Business Architecture Project Manager, 2009 – 2013
Manager for operations workflow development function of North Carolina Medicaid Management Information System (MMIS) project.

• Managed staff of 14 operations analysts and technical writers documenting operations manuals for system for use by fiscal agent personnel in operations phase.
  • Used standard project planning and tracking methodologies to manage aforementioned effort budgeted at 38,000 hours. Project completed on-time and within budget.
  • Addressed over 600 requirements from North Carolina RFP.
  • Included the following business functions: call center, provider relations, provider enrollment and credentialing, third party liability, cash receipt processing, banking operations, general accounting and finance, prior approval processing, pharmacy operations, file maintenance, medical policy, documentation intake, pended claim and claim adjustment processing, IT operations and support, privacy and security, and project management.
  • Negotiated development and customer approval of 29 deliverables with State and CSC staff.
• Managed staff of nine business analysts documenting use-case workflow requirements for automated workflow development using Pega (commercial off-the-shelf workflow management package):
  • Included the following business functions – call center, third party liability, provider enrollment and credentialing, recipient premium payment processing, prior approval, documentation intake, and pended claim processing – and totaled over 60 use cases.
  • Prioritized use-case development order and reallocated resources based on CSC Development needs and availability.
  • Prepared as-needed papers explaining workflow processes for presentation to management and other teams. Developed weekly status reporting for CSC executive project management.
• Organized and operated initial change management process for project:
  • Sole operations resource for first six months. Processed over 130 change requests in this time.
  • Obtained and maintained requirement change requests from State staff, solicited and organized activities analysis from CSC staff, prepared pricing sheets for presentation to State, facilitated joint State-CSC change management meetings, and prepared related reports and documentation
• Led operations transition function during system implementation:
  • Coordinated exchange of data and procedures with incumbent fiscal agent (Hewlett-Packard). Initiated and completed over 70 transition requests in five weeks prior to implementation.
  • Coordinated final pre-implementation operations assessments in following areas – user training, service level agreements (SLAs), systems testing, change orders, operational reports, ICD-10 impacts, system letters, and security testing.
  • Created transition to operations plan covering final six months of operations development. Plan included hiring of over 200 personnel and totaled over 135,000 hours.
• Led joint State-CSC effort to secure Centers for Medicare and Medicaid Services (CMS) certification of new MMIS during 18-month period in development phase. Led team that documented responses to over 500 system review criteria on CMS certification checklists.
• Operations lead for development of Service Level Agreement (SLA) Measurement and Reporting System.
  • Coordinated CSC Operations involvement with CSC Development work on over 200 Service Level Agreement (SLA) measures and associated reporting.
  • Coordinated design, review, and testing of solution with State customers.
  • Performed assessment of initial 25 measures selected for monthly report and assisted in authoring of report card.