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Category Archives: Health Exchange

HealthCare Operations Director – Apps, Change Management & Delivery

Posted on August 8, 2016 | Categories: Health Exchange, Health Insurance, Health System, HealthCare, HealthCare IT, Program and Project Management | Posted by: admin

HealthCare Operations Director – Apps, Change Management & Delivery 

 

  • Self-starter with an entrepreneurial spirit and healthcare hands-on domain expert on Payer, Providers and Tech Applications (Implementation, Configuration, Interfaces, Upgrades, Enhancements and Delivery)
  • Accountable for day-to-day progress of Agile, Waterfall & Hybrid based development project(s) and release initiatives with regard to time, budget, scope and quality
  • 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
  • Exceptional listening, communication, documentation and presentation skills
  • Experience managing at least 10 direct reports
  • Follow and implement HIPAA, CMS and PHI compliance & regulations and maintain center operations
  • Implement company goals and objectives including Change Management
  • Negotiate and manage contracting
  • Oversee and manage Quality Assurance for Business & IT Projects
  • Participate in budget creation and maintenance with help of Finance Team
  • Participate in Infrastructure upgrade, procurement and management with help of Infrastructure Team
  • Participate in Recruiting, Hiring & Training of Key Personnel with help of HR & Training Team
  • Responsible for ensuring the delivery of quality patient care while efficiently utilizing resources and maximizing returns
  • Responsible for Voice of Customer (VOC), Statement of Work (SOW) and C-Sat (Customer Satisfaction) Score
  • Strong physician relationships- dynamic- positive- outgoing- flexible- able to work with boards, committees, regulatory agencies, third party, vendors, patients and all levels of personnel
  • Successfully managed and delivered Multi-million dollar HealthCare Transformational Projects i.e. ePrescribe, EMR, Medicare (MA), PBM, Specialty Pharmacy, Tele-Health, Claims, BPO, RCM & MU (STAR)
  • Track record of success with staff development, coaching and employee performance management

 

Contact Manish for HealthCare Director – Solutions & Delivery 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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Cyber Security and Risk Management in HealthCare

Posted on July 26, 2016 | Categories: Health Exchange, Health Insurance, HealthCare, HealthCare IT | Posted by: admin

Cyber Security and Risk Management in HealthCare

 

Company’s exposure to fraud could happen due to

  • Complexity of IT infrastructure (e.g., more information or assets being stored/moved/processed digitally)
  • Complexity of products or services sold
  • Cost restraint over pay and remuneration
  • Entry to new, riskier markets
  • High staff turnover
  • Increased collaboration between firms (joint-ventures, partnerships etc.)
  • Increased outsourcing and offshoring
  • Increasing exposure to public digital touchpoints (e.g., employee’s social media use, personal computer use, etc.)
  • Lack of budget/resource for compliance infrastructure

 

Company’s adoption of anti-fraud measures

  • Assets (physical security systems, stock inventories, tagging, asset register)
  • Board of Director engagement in cyber security policies & procedures
  • Financial (financial controls, fraud detection, internal audit, external audit, anti-money laundering policies)
  • Information (IT security, technical countermeasures)
  • IP (intellectual property risk assessment and trademark monitoring program)
  • Management (management controls, incentives, external supervision such as audit committee)
  • Partners, clients and vendors (due diligence)
  • Reputation (media monitoring, compliance controls, legal review)
  • Risk (risk officer and risk management system)
  • Staff (background screening)
  • Staff (training, whistleblower hotline)

 

Types of Cyber-attack or Information loss

  • Alteration or change of customer data
  • Data breach resulting in loss of customer or employee data
  • Data breach resulting in loss of IP/trade secrets/R&D
  • Data deletion by malicious insider
  • Data deletion or corruption by malware or system issue
  • Data deletion or loss due to system issues
  • Denial of Service Attack
  • Email based Phishing attack
  • Insider theft of customer or employee data
  • Insider theft of IP/trade secrets/R&D
  • Lost equipment with sensitive data
  • Ransomware attack
  • Stolen equipment with sensitive data
  • Virus/ worm infestation
  • Wire transfer fraud

 

Company’s adoption of cyber security risk mitigation measures

  • An information security incident response plan that’s been updated in the last 12 months
  • Board of Director engagement in cyber security policies & procedures
  • Cyber insurance
  • Employee cyber security training
  • Employee restriction on installing software on company devices
  • Endpoint Threat Monitoring- Carbon Black, Tanium
  • Internal cyber security policies & procedures
  • Intrusion Detection System- network based
  • Intrusion detection system- device
  • Network Operations Center
  • Recruitment of in-house IT security specialists
  • Security assessments of data and IT infrastructure conducted by third parties (e.g. consultants)
  • Security assessments of data and IT infrastructure conducted in-house
  • Security Operations Center
  • SEIM or other Log Management system
  • Testing of an information security incident response plan at least every 6 months
  • Third party cyber security policies & procedures (e.g. for vendors/suppliers/intermediaries)
  • Threat intelligence system

 

Types of security incidents today

  • Environmental risk (including damage caused by natural disasters such as hurricanes, tornadoes, floods, earthquakes, etc.)
  • Geographic and political risk (i.e., operating in areas of conflict)
  • Terrorism, including domestic and international events
  • Theft or loss of intellectual property
  • Workplace violence

Company’s adoption of security risk mitigation measures

  • Conduct a threat and vulnerability assessment
  • Create a security master plan
  • Develop a plan for securing intellectual property
  • Develop and implement an information security plan
  • Develop physical security infrastructure (i.e., integrated security system development, implementation and training)
  • Develop security policies and procedures
  • Implement an executive protection plan
  • Implement business continuity plan (including crisis management and emergency response planning and training)
  • Implement threat management plans and procedures
  • Implement travel risk plans and procedures
  • Perform a security audit & security training

 

 

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Why Manish Jaiswal for Sr PM role

Posted on May 27, 2016 | Categories: Account Manager, ALIP, Analytics, Care Management, Change Management, Clinical Services, Health Exchange, Health Insurance, HealthCare, HealthCare IT, Hire Me Now! | Posted by: admin

Why Manish Jaiswal for Sr PM role?

An MBA with 18+ years of experience in the HealthCare IT & Outsourcing space. An experienced Manager, successfully delivered Revenue Growth, Consulting, Technology, Change Management & System Implementation (SI) Projects with Govt., Payers, Providers & Insurance Carriers. Proven track record around Business Development, Product Management and Application Services i.e. Agile / Waterfall, Mobility, Social Media, Analytics, Research, System Integration, Platform BPO, Web Services, CRM, Document Management, QA-Testing, BPM, Practice Management, EMR, ePrescribe, Billing, Revenue Cycle (RCM) & HL7 – ADT. Successfully delivered transformational Projects for Pharmacy, Medicare, PBMs, Specialty Rx, TPAs, Article 28 sites, Medical Groups, Acute Care & Ambulatory Group clients. An Expert (SME) in eRx, EPCS, SI, SDLC, RFPs, MU, HIE/HIT, Onshore-Offshore Delivery & Client Services.

 

Sector Focused – HealthCare IT Projects Summary

 

Pharmacy Project, Application Project, EMR Project, ePrescription, Registration, Clinical Project, Medical Informatics Project, Tele-Health, 430B Project, Specialty Pharmacy, Reporting / Dashboard, Audit Tool, RCM Project, Tele-Health, Disease Mgt., MTM, Medicare Projects (MA, PDP), Claims, Health Portals, In-Patient, Out-Patient & ED Projects, Identity Management Projects, BPO Projects for MLTC, Health Plans, ACOs, PCMH, TPAs, PACE & Health COOP clients

 

Tools, Technology Stacks & Platforms Experience – Summary

 

Allscripts Sunrise Clinical Manager (SCM), Allscripts AEHR, Allscripts EDIS, Allscripts Insight, ARB, DrFirst Rcopia, DrFirst EPCS Gold, DrFirst InfinID, Cerner Invision, McKesson Series, Microsoft OS, Windows 10, Microsoft Project Plan (MSP) Share Point, Word, Power Point (PPT), Excel, HL7, ADT Interface, VMWare Server, SQL Server, SQL Database – MS, Oracle, ASP .Net,  Java / J2EE, WordPress, Appian, Plexis, NextGen, ALIP, MS Visio, B2B Portal, B2C Portal, Care Management Portal, Claims System, Policy Admin System (PAS) – Accenture, Enrollment & Eligibility System, Lab Info System (LIS)

  • Years of project estimating/planning/monitoring; identifying, estimating and presenting costs and schedules aligned with project activities and deliverables; tracking and reporting deliverables
  • Years of resource management, dependencies; managing project scope, risk, changes and issues.
  • Years of Client Relationship Management – managing customer expectations and satisfaction; weekly meetings/communications.
  • Years of planning/conducting client workshops; collecting/confirming business requirements; documenting application functional use cases and other required documentation.
  • Years of utilizing and applying known PMI Methodology
  • Years of managing teams responsible for IO activities, or equivalent.
  • Years of organizing/directing/managing contract operation support functions involving multiple, complex, and interrelated project tasks.

 

Call or Writ to

Manish Jaiswal

646.644.3049

manish@techcusp.com

 

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Electronic Health Records (EHR) – By Techcusp.com

Posted on June 26, 2015 | Categories: EMR / EHR, Health Cusp, Health Exchange, HealthCare IT, IT Services | Posted by: admin

Electronic Health Records (EHR) – By Techcusp.com

 

Electronic Health Records (EHR) refers to the systematized collection of electronically-stored health information, in a digital format, about an individual patient or a population. The records are theoretically capable of being shared across different health care settings.

 

EHRs are built to go beyond standard clinical data collected in a provider’s office and are inclusive of a broader view of a patient’s care. It contain information from all the clinicians involved in a patient’s care and all authorized clinicians involved in a patient’s care can access the information to provide care to that patient.

 

Now the question arises, what can EHR Services Deliver?

  • Improved Patient Care
  • Increased Patient Participation
  • Improved Care Coordination
  • Improved Diagnostics for Patients
  • Easier Access to clinical data
  • Ability to establish and maintain effective clinical workflows
  • Fewer medical errors, improved patient safety and stronger support for clinical decision making
  • Securely sharing electronic information with patients and other clinicians
  • Reducing costs through decreased paperwork, improved safety, reduced duplication of testing and improved health

 

Techcusp believes that the entire eco-system of Payers, Providers, PBMs etc. have been impacted owing to compliance and new business rules. Whether the context is Health Exchanges, Electronic Health Records, Interoperability, Wellness, Billing, Claims, Meaningful use (MU), Informatics, Analytics, Big Data or Mobile Health, the Health IT is challenging status quo to make Healthcare more affordable, reachable and compatible.

 

TechCusp.com has deep HealthCare domain knowledge for EHR in both Payer & Provider space to manage your growing business & operational needs. Our software engineers and consultants are on stand-by to help you deliver your IT vision & projects. Reach out to us for our seasoned & domain rich IT Consultants; Developers & Software Engineers for short term and long term projects.

 

To know more about our offerings feel free to reach out to us at contact@techcusp.com or

 

Contact

Debanuj Sengupta

Manger Sales – IT Consulting & Technology Services

debanuj@Techcusp.com

Phone: +1 646.644.3049 / 201.258.4704 / 201.589.5962

www.TechCusp.com

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Phone: +1 201.258.4704
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E-mail: Contact@TechCusp.com

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