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Click here or scroll down to respond to this candidateSummaryRevenue Management professional with experience managing enterprise implementations of healthcare information systems. Expert at gathering, analyzing and defining business and functional requirements; leading data- modeling and process-mapping initiatives, designing/customizing processes, workflows and technology for healthcare systems and networks. Proven ability to lead implementations and deliver process solutions improving revenues, margins, and workplace productivity.EXPERTISECustom/Build/ Design & ManagementCandidate's Name
Strategic PlanningMajor Software/Systems ImplementationsData Flow and Process MappingIntegrated Testing/Scripting/DocumentationData Business and Systems AnalysisProject ManagementExperienceOracle (formerly Cerner) Kansas City, MO 10/2011 09/30/2022Senior Consultant (RM Lead) Revenue Cycle (Soarian Financials)Led hospitals enterprise implementation of Soarian Financials system for net new clients and existing legacy clients. Managed large-scale optimization projects, systems conversions, performance and monitoring of applications/systems. Prepared high level Optimization Assessment document for revenue management, presented to Client Project Executives based on analysis, to show problematic errors with system functionality which provides Stage (Pre-Post Live) as to when effort needs to take place to correct, description of the issues, action or resolution involved, Risk level, and the remediation hours that is involved for the effort.Responsible for the custom, build, and design for the revenue management functionality of Soarian financials with build focus in General Ledger, Remittances, Denial Management, SBO, Guarantor Statements, Enhanced Worklists, and NY State SPARCS.Responsible for pulling Analytic Reports, Crystal reports, and Ad Hoc reports for departmental review of data which also includes running Candidate's Name .Built system Masterfile Rules out by writing Java Expressions for each Masterfile rule.Wrote Specs for CRDT rules to be sent to internal programming and development team for deployment.Gathered and assessed client needs for business units; created custom documentation for client specific needs according to system functionality that best fits the department/unit request according to internal process workflows.Identified, analyzed, and documented issues when creating test plans or testing systematic changes. Participated in Functionality Testing, Integrated Testing to ensure the application is producing the desired or intended results. Tested and deployed all CRDT rule packages created according to internal process at that time.Worked directly with internal programmers and software engineers to create detailed specs for NY state SPARCS clients which results in successful testing. Created client-specific SPARCS test documentation for projects where none existed or worked with the client assisting in the creation of their internal documentation around current processes that is already in place but may need to revise per hospital needs. Optimized training documentation prior to go-live and designed custom modifications to accommodate special needs. (e.g. blind users).Successfully facilitated a SPARCS process that turned around facilities that lost funding or were in jeopardy for non-compliance due to shortages. Assisted in helping clients appeal or request extensions or exceptions to be able to be compliant with New York State guidelines due to delinquent filings.Documented issues in functionality and software defects, using REMEDY (ticketing system), and reporting defects or needed software enhancements to be received by the software developers.Created Change Management processes and assisted clients in creating a change management process that works for current need when systematic changes need to be made in Testing and Production environments.Interacted with various clients on various project teams to ensure clear communication with the project team to discuss project status and clarifying any functionality related queries.McKesson, RemoteSenior Implementation Consultant11/2009 09/2011Responsible for implementing the HzERM (Horizon Enterprise Revenue Management)/HSES application, a new development software system, assuming the role of creating the customization, table builds, and design of the system.Key projects:Assists in the development functions of scripts and RM reports that are instrumental to the success of high-priority development projects.Completed HzERM design, table builds, functionality and testing for defects.Bridge the gap between the business and technology to effectively design and customize a system that will meet or exceed the expectations of the business and end-usersManage Beta development partners/client expectations throughout project(s) lifecycle.Analyze current business and operational processes and contribute towards process improvements and process re-engineering to further the goal of successful for the HzERM productSubmit status reports on a weekly basis or as needed per projectProvide support to all AM and RM HzERM Go-Lives. Support readiness and relationships (usually working directly with senior level project managers at client).Ability to interact with all levels of management (internal and external). Evaluate the impact of potential system changes on the membership and on other applications.Comfortable in customer facing situations and proficient in providing business and technical presentations.Design and develop other customizations to the system to support the business workflowsWork with various technology teams including server support, networking, access control, etc. to ensure all systems remain stable and availableFull project life cycle experienceOrthocare Solutions, Gaithersburg, MD Director of Revenue Management01/2009 - 10/2009Lead and Re-organized the structure of a small DME firm working with Sales, Administration, and Accounts Receivable managementKey projects:Analyze and Research data from all sources, Reconciliation, Staff performance, patient satisfaction, etc. to assist with the overall Quality Improvement within the organization.Skilled at building and managing client relationships, influencing othersManaged staff in DME Billing, Verification/Authorization, Follow-upCreate process work charts to serve as a guide to assist with quality and accuracy in maintaining effective protocols for billing all Insurance Payers.Manage Denials and Clearinghouse rejections on all DME claims submitted.Organized meetings regarding sales and develop and recommend sales strategies that increased revenue by $60K within one month of implementation the DME orthotics.Collaborate in the review of business and functional requirements and determine primary technical functions that the project is to provide.Financial Health StrategiesBusiness Operation Project Manager05/2006 12/2008Promoted from Client Services Imports and Reconciliation Supervisor to Business Operations Project ManagerKey projects:Introduced companys first formal A/R reconciliation program, creating a flexible and well-received tool that was later adopted company-wide.Managed Full project life cycle experience, (requirements, specifications, design, construction, testing, etc.Assisted in the development approximately 25 custom financial and auditing reports using Crystal Reports with MS Excel and Access.Monitor the import process, payment posting, new lines of business and payment files processes for accuracy between vendor & clientDirectly involved with New Business Implementation projects. Assisted in new business implementations in the completion of 7+ medium- to large-scale implementations bring in over 4 billion in revenue POST LIVE, managing projects from business requirements analysis to solutions delivery and support.Complete quality checks on supervised staff as well as monitor payroll, employees time & attendance, and complete annual reviewsSystem Issue Research as well as reconciling patient account discrepancies regarding balance differences, cash posting issues, patient statement issues, resolving client invoice issuesSupervise staff with education and training as well as implementing new policies and procedures to serve as a structure or guide to followImplemented plans and work assignments with different strategies for POS in a way to effectively generate more revenue regarding patient self-pay at point-of-service inpatient & outpatient care.Report directly to Director of Client Services weekly regarding progress as well as problems associated with staff or daily operationsDeveloped and managed the Medicaid project from start to completion with clients to ensure and provide effective communication as well as monitoring processes that promote and provide effective business relationships through on-site client visits.Prior Years Work History:PROJECT MANAGER CONSULTANT- JACOBSON SOLUTIONS- REMOTE- NOV 2005 thru APRIL 2006REIMBURSEMENT SPECIALISTS- RPM- ALPHARETTA GA- FEB 2004 thru OCT 2005MEDICAL BILLING MANAGER- FINE & ASSOCIATES- SNELLVILLE, GA- SEPT 02 thru JAN 2004MEDICAL BILLER/MEDICARE SPECIALISTS TEAM LEAD- HCA-NORCROSS, GA- SEPT 1998 thru AUG 2002Education & TrainingNational American UniversityB.S. Healthcare ManagementA.A.S Medical Staff Services ManagementAffiliations: Member of AAHAM, Member of HFMA, NAR, Women in Business, Minority-Owed BusinessNew Jersey Licensed Real Estate AgentSmall Business Owner Britt Property Management |
