Muskegon Community College

Independent Contractor-Sr Project Manager

Houston, Texas, United States

Sr. Project Manager-Contractor/Consultant	06/2016-PresentJGroendyke, LLC Program/Sr. Project Manager-Contractor/Consultant	07/2017-01/2019Total Health Care, Detroit, MICore System Replacement Responsible for oversight and management of the entire Core System Replacement from ikasystems to HealthEdge-HealthRules Payor.  Facilitated and coordinated activities from strategic planning, risks, workstream goals, vision, business process improvement, detailing tasks, managing resources, providing direction on the implementation, etc. Executed using a mix of waterfall and Agile via Jira as well as MS Project.  Network Health, Appleton, WI	June 2016-June 2017Responsible for managing several projects (detailed below).  Activities included: Creating business cases and charters; establish and managing budgets; leading/facilitating kick off and WBS sessions; created WBS dictionaries; develop project schedules; identification and risk management/mitigation; resource management; BRD; execution; status reports; establish and manage vendor relationships; meeting facilitation; lessons learned; project closure; project celebration activities; and various other PMO processes. Infrastructure Project for Disaster Recovery.  Managed the build out of two data centers in two states; managed and participated in the creation of Disaster Recovery plan and Disaster Recovery tests (disruptive and non-disruptive).  Managed the roll out of an eMass Communication tool and training.  Worked with and coordinated activities with CDW, Cerium, and AT&T for implementation (routers, SIP Install, etc).  Enterprise Security Enhancement project with objectives included identifying and addressing security concerns/weaknesses.  Two risk assessments were completed and all identified high risks were addressed; policies and procedures updated.  Added 24x7 Security (ActiveEye) monitoring; implemented OKTA (multi-factor authentication); and DLP (data loss prevention).

JGroendyke, LLC

Responsible for the development of a New Provider Enrollment Team (Payspan is healthcare’s leading provider of payment reimbursement solutions). Establishing a team to manage and perform adoption outreach activities by creating processes that ensure that all outreach activity is analyzed, prioritized, performed, and reported. The processes will ensure successful provider registration/adoption and return for the organization. Project Deliverables included project schedule, playbook, scope, communication plan, charter, decision memos, RAID log and Stakeholder meetings. •	Worked directly with COO, facilitated Executive Leadership offsite planning meeting, and conducted interviews for COO. •	Developed and established a team that handled provider enrollment/adoption including automated drip/nurture campaigns. •	Created staffing model and job descriptions. Coordinated roles/responsibilities for team in conjunction with PMO during implementations.•	Coordinated and participated in activities for research of automated tools for campaign automation and outbound calling. Defined automation opportunities (WhatCounts, Pardot & Five9). •	Oversight of the team and the establishment of a repository of materials for provider enrollment including email blasts, letters, outbound calling scripts, etc. Team reviewed & updated current materials to provide a baseline of outreach materials. Implemented an approval process that ensures we have one repository with standard templates that includes content review and styling & branding. •	Created repeatable process for the team and interaction between Sales, Marketing, PMO, and Call Center. •	Created and established status reporting on success metrics. Created and defined a manual dashboard process to report success metrics until the automated dashboard is developed. •	Defined a prioritization of clients based upon ROI for the organization.

Payspan, Inc.

Sr Project Manager-Contractor

Joined the ICD-10 project midstream to provide structure and additional leadership to meet aggressive timelines, provide team cohesiveness and resolve issues. Managed the Benefit Equivalency and Business Readiness teams through analysis, measurement, and management of the potential business, financial and operational impacts to the organization that could occur as a result of implementing the ICD-10 CM/PCS diagnosis and procedure code sets. Managed testing of all lines of business (Commercial, Blue Care, Medicare Advantage, ITS Host/HOME, and Cover Kids). Testing was performed in cycles. Defects and retesting were captured utilizing HP Quality Center.•	Managed the team utilizing a mixture of Agile and Waterfall methodologies to meet timelines and ensure accurate results. •	Responsibilities included: Managing a multi-functional team, mitigating issues, Operational Steering committee status updates/reporting, ICD-10 Weekly Status reports/reporting, testing status reporting, facilitate daily stand ups, facilitate operational workgroup weekly meeting with business owners. Blue Care Bureau deliverables, creating/managing project schedules, defect management, risks and issues.

BlueCross BlueShield of Tennessee

Implementations of Individual Enrollment On/Off Exchange (Direct Enrollment on <a href="http://Healthcare.gov">Healthcare.gov</a>) including payment redirect—binder/recurring.  LEADERSHIP & OVERSIGHT of large internal team including core team, managers, directors, VP’s and Sr VP’s and a vendor.MODELING SUCCESS by ensuring that all change requests, decision memos; contractual obligations, team coordination and participation with CMS on mandates and ensuring Federal mandates; state; and plan business rules were established and maintained.  When vendor was unable to meet contractual obligations; we brought the work in house and coordinated effort utilizing Agile Methodology. ESTABLISH & MAINTAINED STRONG RELATIONSHIPS with plan and team even during project challenges and lack of performance by outsourced vendor. MENTORING and maturing team members.DEVELOPED, COORDINATED, EXECUTED, & IMPLEMENTED project plans using a variety of PM        methodologies (Waterfall and Agile) based upon needs and structure as well as internal PMO structure, risk management, resource allocation, budgets, SOW’s, change requests, PMO Governances, status reporting to multiple levels of leadership, defect resolution, defined tasks and timelines.  Worked directly with vendor to coordinate implementation.  TOOL EXPERIENCE-All Microsoft tools (project, excel, word, PowerPoint, publisher, etc.), SharePoint, and TFS (Team Foundation Server).

Projé Inc

SR. CORPORATE PROJECT MANAGER

Implementations of ikaSystems products—Medicare Gateway, Claims, Call Center, PortalsLEADERSHIP & OVERSIGHT of multiple implementations for multiple clients over multiple states (MI, TX, NJ, NY) with multiple teams internally and externally, responsible for all aspects of implementations. MODELING SUCCESS by ensuring that all change requests, contractual obligations, client satisfaction, oversight of implementations (from kick off through go-live to production support).ESTABLISH & MAINTAINED STRONG RELATIONSHIPS with clients even during project challenges. MENTORING and maturing team members.DEVELOPED, COORDINATED, EXECUTED, & IMPLEMENTED project plans using a variety of PM methodologies based upon client needs and structure as well as internal PMO structure, risk management, resource allocation, budgets, SOW’s, change requests, status reporting to multiple levels of leadership, defect resolution, defined tasks and timelines.  Worked directly with clients to coordinate implementation.  TOOL EXPERIENCE-All Microsoft tools (project, excel, word, PowerPoint, publisher, etc.), SharePoint, Illient, and Replicon.

ikaSystems

DIRECTOR OF IMPLEMENTATIONS

Proje' Inc

Sr Project Manager

System Implementations experience from Priority Health, Blue Care Network, Grand Rapids MI, and MVP Healthcare, Schenectady NYDEVELOPED project plans, defined tasks and timelines as well as worked directly with vendors to coordinate implementation. Responsible for coordination and implementation on Facets and Amisys. (Value Options, Cue 4 Pilot, Clinical Editing Wrapper – IT PM).EXECUTED project plans, definite tasks and timelines.  Coordinated between sites with Facets and Amisys. (Facets Opt 2 adding Pharmacy product – IT PM).DEFINED tasks and timelines; developed project plans, coordinated new tools: COGNOS and Enterprise Letter Server (Enterprise Integration Reports and Letters – IT PM) LEAD on project for claims department.  Developed and tested strategy and test scenarios; performed claims testing and validated results (Core Operating System). IMPLEMENTED new plans, developed and defined tasks and timelines.  Worked directly with vendors to coordinate implementation.  Created test scenarios and tested software components.    Provided seamless transition for internal and external business structure; developed and delivered provider education and policies and procedures.  Coordinated and trained Member Services, Provider Services, Benefit and Medical Teams. (ClaimCheck – IT PM)

IT CONSULTANT

Directed all aspects of administration related operations for $1 million nonprofit with 48 locations throughout North and South America, Europe, Africa.CONDUCT corporate financial management, budget development, analysis and reporting.   MANAGE all phases of new site launch from demographics analysis and site selection to financial, legal, budgeting, staffing and corporate documentation.HANDLE corporate office management ranging from financial and business analysis to IS and HR functions which included benefits administration and healthcare and health insurance. KEY CONTACT and resource on business matters.  Liaison with hospital and insurance companies to handle all negotiations.PLAN AND MANAGE development and operational launch of new locations.  Serve as liaison to new and existing locations. INTERACT with senior external parties including Senators, Congressmen and State and local public representatives.  Serve as spokesperson for print and broadcast media.

Resurrection Life

DIRECTOR OF ADMINISTRATION

PROVIDED business and business process analysis and project management for mid-sized HMOTRACKED AND ENSURED provider and pricing subsystem data integrity.  Conducted auditing/problem solving. DEVELOPED present medical pricing/billing/process training program for internal staff.MANAGED research and development of annual reimbursement model. UPDATED fees and methods of reimbursement (including per diem, capitation, DRGs, RVU, provider discount, withhold, per anest. unit.

Priority Health

BUSINESS ANALYST III

NEGOTIATED contracts, which included providers, provider groups, hospitals and organizations. FACILITATED communication and training between providers and HMOs. BUILT AND SUSTAINED positive working relationship with provider community by providing complex required documentation more effective communication tools. INVESTIGATED, resolved, and reported provider issues, billing and claims issues.DEVELOPED fee schedules and also handled credentialing. PROJECT LEAD for major clinical editing/unbundling project and updated CPT, HCPCS, and fee schedule revisions

Blue Care Network

Provider Services Rep

Unbundling (Clinic Editing); Provided business and business process analysis and project management for multiple mid-sized HMOs. (Promoted within two years of hire).ANALYZED and RECOMMENDED enhancements for business processes and products for midsized HMO.PROJECT MANAGEMENT LEAD for diverse projects relating to clinic editing/unbundling of healthcare and insurance systems.TRACKED and ensured provider and pricing subsystem data integrity; conducted auditing and problem solving.UPDATED fees and methods of reimbursement (including per diem, capitation, DRGs, RVU, provider discount, withhold, per anesthesia unit. DEVELOPED training program for medical pricing, Premium Billing and Process.MANAGED research and development of annual reimbursement model for team of 30 and core team of 12.  Transferred knowledge of billing and coding to staff members for the initiative acquired by industry standards and experience in the field.  Researched, developed and created Medical Reimbursement Policies. PROVIDED research and development of healthcare and insurance best practices, policies and procedures.  CONDUCTED auditing to identify targets ranging from fraud to overall billing trends. RESEARCHED AND DEVELOPED corporate policies for each clinical edit ensuring AMA guidelines were applied and supported.  Identified appropriateness for pricing subsystem, procedure code and modifier use.  Coordinated appeals for Step II provider clinical editing grievances with medical director and corporate medical team.

Joyce Groendyke

Joyce Groendyke