Available Healthcare IT Consultants

Epic Clarity Resolute HB & PB (#2773)

  • Senior level healthcare business and information systems professional with over 20 years of related experience including hospitals, MSOs, HMOs, and Physician IPAs (managed care)
  • Epic Certified in Clarity Professional Billing, Clarity Hospital Billing and Resolute Professional Billing Administration
  • Expert level report writer in multiple environments, extensive emphasis on technology and decision support systems.
  • Healthcare data warehouse architect with multiple years of experience working with Epic EMR, implementing Tableau in multiple environments
  • Eight years of clinical experiences
  • Provide data architect related work for multiple data warehouses and data marts on a contract basis
  • Utilize and program SQL Server SSMS, MS Access, Crystal Reports, and other related BI Tools
  • Extensive background on Epic Clarity, IDX, and several other platforms
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Senior Clinical Project Manager (#312)

  • Goal-driven healthcare services LPN professional with over twenty-one years’ experience in the Health Plan and Health Insurance Industry.
  • Responsible for evaluating all policy and procedures, reports, and other documents for ICD-10 compliance and Epic HCC experience.
  • Extensive knowledge and experience with FACETS clinical configuration, testing and training of Business Processes and Informatics.
  • Strong clinical background in preventative care, utilization review, case management, disease management, HEDIS, GPRO, and STARS collection, review, and reporting.
  • Excellent communication, documentation, problem solving, and organizational skills.
  • Extensive background in medical chart review and HEDIS collection and reporting.
  • Project Manager and Clinical Liaison between Medical Management and IT.
  • Experienced in State required reports for Appeals/Grievances.
  • Experienced with clinical interfacing PEGA/Compass with FACETS.
  • Experience managing Utilization Review Staff, telephonically, for data entry for pre-authorizations and clinical staff for utilization review.
  • Experience managing multiple projects simultaneously with management responsibilities for 80 staff members.
  • Proficient in Word, Excel, Visio, InterQual, and Milliman.
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CMIO, Revenue Cycle Optimization and Digital Excellence (#4025)

  • Over 15 years of clinical and operations leadership, specializing in healthcare quality improvement, digital transformation, and revenue cycle optimization. Diverse experience across clinical informatics, healthcare operations, and strategic leadership has delivered measurable improvements in patient care, operational efficiency, and financial performance across multiple healthcare systems.

Career Highlights:

  • Chief Medical Informatics Officer: Directed the implementation of the Epic EHR system, revolutionizing healthcare data access across the Central Valley. Leadership was pivotal in launching TogetherCare powered by Epic, enabling seamless data sharing and enhancing clinical workflows across multiple sites
  • Revenue Cycle Optimization and Physician Advisor Experience: During his tenure as a Physician Advisor played a crucial role in improving revenue cycle processes by streamlining clinical documentation, reducing avoidable days, and enhancing severity and acuity capture. His leadership helped decrease observation and inpatient length of stay, optimize clinical workflows, and ensure accurate documentation for coding and billing, leading to significant revenue capture improvements. Work in utilization management and care optimization directly resulted in a $25 million increase through improved clinical documentation across three facilities
  • COVID-19 Response Leadership: As Clinical and Operations Chief, led the hospital’s pandemic strategy, including the rapid deployment of virtual care platforms across 92 hospitals, resulting in over 800,000 virtual visits and a 50% revenue growth. His efforts established an outpatient respiratory infusion room, treating over 2,500 patients in its first year.
  • Informatics Expertise: Known for bridging the gap between technology and clinical practice, spearheaded initiatives that streamline processes and improve documentation. His focus on leveraging data analytics for clinical improvement resulted in a $25 million impact through enhanced clinical documentation at three major facilities.
  • Healthcare Consulting and Innovation: Currently leads strategic innovation and digital transformation projects as a consultant with ProNexus, where he helps healthcare organizations navigate complex challenges by implementing scalable, compliant, and innovative solutions. Recent projects include developing AI-driven utilization review systems and optimizing care delivery for value-based care.
  • Core strengths lie in his ability to drive revenue cycle optimization through enhanced clinical documentation and utilization management, resulting in significant financial improvements for healthcare organizations. With a proven track record in transforming underperforming sites, combines strategic leadership, data analytics, and patient-centered approaches to deliver operational efficiency and elevate patient outcomes. Expertise in digital health transformation has enabled successful implementations of EHR systems and virtual care platforms, driving both care quality and revenue growth. Additionally, deep understanding of regulatory compliance and quality improvement ensures that organizations not only meet but exceed industry standards. As an educational leader and adjunct professor for UCSF School of Medicine and California Health Sciences University, has been deeply committed to fostering the next generation of healthcare professionals, shaping future leaders through mentorship, continuous learning, and a focus on innovation in clinical and operational practices.
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Senior Clinical Project Manager (#627)

  • Healthcare Executive with over 15 years working in health plan operations, including progressive leadership roles.
  • LVN with active licensures in California, Washington, and Oregon.
  • Wealth of knowledge regarding utilization management and the functions and processes required to perform effectively for several different health plans. These included commercial, Medi-Cal, DSNP, and Medicare Advantage plans.
  • Excellent communication, documentation, problem solving, and organizational skills.
  • Project Manager and Clinical Liaison between Medical Management and IT.
  • Experience encompasses roles with a high level of familiarity with industry standard guidelines and criteria including MCG, InterQual,
    CMS, DHS, and commercial plan specific criteria.
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Head of IT Security, CISO (#3001)

  • Senior Cybersecurity Leader and Navy Veteran with over 10 years of proven experience building and leading diverse teams in high-paced military, corporate, nonprofit, and governmental environments. Industry experience includes mergers and acquisitions, IPO readiness, and crisis management across entertainment, gaming, data, financial, defense, and insurance industries. A leader in the cybersecurity community, has spoken at RSA, WiCyS, ISACA, and GHC conferences and sat on industry panels. Has led and championed DEI initiatives at multiple companies. Serves as a mentor to students and junior professionals, as well as industry advisor in collegiate academic settings.
  • Security Programs: Board Reporting, Enterprise Security, Application/Product Security, Security Operations, Identity Access Management, Data Privacy, Identity & Access Management, Security M&A Due Diligence, Cloud Security, Threat Intelligence, ZeroTrust, Data Loss Prevention, Detection Engineering and Response, Vulnerability Management, GRC, Data Governance, Employee Education, Enterprise Risk Management, Incident Response, Insider Threat, and policy development.
  • Compliance: Security: NIST CSF, ISO27001, SOC2 (Type I & Type II), PCI-DSS, NIST 800-53, NIST 800-171, FEDRAMP, DFARS | Privacy: GDPR, CPRA, HIPAA
  • Technology: On prem, hybrid, multi-cloud, cloud native | SaaS, PaaS, IaaS | AWS, GCP, Azure | Linux, Mac OS, Windows | Data Privacy Platforms | Firewalls, CSPM, SIEM, SOAR, EDR, IAM, FIDO2, DLP, ZTNA, CASB, PAM, Generative AI
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Athenahealth SME (#2633)

  • Senior level healthcare business and information systems professional with over 5 years of related experience
  • Proven ability to teach, assist, and provide classroom and Go-Live training support during various stages of Healthcare management EMR software implementations.
  • athenaCollector build analyst for four athenahealth enterprise implementation projects plus dozens of small group projects
  • On-site trainer for athenaCollector front desk and billing staff end users as well as report training for practice managers.
  • Lead the pre-live project for on-site hardware testing with CCP and Ambir
  • Fully trained content expert on athenaOne including Streamlined Clinicals and strong athenaCollector/Rev Cycle knowledge
  • Two years of experience in taking 30 to 50 troubleshooting calls per day on all athenaOne content topics
  • Familiar with the best practice workflows for athenaClinicals and athenaCollector.
  • Designed standards for provider enrollment process and directed the re-enrollment efforts for two new TINs.
  • Completed the Communicator build including standard creation for multiple athena tablespaces
  • Vast knowledge on implementation and optimization practices
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HealthEdge Report Writer (#522)

  • Senior level healthcare business and information systems professional with over 35 years of related experience including hospitals, MSOs, HMOs, PPOs, TPAs, Physician Groups and other managed care organizations.
  • Expert level report and extract writer using SQL in multiple environments.
  • Multiple years of experience working with Facets and HealthEdge managed care systems.
  • Expertise in working with Clients in gathering requirements and providing solutions to business issues.
  • Developed data warehouses and operational data stores.
  • Utilize and program SQL Server SSMS, MS Access, Crystal Reports, Business Objects, Tableau and other related BI Tools
  • Extensive background on HealthEdge Health Rules Answers Data Warehouse.
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Epic Revenue Cycle Project Manager/Director (#3428)

Consultant is a Project Management Professional (PMP) with over 10 years’ experience across multiple full-cycle implementations of Epic and other life sciences applications. As an experienced leader for over 20 years, consultant leverages their extensive experience to advise complex revenue cycle installs, completing projects on time and on budget. Certified in Epic Professional Billing and experienced managing the entire Revenue Cycle, has an excellent track record of leveraging her experience to build strong teams. Has been a dedicated leader in all phases of an installation including overseeing operational engagement in the implementation process (Access and Revenue Cycle Readiness), and provides the knowledge and experience needed to execute a successful Go-live as well as ongoing optimization. Consultant quickly establishes solid professional relationships, naturally identifies and drives towards a common goal, and would make an outstanding Revenue Cycle principal for any implementation.

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McKesson Paragon Revenue Cycle SME (#294)

  • Senior level healthcare business and information systems professional with over 15 years of related experience
  • Detail-oriented Financial Applications Systems Analyst with a background of providing application and analytical and project management support for all of the Financial and Revenue Cycle Systems in a hospital setting.
  • Expert level knowledge of Paragon Hospital Business Systems
  • In-depth understanding of how clinical and financial HIMS applications integrate with each other and other 3rd party systems.
  • IT liaison for hospitals implementing or converting to Paragon
  • Skilled in McKesson Horizon and Star migration
  • Implemenation, Build, Test, and Support expert
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Epic Clarity & Data Extract (#2651)

  • Epic certified in EpicCare Inpatient, ADT, and Resolute Hospital Billing Clarity Data Models, EpicCare Inpatient Orders, Clinical Documentation, VB6, and ActiveX and trained in HIM Clarity Data Models
  • Expertise in Health Care Business Intelligence in Clinical Decision Support, Quality Management, and Revenue Cycle Management.
  • Over 10 years of experience in Analysis, Design and Development (SDLC) of Healthcare and Financial Applications and over 8 years Epic experience and over 6 years of consulting experience.
  • Strong techno-functional hands-on knowledge of Chronicles, CACHE, EpicCare Ambulatory, Inpatient, Resolute Hospital Billing workflows, Clarity and Reporting Workbench technologies and products.
  • Expert developing normal & complex crystal reports with Groupings, Formulas, SQL Expressions, Cross tabs, Command objects and advanced features in Crystal Reports (10.0, XI, and 2008) and carrying out report migration between different versions.
  • Very strong in SQL, PL/SQL, and T-SQL for writing Packages, Functions, Stored Procedures, Triggers, creating tables and indexes, OLAP and Performance Tuning.
  • Involved in Full Life Cycle implementations, Design, Build, Validate (DBV) process. Excellent skills in analyzing user’s requirements, modeling the systems and ensuring the functionality, with client’s satisfaction as the primary focus.
  • Involved in Meaningful use, ICD-10 conversion projects.
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QNXT Configuration and Techincal SME (#3503)

  • TriZetto QNXT Master Certified professional and effective leader with over 15 years’ experience
  • Background in leading health care implementation projects as configuration lead and specialist throughout the duration of project life cycle from inception to post live transition.
  • Strong healthcare background in platform migration, data mapping, plan document interpretation, benefits, contracts, utilization management, member enrollment, claims processing, HIPAA transactions, and user security.
  • Creatively identify innovative ways to solve complex problems while maintaining top-notch quality and world-class service.
  • Strong ability to understand system hierarchy and design architecture to thrive in highly matrixed, fast-paced environments.
  • Effectively presents and communicates information with all levels of the organization.
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McKesson Paragon SQL/Report Developer (#542)

  • Seasoned HIS professional; 25 years of Information Technology experience – technical, PM and Management roles
  • Solid business background and strong technical skills provides a unique insight to problem solving allowing me to provide value-added perspectives/services.
  • Skilled in the areas of data extract programming, report creation, data conversion programming, intranet programming, hardware configuration, networking design, data center design, project msanagement, etc.
  • Knowledge of multiple versions of McKesson Paragon data model
  • SQL Reporting Services and programming skills
  • C#, VBA, ASP, HTML, XML programming experience
  • Ms ACCESS reporting, query generation, macro programming, etc.
  • General knowledge of Paragon applications and how they function as well as Horizon experience
  • 6 years of Paragon and 3rd party interfaces.
  • Directly support Physician Webstation and work with Physicians on a one-on-one basis.
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Epic Ambulatory SME (#2886)

  • Senior level Epic Certified healthcare business and information systems professional with over 12 years of related experience
  • Extensive operational and technical background
  • Epic Certificationed on Epic Ambulatory, Epic ASAP, and EpicCare Ambulatory Graduate Program
  • 4+ years experience with Meaningful Use/MIPS/MACRA
  • 6+ years experience and several implementations in the area of Welcome/MyChart Build
  • Healthy Planet build expertise: Community Connect, HL7-based Interfaces, Extracts and Flat File Imports, Registry Build, Basics & Population Inclusion, Creating and Editing Reports, Registry Build, Metrics, Self-Study, Grouper Build, Registry Build, External Data, Creating Dashboards, and more
  • SDLC implementation expertise: Over 8 years related to HealthCare EMR Projects
  • Hyperspace and TXT areas of expertise: SmartForms, Navigators/ WFE, ED Narrator, ED Navigator, Proc. SmartForms, Epic Printing, MyChart/Welcome, Registries, Data Courier and more
  • Epic Leadership Revenue Cycle Lead: ICD-10 Implementation Outpatient/Inpatient & Specialty Clinics
  • Support & Optimizations Build Team Lead, EpicCare Ambulatory leadership
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AthenaClinicals SME (#2966)

  • Results-driven versatile Healthcare Clinical IT consultant with 20 years’ experience in the healthcare industry.
  • Expertise in AthenaClinicals and Collector in all facets
  • A proactive, high performer with extensive healthcare informatics expertise in leading, planning, researching, analyzing, implementing, and consulting on healthcare systems, business applications, project / programs, policies, procedures, and workflow within the organizational framework.
  • Proven ability to work with multi-discipline, cross-cultural teams, stakeholders, and end users.
  • Clinical Project Management, Clinical Practice Management, Strategic Planning, Compliance Review, Information Systems, Systems Integration, Systems Optimization, Clinical Process Optimization, Business Process Optimization, Data Analysis, Risk Assessment, Risk Management, Medical Terminology, Training, and Education
  • Methodologies: AGILE, Lean Six Sigma Project Management
  • Certification: Active Registered Health Information Administrator (RHIA)
  • Additional Product Expertise:
    • Cerner Millennium PowerOrders, PathNet, SurgiNet
    • McKesson Horizon Clinicals™ Expert Orders, Order Management, Expert Notes
    • Emergency Care, MediCat, UroChart, MedENT, Varian Aria
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Facets Benefit Lead (#344)

  • Facets Product Configuration Analyst with over 12 years’ experience
  • Insightful Configuration Leader who undertakes complex assignments, meets tight deadlines efficiently and delivers reliably.
  • Possesses practical knowledge of requirements gathering, detailed system design, system configuration and testing.
  • Applies considerable Facets platform knowledge to drive efficient configuration designs that satisfy business objectives while lowering development costs and minimizing long-term maintenance.
  • Operates with a strong sense of urgency and thrives in a fast-paced setting
  • Expert in Microsoft Office Suite: Advanced Excel, Word, PowerPoint, Outlook, Access
  • Facets Foundations Certified
  • Facets Technical Certified
  • Software Proficiencies: Mainframe, CustomView, JIRA, PlanView, SharePoint, SQL Developer, Facets
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Cerner Analyst, Trainer, and Instructional Designer (#244)

  • Senior-Level Healthcare IT Consultant with over 6 years of Cerner experience
  • Experienced Classroom/Virtual Trainer with Physicians and Clinical staff, supporting multiple areas.
  • Experience handling all project levels from implementation to initiation.
  • Proficient with the use of multiple EMR/EHR Systems in a clinical and analytical role in the Workflow Design, Curriculum Design, Training and Go-Live process.
  • Instructional Workflow Design and Classroom Training Experience.
  • Responsible for providing initial application analysis/education and assuring client has a thorough understanding of the on-site workflows.
  • Assure the best practices and evidence base processes are utilized with the clinical workflow and integrated with the EMR implementation.

Skill sets include, but not limited to:

  • Cerner Train Domain Build Out
  • Subject Matter Expert/Analysis in Cerner
  • Proficient with virtual mediums – Webex, Teams, Google Meet
  • Instructional Design of workflow processes for Inpatient and Ambulatory
  • EMR implementation experience supporting Cerner Clinical and Ambulatory Modules- Power Chart, PowerNote, Dynamic Documentation, FirstNet, SurgiNet, CareCompass, Powerchart Maternity, Fetalink, Bridge, Revenue Cycle, Access HIM, Patient Access, Registration
  • EMR implementation experience supporting Epic Systems- Epic Stork, Optime, ASAP
  • Utilized CPOE for physician/client access to medical information.
  • Experienced in build, design, troubleshooting, and client communications.
  • Experienced in analyzing clinical workflows and informatics processes for clinical efficiency.
  • Excellent written and verbal communication skills when working in a professional medical environment.
  • Proficient in Microsoft Office
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Facets Benefit SME (#331)

  • Results-driven professional with over 12 years of extensive Healthcare experience in Facets Transaction Processing System and NetworX.
  • Excellent managerial skills with ability to build and manage a highly productive team.
  • Proven ability to implement strategies that improve client services and facilitate production.
  • Operates with a strong sense of urgency and thrives in a fast-paced setting.
  • Core competencies include:
  • Product Design
  • Benefit Configuration
  • Claims Processing
  • Accumulators
  • NetworX
  • Medicare/Medicaid
  • Requirements Solicitation & Documentation
  • SDLC
  • Agile
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Architect (Facets) (#329)

  • Over 15 years of progressive experience in Architecture, Analysis, Design, Development, and support of web based and desktop software applications for Health Insurance (FACETS, HIPAA Gateway, EDI transactions) Applications using .NET/.NET Core Framework and various databases.
  • Strong professional experience in working with technologies like Visual Studio .NET 20XX/2019, C#.NET, ASP.NET, .NET/.NET Core Framework 4.5/4.7, ADO.NET, WEB API’S, Micro services, and RESTful API.
  • Researched new technologies, evaluated their usefulness, and incorporated them into the existing architecture.
  • Extensive knowledge of applying Object Oriented Analysis and Design (OOAD) concepts like Inheritance, Polymorphism, Encapsulation and Abstraction, Design Patterns like Singleton, Abstract Factory and Command Pattern and multi-threading.
  • Strong experience in writing SQL queries, and T-SQL blocks like – Stored Procedures, User Defined Functions, Triggers and tuning procedures and queries.
  • An active team player with excellent communication, time management and presentation skills.
  • Worked extensively with Iterative Agile Methodologies (extreme Programming, and SCRUM), Waterfall methodologies and Test-driven development (TDD).
  • Experience in providing architectural blueprints and end to end solution for payers to solve IT problems.
  • Extensive experience as Facets Technical Architect in Healthcare Domain providing Custom Solutions in MEMBERSHIP, BILLING, PROVIDERS and CLAIMS.
  • Deep understanding of Facets Data model and Data Dictionary.
  • Extensive knowledge in Facets Batch architecture and Build implementation of Facets.
  • Experience in FACETS upgrades, legacy to migration to FACETS and new market implementation.
  • Experience in Benefit Configuration, Medical Plan, Workflow and Provider/Network X configuration.
  • Microsoft Certified Application Developer (5602490) in .NET Framework, C# and ASP.NET, SQL Server 2000 and XML Web services.
  • Trizetto certified SME in .NET, SQL server and VBScript.
  • Experience in deploying applications with Cloud Services by creating a simple Cloud Service with Visual Studio, testing it locally, deploying to a live Microsoft Azure Cloud environment
  • Programming Languages – C#.Net, VB.Net, C, C++, VC++
  • Database Query Languages – PL/SQL, T-SQL (DDL, DML).
  • Scripting Languages – PowerShell, JavaScript, Python, Perl and VB script.
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Cerner Build Analyst & Instructional Designer SME (#245)

  • Senior-Level Cerner Healthcare IT Consultant with over 7 years of experience
  • Healthcare Information Technology, EMR/EHR Software Support, System Support, Troubleshooting, System Analysis & Implementations, and Go-Live/Team Leadership.
  • Understanding of basic technology and networking concepts.
  • Familiar with Active Directory, Citrix, Powershell, SQL, VMWare, completing tickets through ticketing systems such as ServiceNow.
  • Experience trouble shooting and recycling servers to push updates and changes, and correct system issues.
  • Instructional Design experience using Articulate 360, Storyline 360, etc.
  • Actively working on completing A+ Certification and Networking+ Certification.
  • Outstanding expertise in supporting analysis, design, development, documentation, testing, and implementation of new systems; strong specialization in health information systems and services.
  • Excel at clarifying business requirements, technical systems specifications, and systems processes.
  • Able to analyze and re-engineer business processes using cutting-edge industry tools and methods to produce innovative IT solutions for critical situations specific to hospital environments.
  • Promote and encourage cooperative efforts and communication among multiple healthcare departments to achieve optimum clinical workflow.
  • Experience as an unlicensed medical scribe rounding with ED physicians and Ambulatory providers.
  • Proven talents in technical training, team leadership, process analysis and optimization, requirements analysis, instructional design, and steering seamless implementations.
  • Sound understanding of workflow processes in healthcare environments and able to quickly identify areas for improvement; proficiency with all major EMR applications (Cerner, Epic, Allscripts, Meditech, etc.).
  • Vast software expertise spans Captivate, SnagIt, PowerNote, Surginet/Anesthesia, MPages, Rev Cycle, PM Office, PathNet, RadNet, Dragon, ServiceNow, Remedy, and PowerChart.
  • Expert in Microsoft: Office 365, Word, Visio, Excel, PowerPoint. Ability to type 50+ wpm.
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