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Monthly Archives: July 2016

HealthCare IT – Director of Enterprise Architecture & Business Analysis

Posted on July 29, 2016 | Categories: Business Analyst, Solutions Architect | Posted by: admin

HealthCare IT – Director of Enterprise Architecture & Business Analysis

 

  • Ability to provide Business Solution Architecture that fits within the Agile / Waterfall methodology
  • Ability to quickly and effectively understanding business issues and challenges
  • Ability to work with product managers and/or project sponsors to document the business vision and the project scope
  • Contributing to a consolidated business and technology roadmap (ensuring that resources, interdependencies and business priorities are effectively aligned)
  • Eliciting business needs and assisting in the refinement of business requirements
  • Engaging with business and IT groups to align solution architecture with strategic business direction
  • Experience in gathering and documenting detailed functional requirements using UML (Unified Modeling Language) T techniques (viz. use case preparation etc.) for software engineering or to analyze, design, and implement software-based systems along with other business processes for HealthCare domain.
  • Good knowledge in Cerner (formerly Siemens) Invision & Invision Registration and Billing (RCM) products
  • Helping to define the set of concepts, processes, and services that comprise the enterprise’s value chain and operations
  • Helps Technical Analysts with Application maintenance and support i.e. L1-L2-L3 set-up
  • Lead Business Analyst with at least 8 years of experience on US Healthcare Provider Platforms.
  • Providing informal mentoring to other members of the solution architecture team
  • Staying engaged throughout the entire project lifecycle to ensure ongoing alignment to solution architecture
  • Strong analytical skills, exceptional verbal and written communication skills, and a strong client-facing presence
  • The Director Accountable for aligning strategic goals and objectives with decisions regarding products and services; partners and suppliers; organization; capabilities and key business and IT initiatives
  • The IT Business Solution Architect plays a key role in structuring the enterprise in terms of its processes, capabilities and information
  • The primary responsibility is translating business goals and objectives into detailed business capabilities through the use of process flow diagrams, future-state operational changes and technical solutions
  • Thought Leader to product portfolio to improve competitive position and/or optimal product performance
  • Translating requirements into solution diagrams and other artifacts. Presenting artifacts to IT delivery teams to assist with the estimation and systems design process
  • Working with business and technology leaders to understand current and future-state process flows

 

Contact Manish for HealthCare Business Analyst or Solutions Consultant at 646.644.3049 or manish@techcusp.com

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Principal Consultant & Delivery Manager – HealthCare (Payers & Providers)

Posted on July 29, 2016 | Categories: ACOs, Analytics, Apps, Big Data, Care Management, Claims, Clinical Services, Clinical Trials, Consulting, Data Analytics, Health Exchange, Health Insurance, HealthCare | Posted by: admin

Principal Consultant & Delivery Manager – HealthCare (Payers & Providers)

 

  • The Principal Consultant & Delivery Manager (PCDM) leverages combined people, process, analytics and technology competencies to support large-scale, complex customer engagements
  • The Principal Consultant & Delivery Manager (PCDM) is responsible for driving customer value through client facing advisory and delivery services. A subject matter expert and trusted advisor for Payers, Providers, Clients & Program Management Team and works closely with engagement and technology team to define strategic and tactical direction
  • Collaborates with Leadership, Product, Infrastructure &Security teams to configure solutions and deliver value to customers. Responsible for identifying and solving business / systems issues
  • Contribute to the delivery and execution of complex, large scale, multi-year (high cost, high complexity and/or high risk) client enterprise transformation programs
  • Deliverables include leading major work streams and projects, supporting pre-sales and sales activities, owning deliverables, building key customer relationships, building and sharing institutional knowledge, and developing junior professionals
  • Build, share, and maintain expertise in both practice area and client environment, regularly interface with Product, Infrastructure, and Security teams to deliver on customer commitments
  • Contribute to operational readiness, organizational change management, solution capability, packaging, and estimating, planning and delivery management
  • Contribute to pre-sales and sales activities for revenue growth
  • Lead major engagement work streams and projects to meet milestones on time, and to deliver with high quality and within agreed to budgets
  • Plan, organize, staff, direct and control the operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority
  • Use Data Analytics & information sets for analysis, creating hypotheses and presenting recommendations to team; developing client specific requirements, standard operating procedures (SOP), functional roles & responsibilities, process flow and user guide per SOW

 

Contact Manish for Sr HealthCare Consultant @ 646.644.3049 or manish@techcusp.com

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Tele-Health and Medical Devices

Posted on July 28, 2016 | Categories: Uncategorized | Posted by: admin

Tele-Health, Mobile Health and Medical Devices

  • Assistive Devices – FDA approved hearing aid etc
  • Durable medical equipment – FDA approved For Diagnostics, monitoring, and medical therapeutics viz. Pacemaker, Sleep Apnea Machine etc
  • Medical Sensors – For Tele-Health via Networked or Wi Fi protocol viz. Qualcomm etc
  • Wearable Devices – For health & fitness viz. Fitbit Blaze, Google Glass, Apple Watch, Samsung etc
  • eRX, EMR, PHM, CM, Medical sensors and Wearable Devices are generating enormous amount of Clinical Data. All of this data could be pushed to cloud for further processing of Big Data Analytics, Machine Learning Algorithm to generate actionable for Preventive Care

 

Call Manish for Tele-Health / Clinical Trial PM Solutions @ 646.644.3049 or manish@techcusp.com

 

Delivery Director – HealthCare IT

Posted on July 27, 2016 | Categories: Account Manager, Claims, Consulting, Health Insurance, HealthCare, HealthCare IT, Program Manager, RCM, Senior Consultants | Posted by: admin

Delivery Director – HealthCare IT

 

 

  • Manage & Lead Project Initiations, Estimates, SOWs, Budgets, Charter, Scheduling, Plan, Risks etc in support of on-going client needs and new opportunities
  • Managing complex plans to resolve client production incidents and service requests through understanding of client priorities and internal processes. Tracking to plan and working across the organization to effectively meet the client’s business needs. Establishing positive relationships with clients and program resources through effective communication and on-time delivery of commitments
  • Responsible for Client Relationship Management (CRM), Voice of Customers (VOC), Solutions and Escalations that demand a high degree of diplomacy, discretion, insight, and judgment
  • Managing SOW / contract scope to include establishing agreed upon contract deliverables, roles, responsibilities and budget
  • Lead and directly manage a team of resources, in particular as it relates to the delivery of project-based activities
  • Participate and contribute thought leadership to help drive Professional Services & Business Development strategies
  • Acts as a liaison between various internal organizations (Marketing, Finance, Product Management, etc.)
  • Managing and developing agendas and action logs for all client meetings. Tracking open items in action log and ensuring timely delivery across the organization
  • Managing and facilitating weekly and monthly client meetings and reporting on projects at a line level up to senior executive level
  • Managing multiple operational projects on time, budget, and quality while accommodating competing priorities
  • Managing multiple project teams to completion in parallel within time and budget and completing all project close-out activities.
  • Managing project environments through the product lifecycle including procurement, build and configuration, network and security configuration, and coordinate and schedule resources
  • Proactively identifying gaps in internal change, incident, service request, batch and problem management plans and external expectations; and managing client expectations regarding risks and issues mitigation
  • Provide delivery engagement for existing & client portfolio. Manage client level P&L
  • Strong presentation skills with ability to effectively communicate through written or verbal forums and strong interpersonal skills
  • Working with Communication Team and Project Managers / Program Manager to disseminate project status, information, and expectations to internal and external client resources and stakeholders and reporting on projects at the executive level.
  • Working with technical leadership to ensure their client program is properly resourced based on scope, skillset and timeframe for delivery. Escalating production issues quickly and driving resolution while communicating status and resolution path to client. Proactively escalating to resource teams to avoid risk of missing client deliverables.

 

Contact – Manish @ 646.644.3049 or manish@techcusp.com

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Data & Analytics in HealthCare

Posted on July 26, 2016 | Categories: Big Data, Claims, Clinical Trials, CMS, Data Analytics, Data Mining, Data Scientist, Database | Posted by: admin

Data & Analytics in HealthCare

 

Data & Analytics Adoption Model in HealthCare for Access, Cost, Quality (ACQ)

  • Three stages of data management via EDW – 1) data collection 2) data sharing / access and 3) data analytics
  • Bulk of Data Collection are done via electronic health records (EMR/EHR) and health information exchanges (HIE/HIX)
  • Data & Analytics is playing a big role in Health System Quality improvement and cost reduction efforts
  • Healthcare Analytics Adoption Model borrows & leverage recommendations from HIMSS EMR Model, Health & Human Services (HHS), Food & Drugs Administration (FDA rules for Clinical Trials) and Center for Medicare & Medicaid (CMS)
  • The Adoption Model may include – evaluating the industry’s adoption of analytics, roadmap for measure progress toward analytics adoption and evaluating vendor products for improving the quality of care while lowering costs and enhancing clinician and patient satisfaction

 

8 Stages of the Data & Analytics Adoption Model

  • Adoption Stage 1 – Enterprise Data Warehouse (EDW) using Physical or Virtual Servers
  • Adoption Stage 2 – Registration & Billing System including Patient Registries via Personal Portal
  • Adoption Stage 3 – Electronic Health Record &Electronic Prescription System (EMR & eRX) for clinical observations and lab results
  • Adoption Stage 4 – Management & Internal Reporting Tool / Dashboard
  • Adoption Stage 5 – Statutory& External Reporting Tool / Dashboard i.e. Meaningful Use Reporting
  • Adoption Stage 6 – Fraud & Abuse reduction using Claims Data
  • Adoption Stage 7 – Population Health Management (PHM) & Care Management Analytics
  • Adoption Stage 8 – Predictive Analytics (PA) leveraging PHM, CM, UM Data for Preventive Care to Cost Curve and Patient Care / Patient Satisfaction

 

Top use cases for data and analytics for Health IT organization

  • Adoption Analytics – Clinical Workflows & Applications
  • Claims Analytics – Fraud & Abuse
  • Cost Analytics – Planning & Control
  • Customer insight Analytics – Customer Care
  • Discovery/search Analytics – Clinical Trials
  • Meaningful Use Analytics – Positive Outcome
  • Operations Analytics – Customer Service
  • Predictive Analytics – Bend the Cost Curve
  • Risk and Compliance Analytics – PHI & HIPAA

 

How much data and analytics contribute to Health organization’s decision?

  • Differentiate
  • See the future
  • Drive revenue growth or Bend the Cost Curve
  • Clinical Workflows & Software Applications
  • Customer Care
  • Fraud & Abuse
  • Guide future strategy
  • PHI & HIPAA Compliance
  • Planning & Control
  • Product research and development
  • Product research and development – Clinical Trials for Drugs discovery & approval for medical equipment by FDA
  • Sales/Marketing

 

Challenges in Health organization in adopting data and analytics strategy

  • Budget & Priority
  • Information Explosion
  • Inoperability of Data
  • Managing Data Vs Analyzing Data
  • PHI / HIPAA Challenge
  • Quality of Data – Data duplication or Data Integrity
  • Varied Application System within Health System

 

Metrics or benefits /business outcomes for data and analytics in HealthCare

  • Cost Curve
  • Ethical intent
  • Go-to-Market for Drugs
  • Interoperability
  • Legal compliance for PHI (Privacy) & HIPAA
  • Population Health Management (PHM)
  • Transparency

 

Proof of Data & Analytics working for Health Organization

  • A code of ethics around data and analytics
  • C-level support
  • Claims Dashboard
  • HEDIS STAR Rating
  • Meaningful Use Metrics
  • Pain Management Dashboard
  • Prescription Dashboard for Controlled Substances
  • Tracking customer views
  • Transparency on what customer data is being used

 

 

 

 

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