Healthcare Technology Leader

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Position
Healthcare Technology Leader
Location Confidential
Yes
Willing to Relocate
No
Industry
HealthCare-HMO/Hospital&Nursing/Med./Dental
Function
TECHNOLOGY(IT/EDP/MIS/Communications)
Compensation
$200,000 to $400,000

Resume Summary
IT Executive, expert in program management, planning, delivery of critical, enterprise systems. Responsible for program budgets of over $60M/year. Expert in transforming legacy platforms and SDLC methodologies into Cloud-Based technologies and Agile methodologies. Skilled in building/directing matrixed teams of ~400

Resume Body      HEALTHCARE TECHNOLOGY LEADER

Information Technology Vice President, expert in program management, planning & delivery of critical, multi-application enterprise systems. Have had full ownership of programs with budgets of over $60M/year, including end-to-end applications delivery responsibility. Highly skilled in building and directing large, matrixed global technical teams (including vendors) of over 400 staff. A skilled collaborator, able to interact closely with business partners to develop product portfolios, roadmaps, solutions, and rollout strategies. Expert in transforming legacy platforms and SDLC methodologies into Agile and Cloud-Based methodologies. Acknowledged as insightful and organized, and able to attract and retain the best staff, instilling loyalty and respect.

KEY STRENGTHS
Strategic & Tactical Leadership
Program Management
Agile Methodology Transformation
Building & Directing Global Teams
Software Delivery Excellence
Project Rescue & Turnaround
Achieving Revenue Growth
Business-Technology Partnership

KEY ACCOMPLISHMENTS
2015 September2017
Led application integration delivery for a key program in Optum Technology (UnitedHealth Group) to modernize and consolidate corporate legacy claims processing systems. This $400M+ program integrates over 90 enterprise applications with a new modular, cloud-based, and highly configurable claims adjudication system. It also pilots the migration of a legacy system to this new claims platform.
" Responsible for integration and end-to-end delivery of 10 new Big Data functional streams / technology applications being built to support the new program.
" Managed capital budget of $60M+, directing over 400 technical staff in 4 locations. Led planning, solution, staffing, financials, and development for integrating this new core platform with various systems including
o UnitedHealths Big Data platform for Reporting and Analytics, enabling self-service generation of over 400 key financial and federal/state regulatory analytical reports. Project also mapped & loaded over 1000 tables for 7 functional domains.
o New UnitedHealth provider portal enabling integrated, transparent provider experience.
o New enterprise Provider and Member Master Data Management (MDM) systems to uniquely identify all UnitedHealths providers and members.
" Rescued troubled $20M Provider MDM application, scheduled for rewrite after struggling for 3 years. Restructured team, overhauled roadmaps/plans and steered the project to success, in just 10 months.
" Led planning, solution and development for more than 35 APIs in a Hadoop/BDPaaS environment, integrating with the new applications listed above.
" Successfully spearheaded major transformation from Waterfall to SCRUM Agile methodology for all applications listed above. Restructured delivery mechanism and roadmap, piloting new Agile concepts and tools, overcoming team resistance and learning curve.
" Led analysis for selection of Salesforce.com as the new enterprise issue management/customer service desk (CRM) application to support 1.2M members.

2015 April  2015 September
IT ownership & accountability for OptumRx suite of pharmacy benefits applications (Home Delivery, Claims Adjudication, Prior Authorization, Formulary Management), supporting 45M members, across 3 business lines.
" Led planning for integration of OptumRxs applications suite with those of Catamaran (new acquisition), and for merging IT staff and portfolio.
" Managed capital budget of $60M+. Directed technical teams of 250 staff and vendor consultants.
" Revamped teams, offset high-cost consultants by offshoring, reducing development costs 15% in 6 months.
" Led rebuild of Formulary Management System using new technology and piloting Agile Methodology. Transformed culture, process and technology, influencing business partners and cross-functional teams.

March 2012  April 2015
Full IT ownership and accountability for two of UnitedHealth Groups major claims administration platforms, supporting 8 million members across 3 lines of business (Medicare, Medicaid and Commercial business).
" Managed $45M+ total annual budget. Directed technical teams of over 300, in 3 US and 2 global sites, to deliver regulatory-compliance, acquisition-integration, migration, business-requested projects.
" Turned around a high-cost, negative-revenue $36M portfolio, plagued by high attrition rates and inflexible resource model. Transformed culture, right-sized teams, cut unit labor costs, and moved project from -$250K/year to +$230K in 8 months.
" Achieved 3-year attrition rate of under 2%, building motivated, cross-trained teams, introducing rotational assignments and raising morale.
" Increased revenue, lowering unit labor cost 33% in 1 year by revamping teams & increasing offshore staff 25%. Took offshore/onshore to 40:60 mix; created & directed a global team that worked seamlessly as one.
" Implemented a flexible demand/capacity resource model to align with business spend, enabling nimble, seamless reassignments. Established proactive project intake planning process with business partners to set priorities and maximize value, while maintaining staff work-life balance.
" Estimation/Budgeting:
o Improved project estimation process and met target of 10%, 95% of the time.
o Reduced release defects by 60% with rapid prototypes/process improvements.
" Partnered closely with production support and infrastructure teams for system maintenance, increasing availability of a critical system from 99.6% to 99.99%. Reduced defect backlog by 70% in 2 years.
" Sample critical projects delivered successfully: ICD-10, HIPAA 5010, CMS EOB, iCES Editing, Provider Reimbursement, and migration of new acquisitions.

2009 March - March 2012
Full IT delivery ownership and accountability for PacifiCare Health Systems primary integrated claims adjudication platform, supporting 3+ million members across 2 lines of business in the Western Region.
" Accountable for managing IT capital budgets of $10M with staff in US and global locations. Delivered regulatory-compliance, migration-integration, and business-requested projects.
" Led multiple initiatives to integrate PacifiCares systems with Uniteds enterprise applications and processes, including EDI, Unified Data Warehouse, Prospective 2.0 for Fraud, Waste and Abuse.
" Led decommissioning of a secondary legacy PacifiCare claims platform supporting 3 western states.
" Brought capital budget, capacity/demand planning &project intake processes in line with UnitedHealths standard practices, partnering closely with stakeholders and business partners for a smooth transition.

March 2006  April 2009
" Led integration/migration of PacifiCare membership to UnitedHealth systems after PacifiCare acquisition by UnitedHealth. Transformed IT culture to adopt UnitedHealths project intake, resource, capital budget & planning processes.
" Led migration of 500K membership from a secondary legacy claims PacifiCare platform to the primary adjudication platform.
" Managed project delivery for re-engineering the Enterprise Capitation system for UnitedHealth, modeled after PacifiCare capitation functionality. Program of $30M IT capital budget with 100 staff.
o Lowered IT cost by 40%, partnering with vendor moving development and testing offshore.

ADDITIONAL LEADERSHIP SKILLS
" Outstanding interpersonal skills. Established a culture conducive to open communication with key technology and functional leaders. Effectively managed key stakeholders, challenging partners and peers.
" A sought-after mentor. Have successfully coached upcoming leaders now in key positions in UnitedHealth.

CAREER TRAJECTORY
20142017: Vice President, Solution Delivery and Support Services, UnitedHealth Group, Irvine, CA
20112014: Senior Director, Solution Delivery and Support Services, UnitedHealth Group, Cypress, CA
20082011: Director, PacifiCare Core Administration Systems, UnitedHealth Group, Cypress, CA
20062008: Software Delivery Manager, PacifiCare Core Systems, UnitedHealth Group, Cypress, CA
2003  2006: Service Delivery Manager, Keane Inc., located at PacifiCare Inc., Cypress, CA
1995  2006: Quality Assurance Manager, Medstat Group, Ann Arbor, MI

EDUCATION & TRAINING
" M.S. in Computer Information Systems, Eastern Michigan University, MI
" UnitedHealth Groups Executive Development Program at Wharton School of Business, PA
" Senn Delaneys Corporate Culture Workshop

PLATFORMS & TECHNOLOGIES
Oracle Mainframe/DB2 Java ETL Tools Data Analytics Data Fabric Hadoop NoSQL Mark Logic Agile Methodology

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