Orlando, Florida, United States
I've spent 26 years at the intersection of healthcare operations and technology — leading IT teams, modernizing infrastructure, and building the data pipelines and compliance frameworks that keep healthcare organizations running. My background spans Third Party Administrators, managed care, behavioral health, and EHR-integrated environments. I've directed teams ranging from in-house developers to offshore groups, managed Oracle and multi-value databases, and overseen daily transfers of millions of eligibility and claims records. Whether it's driving a CMS encounter acceptance rate from 78% to 96%, earning NCQA or AAAHC accreditation through disciplined process-building, or architecting an EDI ecosystem from the ground up — I tend to stay until the job is actually done right. Today I'm IT Director at Benefit Logistics, where I lead technology operations for a healthcare management and benefits TPA, including cloud infrastructure, vendor contracts, and a real-time pharmaceutical benefits verification pipeline processing over 2 million records daily. I'm always open to connecting with others in the healthcare IT space — whether that's peers, innovators, or organizations doing interesting work in managed care, data integrity, or compliance-driven IT.
Guided Information Technology operations of company providing healthcare management, claims and benefit solutions. Effectively managed organization, network, software, and cloud infrastructure for a successful Third Party Administrator. Overseed technical development and IT projects in a manner which fit with the overall company plans and goals. Implements new technologies and prepares policies, procedures, and documenting protocols to improve IT processes. Ensured efficiency, effectiveness, and viability of all IT systems and tech processes. Successful in project management deliverables, supporting projects and programs, including scope, quality, resourse, schedule, communications and third party contract management. • Oversaw full scope of project leading to the daily transfer of over 2 million records between large pharmaceutical company and allowing for real time verification of benefits. • Drafted and implemented processes for the production of the IRS tax form 1095B and its corresponding electronic file. • Developed an import and export process to be able to view health claim images and their corresponding EDI transactions.
Oversaw daily operations of a $200M company. Supervised six IT professionals working on the critical business application, data reliability, and reporting. Administered transfer of more than 3-million-member eligibility and claim records daily. Designed and managed project plans, delegated workloads, and implemented on-schedule software updates, unique technologies, and reporting controls. In charge of overseeing CMS/AHCA contracts from IT perspective. • Enhanced CMS Medicare encounter reporting acceptance rate from 78% to 96% in the first three months. • Introduced data scrub system removing non-compliant CMS/Medicaid claims to improve auto-adjudication rate to 82% (70K claims per month) • Arranged IT functions to better address imminent company needs and properly schedule long-range strategies. • Produced and initiated formal IT processes, policies, and procedures helping the company earn and maintain NCQA accreditation.