Program Management Office lead for ICD-10 Implementation
Bruce was engaged by a large Blue Cross Blue Shield plan to lead the Program Management Office for their ICD-10 impact assessment and remediation initiatives. Bruce managed multiple business process and technical work streams over a 2 year period resulting in the clients preparedness for the ICD-10 implementation date. The work streams included end-to-end claims, care management, provider contracting, training, communications and technical implementation. Specific deliverables included an over-arching program plan, detailed work stream plans, training and communication plans, SIT and UAT test plans and periodic status reporting.
Pre-Implementation Risk Review
Bruce was engaged by a regional Blue Cross Blue Shield plan to lead a pre-implementation risk review of Facets. The risk review looked at all aspects of the implementation, including; project planning, project management discipline, budget tracking, requirements development, solution design, testing strategy, communications plan, training plan and cutover planning. The team identified areas of program risk and developed specific, actionable recommendations to mitigate the risk. The client engaged the team to conduct a series of similar reviews for each phase of the Facets implementation.
PMO lead for hospital lab system implementation
Bruce was engaged by a leading academic medical center to initially perform a risk assessment on a lab system implementation that was behind schedule and over budget. This was the clients first attempt at implementing a single solution across five facilities. The risk assessment identified numerous deficiencies in how the project was planned and how the execution was being managed. Bruce and his team took over the project, re-planned the remaining work, and drove the project to completion through the final phases of development, testing and cutover.
System Vendor Selection and Implementation
Led numerous system selection and implementation projects. Modified existing firm methodologies and developed a fast track selection approach, providing clients enhanced speed to value.
Operational Readiness Assessment
Conducted numerous managed care readiness and operational assessments. Developed assessment tools later adopted as firm methodologies.
Program Risk Assessment for workflow management system implementation
Bruce was engaged by a national Medicare payer organization to conduct a series of program risk assessments of a PegaSystems implementation. The client was implementing the new workflow management system in a number of key business areas, including; pended claims management, appeals & grievances, provider contracting and care management. This implementation was the clients first exposure to the Agile development methodology, which added considerable risk to the program. The risk assessments addressed all aspects of the program including, planning, executive sponsorship, program management, development of user stories, sprint planning and execution, technical design, testing strategy, cutover planning and post go-live support. Each assessment identified key risks based on where in the lifecycle each project was and included actionable recommendations for remediating the risks.
Claims Adjudication Engine Due Diligence
Bruce led the due diligence of a new claims adjudication engine being considered by a large national limited benefit health plan. The review included the documentation of business requirements, the development of business process flows, and the creation of new claims system business case.
PMO for Payer Operations Integration
Bruce led the PMO for the integration of an external disease management company into the care management operations of a large national payer organization. The scope of the project included a mapping of business processes between the 2 organizations, developing an integration plan and managing the execution of the implementation.
Behavioral Health Managed Care Company Integration
Bruce facilitated the integration of a behavioral health company into a large national payer organization, resulting in significant administrative savings. The scope of the project included a mapping of resources and capabilities for the 2 organizations and developing an integration plan.
Consumer-Directed Healthcare Product Deployment
Bruce led the strategy development and deployment of a second-generation consumer directed health care product for a large regional health maintenance organization. The strategy encompassed the rollout of several consumer directed healthcare products across multiple regions. The deployment included defining requirements, vendor selection and integration of the vendors into existing health plan systems and process