Candidates About

 

Luis c. Lopez

SUMMARY

·         18 years in Project Management with experience in Project Definition, Solution Definition and Design

·         16 Years of project implementation via PMO or Project Assessment Office

·         10 years of Project Management experience in HIPAA System Development, Implementation, and Documentation

·         8 years of PM experience with ICD-9, ICD-10, HIPAA X12N Standards 4010 and 5010

·         Strong Agile and Scrum practice experience

·         Experience with Trizetto - QNXT and CCA-UM/DM/CM Platforms

·         Experience with Commercial and MediCal - MediCare claims

·         Experience in Covered California Exchange systems and processes

·         Experience in writing and creating a roadmap for Security Policies and Procedures for GDPR- The EU -General Data Protection Regulation

·         CRM experience, Data Management and Integration Management, Business Intelligence, Cloud Based Network implementation via AWS and MS Azure

·         Experience with Vendor Selection Methodology, RFP development, Technical Review, Risk Assessment, Vendor Management, Contracts      

·         Experience in Organizational Governance project lifecycle, definition approval to implementation approval to benefits realization

·         Experience in strategic assessment and analysis, development of business presentations, Master Data Management and documenting complex business requirements

·         Managed reimbursement system for health care inpatient and outpatient services including Clearinghouse, MediCare, MediCal, Managed Care and Worker’s Compensation payors

·         Experience with Project Management Model (PM2) and System Development Life Cycle (SDLC)

·         Windows-Visio and Project, SharePoint, Office, Idx, Remedy, Oracle, SHIMS, Ariba, EDI, IBM Tivoli and Rational Unified Process, NIKU clarity, JDE Xe and JDE E1, Informatica, IBM MaaS Watson

·         Clinical Systems-Idx, Diamond, Epic, Cerner-CoPath, GE Centricity, McKesson, MIDAS

·         Experience in latest IT- LAN, WAN, HTML, XML, Java, Oracle, NT, DB2, E-Commerce, SQL, B2B, Mobile Platforms

·         Contract Negotiation and Account Management skills, Organizational and Resource Management skills

·         Business development and presentation skills

·         Designing and Implementing best practices and ITIL processes and procedures

 

 

EDUCATION and CERTIFICATIONS

·         Bachelor of Science, Integrative Biology - University of California, Berkeley                              1994

·         PMP Certified Project Manager - PMI                                                                                     2006

·         Certified ITIL - Kaiser                                                                                                                    2003

·         Certified Project Manager - University of California, Irvine                                                                   1997

 

 

EXPERIENCE

 

OneCity Health, New York, New York                                                                     04/2017-10/2017

IT PMO Project Manager

·         Oversaw the planning, scheduling and tracking of program/project timelines, resources, milestones and deliverables using portfolio/program/project management tools and best practices.

·         Supervised the development and on-going management of full-scale project plans and associated communications documents for all portfolio programs, projects and enhancements.

·         Continually managed portfolio expectations with all internal and external stakeholders in a timely, clear and concise manner.

·         Designed, developed and implemented continuous improvement initiatives using Agile and SDLC to incorporate lessons learned from successful programs/projects/enhancements.

·         Proactively managed changes in scope, schedule, resources and budget for all portfolio projects and enhancements.

·         Established and managed resource capacity planning process in collaboration with IT functional leaders.

·         Identified issues/risks to portfolio/program/project success and developed mitigation plans to manage them throughout the development life cycle.

·         Directed the day to day activities of all project team members and contractors, influencing them to take positive action and accountability for their assigned work.

·         Assisted in the day to day management and administration of the IT Governance department.

·         Coached, mentored, and supervised team members and contractors, and influenced them to take positive action and accountability for their assigned work.

·         Coordinated with IT Product Management to ensure that all program/project deliverables aligned with and supported the strategic business goals of the applicable products.

·         Built, developed business relationships vital to the success of the PMO and the IT Governance function.

 

LegacyShield, Los Angeles, CA                                                              August 2016- March 2017

IT Security Project Manager

·         Responsible for SOX compliance audit support and remediation for insurance clients

·         Worked with vendors for PCI compliance insurance and audit support and remediation

·         Responsible for Web security solutions (i.e. proxy) for 10 custom finance interfaces

·         Responsible for Internet security, including Intrusion Detection, Firewall solution

·         Worked to write and roadmap Security policies and procedures for GDPR- General Data Protection Regulation

·         Reviewed IT contracts with clients

·         Used Agile to customize antimalware/spyware solutions for interfaces with clients

·         Responsible for creating a Scanning IT infrastructure

·         Set up an Internal auditing process

·         Provided reports on software and firmware revision levels, worked with IT team using Scrum/Agile to schedule upgrades

·         Created and maintained Security, compliance and privacy documentation

·         Ensured compliance with regulatory requirements related to SOX, PCI and internal audit findings

·         Developed policies, procedures, and activities to support security, compliance and privacy

·         Oversaw Requests for Information (RFI) and Requests for Proposal (RFP) processes related to I.T. Security

·         Worked with the Finance and Legal departments to negotiate vendor contract Terms and Conditions (T&C's); Service Level Agreement (SLA), and payment structure

·         Managed and directed the staff in planning, development, maintenance, and the adherence to best practices and compliance

·         Working toward security certifications (CISSP, CISM)

·         working knowledge and strong understanding of security best practices for: Windows Active Directory, network routing and switching, firewalls, IDS/IPS, cloud computing and cloud-based services, MDM, server and desktop virtualization, Internet-facing applications, and VoIP systems

 

LA Care, Los Angeles, CA                                                                         May 2013 - August 2016

Project Manager

·         Working with various Business units and Vendors to Prepare for the CMC Duals Line of Business Audit

·         Work with IT and Business to prepare for the ACA California Covered Exchange Program

·         Work with different departments to meet CC Exchange testing audits and configuration of systems for readiness for the Exchange

·         Work with different Business users and IT to roll out the Trizetto QNXT and CCA platforms

·         Using the UM/CM/DM modules

·         Write Project documents including Business Requirements, Project Plan, Training, Policy

·         Manage relationship with project sponsors and project team members through status documentation and meetings to ensure project meets the needs of the business

·         Manage the ACA Exchange IT Program-including enrollment, invoicing, downstream interfaces, configuration and data exchanges with Calheers.

·         Managed ACA Data Warehousing via MDM

 

Warner Bros., Burbank, CA                                                         September 2012 - February 2013

Project Manager

·         Worked with Deloitte Consulting and business to gather requirements for upgrade of creative talent payment systems

·         Worked with WBDTD to gather requirements to upgrade interfaces for Television distribution

·         Worked with IT to support newly acquired publishing company (DC Entertainment) and their new lines of business

·         Manage relationships with project sponsors via organization’s central project management office

·         Responsible for rolling out upgraded payment system for DC Entertainment

 

Molina HealthCare, Long Beach, CA                                                     November 2011 - July 2012

Implementation Project Manager

·         Working with Business and Vendor to roll out Trizetto Care Advance 4.71 Platform

·         Work with IT and Business to build Project Charter and Business Requirements for implementation using SharePoint

·         Responsible for leading implementation of ICD 10 compliant Vendor platform

·         Work with ICD10 group for Vendor Management of systems with ICD10 impact

·         Provide experience in the Managed Health Care industry and stellar communication skills across organization with Care Support, Provider Relations, Compliance, Finance, Customer Service and Claims teams

·         Write Project documents including Charter, Business Requirements, Project Plan, Training, Policy and Procedures​

·         Effectively interface with project sponsors to reach a mutually acceptable agreement on project objectives, scope, deliverables, timeframes, resources and outcomes

·         Manage relationship with project sponsors and project team members through status documentation and meetings to ensure project meets the needs of the business

·         Interface with IT to ensure the project meets the needs of the business.

 

Kaiser Permanente, Pasadena, CA                                                       June 2011 - October 2011

Lead Project Manager

·         Worked with Ernst & Young to prepare for the ICD10 transition in Southern California KP-IT

·         EDI Project Manager for the transition of new HIPAA X12N 5010 in preparation for ICD10 transition using Scrum/Agile

·         Lead PM for implementing roadmap for scope documents and requirements for non-Epic systems for ICD10 compliance-including MDM via Informatica

·         Responsible for leading 5 Southern California PMs and 9 Solution Design consultants

·         Responsible for Vendor Management of systems with ICD10 impact

·         Working heavily with Interface Testing team using Scrum and Agile methodology

·         Charged with scheduling resources and budget for non-Epic systems with ICD10 impact

·         Responsible for engaging business partners for integration testing and UAT  

·         Report upstream on a regular basis to stakeholders and realization team on ICD10 roadmap and status

 

Deluxe Entertainment, Los Angeles, CA                                               October 2010 - April 2011

Senior Project Manager

·         Development of Real Time Interface for entertainment client using Agile and Scrum methodology

·         Project Manager for the implementation of Real Time Interface for Film Content and Digital Content Media

·         Charged with scheduling resources

·         Responsible for managing Integration Testing and UAT

·         Charged with making sure resources were on time in making changes to the RTI and delivering changes to client

·         Follow through with client to make sure all client requirements were met

·         Test and make sure Go-Live sign off from stakeholders

·         Direct Report to CIO on development of RTI for Sony Pictures Entertainment

·         Direct Report to VP of distribution at SPE on development and implementation of RTI

 

The Westfield Group, Westwood, CA                                                    May 2009 - September 2009

Program/Project Manager

·         Worked with Deloitte Consulting to develop Project Plan, Risk Log, Current State process and Future State process flow.

·         Project Manager for the integration of Financial, Design and Construction applications into a single platform for US Operations.

·         Charged with consolidation of Job Cost, General Ledger, Accounts Payables and Procurement functionalities into the JDE E1 platform.

·         Responsible for the interface development from Proliance, eSM and Xe to JDE E1.

·         Responsible for managing the Data Conversion from Xe to E1.

·         Managed the conversion and development of 21 Reports to 56 new Reports in the JDE E1 Platform.

·         Worked with Deloitte to develop configuration of new JDE E1 Platform.

·         Worked with Deloitte team to manage and develop data migration routines and test scripts and UAT.

·         Reported directly to CTO and CIO of Global Operations, reported monthly to Steering Committee

·         Served as the primary contact for assessing client needs and ensuring the quality of deliverables.

 

K&L Systems, Miami, FL                                                                      August 2008 - November 2008

Project Manager

·         Served as Senior Program Manager for Application development of Medical Revenue Lifecycle System for a software development start up.

·         Charged with System Quality Control and All UAT (User Acceptance Testing)

·         Wrote Business Requirements for Application Platform and Managed Development team performing work offshore.

·         Wrote test plans, user interface and client pre-implementation testing.

·         Created and maintained project plan, ensuring smooth implementation on a day to day basis.

·         Reported directly to CEO and CIO and maintained all major clients informed of application development and contingent implementation plans.

·         Served as the primary contact for multiple client projects, assessing client needs and ensuring the quality of deliverables. Including keeping up with client and obtaining feedback on project implementation.

    

Cedars Sinai Medical Center, Los Angeles, CA                                                  May 2005 - June 2008

Project Manager          

·         Responsible for creating the PMO office and building PMO processes

·         Worked with Deloitte Consulting to develop and manage the implementation of Change Management, Project Initiation, Project Solution Definition, Project Solution Design, ROI, Configuration Management and Release Management and submit the project to Governance for approval.

·         Implemented Enterprise Tactical Plan with long range goals for Fiscal Year. Tactical Plan involved scheduled projects as new initiatives that needed to go through Project Definition, Project Solution Design, and Implementation.

·         Worked with implementation team to implement the Centricity Care Management System

·         Worked with Care Management team to automate key workflows and tasks associated with Managed Care  

·         Assisted business users with required documentation to put tactical and non-tactical projects through governance approval and providing solution design including but not limited to:

o    Creating the Project Definition Document (PDD)

o    Creating the RFP

o    Vendor Selection

o    Technical Review documentation

o    Providing Risk Assessment

o    Pre-Implementation Documentation

o    Work with the Implementation Manager

o    Benefits Realization Reporting

·         Analyzed proposed solutions, identified and addressed risk mitigation in relation to the management, execution and control of projects.

·         Worked with PMO director to define the methodology framework for Planning, Reporting and execution of Remediation efforts, Audit Controls, Risk Assessment.

·         Conducted resource leveling across IT and business areas.

·         Responsible for cross-functional design meetings of new processes and implementing best practices.

·         Partnered with Change Management leadership within Enterprise PMO and PMO Director.

·         Responsible for re-engineering of Change Management from a process and technology perspective including integration with other ITIL processes (Configuration Management, Service Support, Release Management) and ensure compliance with HIPAA regulations.

 

Kaiser Permanente, Pasadena, CA                                                          February 2004 - May 2005

Project Manager NOPS/PMO-KP IT

·         Project Manager for deployment and implementation of Kaiser KP-IT EDS Deliverables. Manager for Kaiser’s Workstation Management Initiative Program, a multi-phase rollout plan to manage comprehensive enterprise applications in 10 states.

·         Project Manager for EPIC Resolute roll out in Northern California Region

·         NOPS PM for SCAL HATS project. HIPAA application security remediation project. Work in close contact with NCAL and enterprise HATS staff.

·         Member of the Cerner-CoPath Plus implementation team for Northern California deployment at 18 KP sites.

·         Managed ICE (Infrastructure Cable Engineers) NDE (Network Design Engineers) and

·         Coordinated with outside vendors to standardize infrastructure to achieve Kaiser deliverables

·         Accepted overall responsibility for project management, including Project plan and Budgeting

·         Reported to Project Management NOPS Office (National Operations Project Systems)

·         Managed assignment of project personnel and managed administrative project staff

·         Oversaw company-approved project management framework and where applicable - followed SDLC throughout the life of the project

·         Coordinated activities between multiple team leads and business channels

·         Coordinated and monitored activities of project personnel ensuring that progress is on schedule and within budget, with the ability to recognize issues and recommend resolutions

·         Reviewed team status reports prepared by project team leads, modifying schedules and plans as required

·         Managed all project documentation

 

Somega Systems, San Marino, CA                                                                   June 2000 - June 2003

Project Manager

·         Served as the primary contact for multiple client projects, assessing client needs and ensuring the quality of deliverables. Including keeping up with client and obtaining feedback on project implementation

·         Managed large-scale revenue cycle transformation projects for health care delivery systems

·         Managed team of experienced front and back end revenue cycle functions with

o    understanding of the functionality of patient accounting information systems and bolt on tools

o    (ICD-9, CPT codes, Patient Management, Registration, Medical Records, Patient Verification, Payor Verification)

·         Managed reimbursement system for health care inpatient and outpatient services including Clearinghouse, Medicare, MediCal, Managed Care and workers’ compensation payors

·         Experience with revenue cycle system interfaces to clinical information system software solutions (Including HIPAA ANSI X12N transaction standards 837, 276, 277)

·         Managed project components of the front to back end revenue cycle functions for medium size to large health care delivery systems and hospitals

·         Participated in key client meetings

·