollar infrastructure project along with three junior project managers.

Developed the bridging strategies necessary when timelines/solutions between projects did not line up. 460 Ridgemont Drive

Louisa, Va 23093

Avid Bruce Napier

www.linkedin.com/in/avid-bruce-napier-b02636139

Home Phone: 540-***-****

Email: ad1vkj@r.postjobfree.com

PAGE 4 OF 6

Capital One - Information Technology Division Oct 2004 – Apr 2005 Roles: IT contractor via Prism Inc; Project Manager, Technical Oversight Group (PMO) – Solicitation ID Expansion Program (SoLID)

Skills: PMO; Change Mgmt; BRD Review & Approval; RTM Review & Approval; Schedules Review & Approval; Bridging Strategies Definition & Management;

Tools: MS Office; MS Project

Overview: I oversaw over a dozen project managers that were leading over 60 projects to modifiy over 80 applications and 200 data sources to expand the size of a single data point.

Was brought in as a replacement for the in-flight program that was in a poor state and quickly turned it around.

Was the primary representative to the executive leadership team for the PMO and was responsible for reporting out the current state of the overall program on a weekly basis.

Improved cross-project documentation and enhanced the quality of the design documentation.

Instructed, monitored and mentored the project BSAs and Technical Designers. KC Automation Mar 2004 – Oct 2004

Roles: FTE; Project Manager, Senior Business Analyst, ERP Administrator, Database Administrator Skills: Project Mgmt; Customer Relations; Mentor; Business Analysis; Systems Analysis; Process Improvement; Process Engineering; Data Modeling; Database Design; Database Administration; Tools: MS Office; MS Access; Vista ERP;

Overview: As an employee of this manufacturer of automated, custom built cigarette and cigar testing equipment, my primary role was to implement the upgrade to their ERP tool they had purchased but had been unsuccessful with up to that point.

Designed the usage approach, developed and executed the transition plan and provided on-going support of the Company’s ERP tool (Vista). The end result was a streamlined business process that improved employee performance, reduced costs and improved product quality.

Worked onsite with customers in VA, NC and SC on how best to utilize the testing equipment and upgrades thereto

Assisted with support of the office hardware and software.

Implemented a parts inventory RFD tag system that was integrated with the ERP system First Health Services Corp - Information Technology Division Jan 2003 – Mar 2004 Roles: FTE; Project Manager, Systems Analyst, Data Modeler, SQL Server Developer, Application Developer Skills: Project Mgmt; Mentor; Waterfall; Requirements Mgmt; Business Analysis; Systems Analysis; Process Improvement; Process Engineering; Data Modeling; Database Design; Database Administration; Tools: MS Office; MS Access; SQL Server; Remedy

Overview: I took over the management of an existing “home grown” documentation tool (TraxxSuite / Docutraxx) while developing its next generation replacement.

I first stabilized and then redesigned the core system from the ground up. Once the new direction was established, I led two other contractors thru the life cycle to completion.

My leadership led to the enhancement of the system to include the management of their contract proposal process which encompassed requirements gathering and refinement, the facilitation of the testing process of their MMIS system and the integration of this suite of applications with their other systems such as Remedy and Project Invision.

Philip Morris USA - Operations – Cigarette Manufacturing Apr 2001 – Oct 2002 Roles: IT contractor via Merge Computer Group; Team Lead, Senior Business Analyst Skills: Mentor; Systems Architecture; Change Mgmt; Waterfall; Requirements Mgmt; Business Analysis; Systems Analysis; Process Improvement; Process Engineering; Data Modeling; Database Design; Database Administration; Tools: MS Office; MS Access; SQL Server

Overview: I led the design, development and implementation of a completely new reporting system, Cabarrus Production Reporting Project (CPR), that tracked and reported on 75 data points for each cigarette produced. A daunting task given that the plant was producing nearly 700 million cigarettes a day. 460 Ridgemont Drive

Louisa, Va 23093

Avid Bruce Napier

www.linkedin.com/in/avid-bruce-napier-b02636139

Home Phone: 540-***-****

Email: ad1vkj@r.postjobfree.com

PAGE 5 OF 6

Philip Morris USA - Operations – Primary Processing Apr 2001 – Jul 2001 Roles: IT contractor via Merge Computer Group; Business Analyst, Data Modeler, DBA, SQL Server Developer Skills: Systems Architecture; Waterfall; Requirements Mgmt; Business Analysis; Systems Analysis; Process Improvement; Process Engineering; Data Modeling; Database Design; Database Administration; Client/Server Application Development;

Tools: MS Office; MS Visio; MS Access; SQL Server; Overview: I was retained as a team of one to design, develop, deploy and support their new Hold & Disposition Status Tracking System (HDSTS) which tracked all sub-standard materials and product. This was completed in a fraction of the time expected.

Philip Morris USA - Quality Assurance Group Jul 2000 – Aug 2001 Roles: IT contractor via Merge Computer Group; Business Analyst, Data Modeler, DBA, SQL Server Developer, Client/Server Application Developer

Skills: Systems Architecture; Change Mgmt; Waterfall; Requirements Mgmt; Business Analysis; Systems Analysis; Process Improvement; Process Engineering; Data Modeling; Database Design; Database Administration; Tools: MS Office; MS Access; SQL Server;

Overview: I was brought in to evaluate a failing home grown system, the Quality Systems Training Database (QSTM), that tracked all training requirements for a given job and identified employees that had gaps in this training. After identifying the issues, I was retained to rewrite the system which I completed, deployed and briefly supported. Reynolds Metals Company - Human Resources Department Jan 1998 – Apr 2000 Roles: IT contractor via Merge Computer Group; Business Analyst, Data Modeler, SQL Server Developer Skills: Data Modeling; Database Design; Database Administration; T-SQL Coder; Systems Architecture; Waterfall; Requirements Mgmt; Business Analysis; Systems Analysis; Process Improvement; Process Engineering; Tools: MS Office; MS Access; SQL Server;

Overview: I was brought in primarily as the team’s replacement data modeler and SQL coder for an on-going effort to redevelop their new Human Resources Data Warehouse (HRDW). One feature of this new system was the calculation of their financial liability for retirement and disability payouts for the company and all its subsidiaries. The end result was a database that housed all the necessary HR data and a SQL Server process that reduced the amount of time to make the calculation from months to less than 48 hours. This included a complete cash flow projection with anticipated tax code changes.

Reynolds Metals Company - Mill Products Division Apr 1996 – Dec 1997 Roles: IT contractor via Merge Computer Group; Business Analyst, Data Modeler, SQL Server Developer Skills: Systems Architecture; Waterfall; Requirements Mgmt; Business Analysis; Systems Analysis; T-SQL Coder; Client/Server Application; Process Improvement; Process Engineering; Leader; Data Modeling; Database Design; Database Administration;

Tools: MS Office; MS Access

Overview: I was brought in to assist with a failing project for their home-grown Capital Management System (CMS) that managed all projects costing over a one million dollars. After assessing the design flaws and determining the course of action needed to get the effort back on track, I directed the work of the other contractor and performed over half of the work myself.

Overnite Transportation Company – Marketing / Pricing Department Nov 1983 – Apr 1996 Titles: FTE; Rate Clerk; Manager, Discounts & Allowances; Costing Analyst; Manager, Marketing & Pricing Systems Skills: Project Mgmt; Enterprise Systems Ownership; Systems Architecture; Change Mgmt; Requirements Mgmt; Business Analysis; Systems Analysis; Client/Server Application; Process Improvement; Process Engineering; Mentor; Data Modeling; Database Design; Database Administration; Tools: MS Office; MS Access

Overview: I started with the company as a Rate Clerk, one of the lowest white-collar jobs in the trucking industry, and ended up as the Manager of all Marketing & Pricing systems. 460 Ridgemont Drive

Louisa, Va 23093

Avid Bruce Napier

www.linkedin.com/in/avid-bruce-napier-b02636139

Home Phone: 540-***-****

Email: ad1vkj@r.postjobfree.com

PAGE 6 OF 6

Education

Institution Major / Area of Study

University of Kentucky, Lexington, KY Business Administration Northern Kentucky University, Highland Heights, KY Business Administration University of Virginia - Darden School of Business Digital Product Management Modern Fundamentals References available upon request



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