JAMES H. TROUT, LPN

**** ****** ***** **, *******, MI 49306

248-***-**** adhx3y@r.postjobfree.com

Objective:

Objective: To leverage my 19+ years of clinical project/program management consulting experience, in the health care and information technology industries into a challenging and rewarding role that is client facing using the latest in technology to better patients and members lives.

Skills

HEDIS/NCQA Accreditation and quality improvement

Cognizant Claimsphere and Clinical Plus for HEDIS reporting.

Innovalon QSI XL/QSHR Experience

20+ Full lifecycle EMR conversions

Experience in working with Epic Willow, Cadence, Prelude, Grand Central, and Referrals

Cerner Ambulatory and Inpatient experience with training and workflow Including Powerchart, Powerorders, Powernotes, and Powerplans.

ICD-10 Project management

Informatica Provider Master Data Management

Experience

Manager, Heathcare Quality Management, HEDIS Data and Reporting 2019-present

Aetna, A CVS Health Company I am currently responsible for Managing a nine person team that is responsible for HEDIS data and reporting for all of Aetna Medicaid nationally. I currently lead a team of analysts that provides analytics and support for the member health plans, management of all supplemental data sets, and have responsibilities for all IDSS and PLD submissions at a national level. We are also responsible for planning for HEDIS transformation to Digital measures and ECDS reporting. Constantly onboarding expanded lines of business as well as acquisitions to the HEDIS processes. With the CVS acquisition we are creating new business goals in order to have a successful integration and leverage cross technologies. Working on integration of HIE/Clinical/EPIC roadmap to leverage data for HEDIS. Responsible for all aspects of HEDIS audit and roadmap coordination and completion.

Senior Consultant/Sr. Program Manager 2016-2019

Spectrum Health/Priority Health Was responsible for program operations of HEDIS/Value Based Payments/Accreditation for an 800,000+ member health plan. I handle all aspects of the HEDIS program including CMS, Medicare, Stars, & Medicaid, as well as Commercial, ASO and Individual product lines. I oversee all data collections including claims, supplemental data sources. HIE data and assist with Medical Records Review and abstraction. I’m also responsible for final submission of IDSS/PLD to CMS/NCQA. Over the last 3 years I have worked with CAHPS and chase file prioritization management, extraction and all external audit functions. In the off season I’m responsible for running multiple quality improvement projects including supplemental data, provider address inventory, HEDIS vendor management and replacement. I also am charged with chase & abstraction vendor contracting and management of clinical resources. Participate in planning for off season measure improvements, and quality analytics projects as well as health plan accreditation.

Senior Consultant/Sr. Project Manager 2015 – 2016

Spectrum Health

Worked on several key strategic projects for Spectrum Health & Priority Health, within the Enterprise Digital and Nexus (EMR conversion) project space. This includes Project Nexus, Spectrum's solution to consolidate to one EMR across the system using Epic. With this initiative, I have project responsibilities for the Ambulatory site conversion of Cerner Radnet to Epic Radiant. This includes 18 ambulatory sites over a newly consolidated timeline with the last site scheduled for live early 2017, ahead of the inpatient conversion. I am responsible for the project, resource, timeline, budget and overall management of a large team with representation from all key affected areas such as revenue management and Radiant build. To date, I’ve created the charter, held key stakeholder meetings, daily standup with the core build team, and Status reporting using Clarity PPM. I met with each of the modalities and was in charge of facilitating the CDM/order catalog cleanup efforts held with each of them for submission with the inpatient catalog to Epic for build efforts. Build bucket management, along with taking the teams through the adoption sessions, reporting on statuses and preparing for the Epic build audits. Also work breakdown structure and sub team task workgroup assignments and estimation is underway, as well as resource allocation and acquisition. The other area of responsibility is really program management in the space of the Access team working on Epic’s, Welcome, Prelude, Grand Central, Cadence, referrals and patient movement. Tracking all statuses, monitoring build buckets and reporting on escalations, am also responsible for any 3rd party applications that cross the access space as well. I’ve worked several Care Management projects as well evaluating and implementing a Real time Analytics and alerts program. This very important initiative includes several sub projects that include: HIE/HIM integration, Master Data Management, Real Time analytics and alerts for Case Management, Population health management and Wearable technologies. I previously worked on a 3.M+ project to update our "Find a Doc" physician finder tool on Spectrumhealth.org.The above projects will be leveraging several core technologies within Epic such as Healthy Planet and Cogito as well as Bjond Health other in flight projects included Master Data Management of the Provider and Location using the Informatica MDM solution. . We are also working closely to align with the Epic Service Area consolidation project to convert each site in conjunction with all of these efforts. Both Traditional and Agile project management styles are used.

Senior Consultant/Project Manager 2014 - 2015

Deloitte Consulting, LLP Seasoned consultant, working on multiple projects within the firm. Most recently working as the ICD-10 Cerner/McKesson markets project manager for a large health system in charge of the northeast region. This encompasses all ICD-10 activities for multiple facilities within that region. Coordinated the executive steering committee meetings, managed a team of analysts during the testing, training and activation phases of the ICD-10 Initiative. Communicated with corporate and local resources to deliver and execute all corporate initiatives while incorporating the individual needs of the facilities. Worked with third party vendors to ensure all software within the facilities was ICD-10 compliant. Managed all aspects of the upgrades to necessary systems for the project. Held weekly status meetings with corporate, local, C-suite and project resources. Traveled to various locations as required to ensure on time delivery off project deliverables. Careflow analysis and design with multiple clients for the Epic platform, attending and preparing for the direction and adoption sessions. Working with the AC/AM’s on project planning, build bucket tasks, and reporting for Willow/Radiant/Welcome/Grand Central. I also was assigned to the military defense health EMR initiative working on current and future state workflows for the implementation of the Cerner EMR

Senior Consultant/Project Manager, Meaningful Use/Emergency Care 2013 - 2014

TotalMed/Various Contracts/ Bayheath Medical Center/Adventist Health

Worked on several projects, including at a 200+site Cerner Millennium Ambulatory/Inpatient go live contract doing end user support and site management. Coordinating daily resources, reporting on progress of providers as well as working directly with the CMIO reporting and managing issues for providers which included elbow to elbow training and support for staff and providers on Powernotes, Powerorders, Powerplans, and Powerchart. I also worked Providing Senior level consulting and project management services to a two member hospital system, with emphasis on the health systems three emergency departments, which includes two hospitals, 40 and 25 bed ED’s respectively, and one standalone satellite ED that contains 18 beds. Major projects managed include McKesson Horizon ER11 to ER12 upgrade, Horizon Expert Orders (CPOE) physician implementation, and Horizon Care Tracker. Responsible for both the build and project management parts of each project. Was instrumental in the Meaningful use Stages 1 and 2 builds for HEC and HEO, with stage 1 attestation completed in Sept 2013, working towards requirements for stage 2. Provide primary support to the emergency department personnel and physicians. Worked with vendor project team for the reporting of issues and metrics, and ensured resolution of problems before go live. Provided input on the CPOE committee, with recommendations for enhancement. Perform workflow optimization and enhancements to the HEC product for enhanced patent satisfaction and physician/nursing compliance for meaningful use reporting. Meet with senior level directors on a regular basis for continued support, this includes the CMIO, CIO, senior level Nursing department directors, and physicians.

Senior Consultant/Project Manager, Meaningful Use 2012 – 2013

Promedica Health Systems/Contract

Provide consulting, both build and project management and coordination primarily for the Implementation of Horizon Emergency Care/Horizon expert orders in a 12 member hospital system ranging from 80-900 beds, once of which is a children’s hospital. Successfully implemented end to end implementation of McKesson’s HEC/HEO in 5 facilities to date. Provided process and workflow design, build test and train for all facilities as well as go live support. Extensively involved in the building of both the HEC charting components as well as orders, order mapping, outlines and iform development and testing. Worked extensively on Meaningful use stage one for HEC and HEO, began data collection for attestation stage one and prep for stage two. Worked with the hospital C-suite and physician groups to ensure successful design and buy in from all key players.

Senior Consultant/Project Manager, Meaningful Use Mckesson Implementations 2011 – 2012

Community Health Systems/Contract

Provide consulting and project management for one of the largest health systems in North America. Specifically responsible for build and implementations of HOM/HEO at the corporate office model hospital environment. Keeping build analysts on task tracking to plan, provide status reporting to management on a weekly basis. Provide installation documentation and project plans based on the model to deployments to be used in the field. Work closely with the pilot sites and physicians for the creation of outlines and iforms. Very Involved with the various stages of meaningful use.

Education

University Of Phoenix, Phoenix, AZ

September 2001 Bachelor of Science in Business Information Systems

Fairfax County School Of Practical Nursing, Falls Church, VA

August 1995 Associates Certificate in Nursing

Licenses/Certifications & Organizations

Licensed Practical Nurse - 1994- Present

Certified Pharmacy Technician CPhT – 1995-Present

HP Certified Systems administrator – 2002-Present

Treasurer, of The Preserve of Grand Blanc Condominium Association – 2002

Member of Interex, Insight, and HIMSS

President of the Heath Occupations Students of America – 1991-1993

Member of Insight – McKesson User Group

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