Program Manager Management

JAMES WALSH

Spring Hill, ***** Tennessee 615-***-**** *******@*****.***

Summary

Experienced Healthcare IT Leader adept in strategic planning, program management, and cross-functional collaboration. Expertise in navigating dynamic IT landscapes and implementing innovative technologies for transformative initiatives. Proven track record of enhancing operations, customer experiences, and revenue cycles through compelling solutions.

Skills

Strategic Planning

Leadership in Team Building

Proficiency in Agile Methodologies

Management of Costs and Compliance

Skills in Product and Program Management

Application of the Software Development Life Cycle

Proficiency in System Analysis

Knowledge of Disaster Planning and Recovery

Experience in Data Center Management

Collaboration across Functions

Negotiation Skills

Proficiency in Revenue Cycle Management

Experience

PROFESSIONAL SERVICE AND CONSULTATION 02/2023 - Current

James Walsh Consulting LLC. (Owner)

Seasoned Solutions Services Consultant in healthcare sector with a focus on hospitals and healthcare professionals

Proficient in EHR systems selection, integration, and functionality optimization for hospitals

Expertise in compliance consulting, including CMS rules and Meaningful Use, to ensure regulatory adherence.

SOLUTIONS SERVICES ADVISOR/ PROGRAM MANAGER 06/2022 - 02/2023

Quorum Healthcare (QHR Health)

Conducted comprehensive technical assessments of an Ohio hospital's IT department, evaluating all facets from helpdesk to software, and devised strategic plans for cost savings.

Guided a hospital in Moscow, Idaho, through the selection process of a new EMR/EHR and Ambulatory Clinical system, managing demos and facilitating decision-making.

Led the redevelopment of the company SharePoint site, utilizing Jira for bug documentation and project management, and Visio/PowerPoint for management updates, while collaborating closely with cross-functional teams and executive stakeholders.

MEDICAID IT STRATEGY DIRECTOR/ PROGRAM MANAGER/ HEALTH PLAN CIO 10/2020 - 04/2022

CIGNA Healthcare

Implemented a transition from a combined Agile and Waterfall methodology to a full Agile methodology, enhancing project efficiency and responsiveness.

Facilitated Scrum meetings with development teams to ensure alignment and progress on project deliverables.

Played a pivotal role in developing programs aimed at managing the care of Medicaid beneficiaries in Texas, emphasizing access to quality healthcare services.

IT DIRECTOR / PROGRAM MANAGER/ HEALTHPLAN CIO 09/2015 - 07/2020

United Healthcare of Tennessee

Directed IT operations for United Healthcare's State of Tennessee Community and State (C&S) program, collaborating closely with the state to develop and implement technology-driven initiatives for the health plan.

Managed EDI transactions including 834, 271, 835, 820, 837I, 837P, HL7, and Azure cloud applications, while ensuring compliance with HIPAA, Disaster Recovery, and HITECH regulations.

Coordinated with the Tennessee MMIS group to develop high-level programs for United Healthcare, including initiatives like Employment and Community First (ECF CHOICES).

SENIOR PROGRAM MANAGER – CONSULTING 02/2014 - 09/2015

Community Health Systems Inc. - Franklin, Tn.

Spearheaded the successful implementation of Community Health Systems' (CHS) Computerized Provider Order Entry (CPOE) systems across CHS tier II hospital facilities, ensuring alignment with Meaningful Use (MU) Stage 2 certification requirements set by the Centers for Medicare and Medicaid (CMS).

Supervised a team of 16 project managers, providing direct oversight and collaboration with CHS corporate liaisons, facilitating seamless communication and coordination.

Achieved project completion approximately 30 days ahead of schedule, showcasing adept management and efficient execution throughout the full SDLC life cycle implementation.

SENIOR CONSULTANT/PROGRAM MANAGER 04/2013 - 02/2014

Xerox Corporation

Served as a seasoned consultant and program manager overseeing revenue cycle optimization initiatives for 7-10 hospital business offices, tailoring coding platforms to maximize efficiency and financial outcomes.

Demonstrated proficiency in navigating diverse hospital information systems including Epic, Meditech, McKesson, and HMS, ensuring seamless integration and functionality.

Led engagement management as well as program management, directing project managers in the successful implementation of revenue cycle software platforms across hospital facilities.

DIRECTOR OF PAYER PRODUCT MANAGEMENT 06/2011 - 04/2013

United Health Group/OPTUM

Led as Director of Payer Products at UnitedHealth Group, overseeing three product lines and two clearinghouses, with a focus on developing revenue cycle solutions for payers and facilities.

Spearheaded the creation of innovative solutions to meet evolving industry standards mandated by CMS, HIPAA, and other regulatory bodies, ensuring compliance and operational efficiency.

Collaborated extensively with legal, sales, business operations, and development teams to address new business requirements and capitalize on emerging opportunities.

PRODUCT MANAGER 11/2010 - 06/2011

Health Ways Inc.

Designed and implemented technical requirements tailored to the development of call center applications, ensuring alignment with organizational objectives and user needs.

Instituted a structured framework to facilitate seamless collaboration between design and development teams, fostering synergy and efficiency in project execution.

Enforced the Software Development Life Cycle (SDLC) process to streamline workflows and optimize communication between design and development staff, thereby enhancing project outcomes and productivity.

IMPLEMENTATION DIRECTOR, RESEARCH & DEVELOPMENT DIRECTOR 02/2001 - 04/2010

MediFax EDI - EMDEON Inc. - Change Healthcare Inc. - Nashville, Tn.

Conceptualized and directed the system scope and objectives for pioneering revenue cycle products, yielding over $100 million in revenue, leveraging .NET technology.

Provided strategic technical and managerial guidance to IT teams, orchestrating a transition from waterfall to Agile development methodologies, resulting in enhanced efficiency and productivity.

Developed and enforced departmental standards, conducted hiring processes for both onshore and offshore personnel, and negotiated contracts, contributing significantly to the widespread deployment of revenue cycle products across more than 900 facilities.

Education and Training

University of Phoenix - MBA

01/2008

Lamar University - B.B.A

Websites, Portfolios, Profiles

https:/www.linkedin.com/in/jim-walsh-mba

Certifications

Six Sigma Green Belt Certification

Scrum Master Certification

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