Phone:

+ 1 570-842-8144

Charles Fontaine, HIPAA Certified Medical Chief Privacy Officer (mCPO)

Technology Leader | Principal Consultant

Mr. Fontaine is an accomplished senior level IT professional with broad-based expertise in project management, systems design, application development, implementation, and support. He has an extensive background in the healthcare insurance and pharmaceutical industries and is adept at analyzing existing technology and implementing cost-effective software and infrastructure solutions.

Charlie’s information technology experience includes full lifecycle SDLC, managing the implementation of resource planning (COTS ERP) solutions, data cleansing, data conversions, data migrations and system upgrades. He has extensive experience in

vendor management, and contract negotiation, and has successfully renegotiated and consolidated multiple contracts from one vendor that resulted in the elimination of a $15 million dollar balloon payment.

Mr. Fontaine has extensive technical experience in reporting and analytics, claims repricing, and EDI file processing. He has managed teams that have developed hundreds of enterprise reports, extracting pertinent data from data warehouses and multiple databases.

Charlie excels at problem solving, team building, project management and software delivery.  He is a performance driven leader with exceptional organizational skills and aptitude to motivate and energize large cross-functional teams. He partners with key stakeholders to effectively plan and execute strategic enterprise-level business initiatives.

In addition to attaining his certification as a HIPAA Medical Chief Privacy Officer (mCPO) from Florida Gulf Coast University, Mr. Fontaine graduated from the Taylor Institute with a degree in Application Programming, and has continued his education at the University of Phoenix with courses in Computer Science, at Raritan Community College with courses in Business Administration and is Scrum Fundamentals certified.

Key Capabilities

Project Management
Systems Integration
COTS Systems
Data Warehouse

  • ­Application Development
  • Technology Security
  • Compliance
  • Reporting & Analytics
  • ­Quality Assurance
  • Vendor Management
  • Data Management
  • ITIL/Service Now

Program and Project Management

Experienced in the management of custom application development initiatives, the implementation of ERP/COTS solutions, infrastructures and databases. Capable of leading multiple projects simultaneously and achieving successful outcomes.

  • Experienced in the development of project roadmaps and schedules.
  • Capable resource manager, able to procure appropriate resources at required times; successfully manages resource allocation and schedules as well as conflict resolution.
  • Works effectively with stakeholders to negotiate and manage change requests (CRs); provides accurate estimates for CRs.
  • Experienced in leading virtual and offshore teams, taking advantage of different time zones to accomplish tasks and complete deliverables in a timely manner.
  • Adept in managing risks, identifying mitigation strategies, and resolving issues in a timely manner.
  • Develops weekly status reports and monthly executive project dashboards; presents status to project executives. Effectively tracks and reports project progress against performance objectives.
  • Managed posting of project artifacts to a shared repository to support project audits and established an historical knowledgebase.
  • Created anonymous SharePoint Lessons Learned project polls for process improvement as part of project closure activities.
  • Performs schedule management and effectively monitors and controls project work.
  • Develops effective communication protocols to ensure appropriate and timely communications to all project stakeholders.

Technical Project Management

Proficient in managing large technology projects, including a claims re-pricing project for a large healthcare organization. Expertise includes managing multiple complex projects across all phases of the software development life cycle, including application development, database and application security implementations and upgrades. Technical application support leader for a healthcare organization’s core administrative system, Trizetto NetworX Pricer, a COTS application that processed over 70M claims annually; 99% of par claims repriced automatically with over 98% accuracy.

  • PMO claims re-pricing portfolio manager, allocated and managed project resources via Innotas.
  • Project manager for the testing and deployment of all new releases of NetworX Pricer, IBM WebSphere, Optum EASYGroup, Web.Strat & Rate Manager.
  • Managed quarterly internal software releases of custom calc beans and qualifiers (i.e. negative/non-qualifying, embedded/nested, etc.) for NetworX Pricer.
  • Initiated projects utilizing ClearQuest & Jira and established e-time codes for financial tracking.
  • Reviewed Technical design documents (TDD’s), Business requirements documents (BRD’s) & use cases, SQA & UAT test plans, contingency plans, implemented automated large-scale regression tests & managed risk.
  • Subject matter expert in all areas of repricing and in the configuration and use of NetworX. Configured rate sheets, routing rules, comment rules, qualifier groups, calcs, code groups, mailboxes, users, roles and system properties.
  • Educated staff and arranged demos of potential new product acquisitions including Payment Bundling Administration (PBA), Modeler, Claim Test Pro, Healthcare Process Automation Service (HPA) “Robots”.
  • Participated in Change Advisory Board (CAB) meetings and planned & coordinated software deployments with release managers.
  • Eliminated over $150K annually in extended maintenance software fees.
  • Negotiated and executed Cognizant, TriZetto, Optum and other third-party software vendor contracts and custom product enhancements statements of work (SOW’s).
  • Eliminated a $15M balloon payment by renegotiating and consolidating multiple contracts.
  • Governed web applications and attained the top BitSight Security Rating in the Healthcare/Wellness industry.
  • Managed Oracle and SQL Server database encryption projects, Oracle 12c database upgrade, SQL Server 2014 & 2016 database upgrades and assisted with an Informatica PHI data masking project which contributed to HITRUST certification.
  • Co-managed a ServiceNow implementation to track and manage ITIL processes including Incident, Problem, Knowledge, Change, Configuration and Service Catalog.
  • Led infrastructure projects including ColdFusion, IE & GoldenGate upgrades, Informatica & Embarcadero implementations.

Application Development

Experienced manager of technology staff for a self-insured dental benefits organization servicing over 110K active and retired police officers and their dependents. Oversaw all IT functions including data center management, help-desk support, application development, vendor relationships and network management. Supervised the execution of critical EDI processes between various city and business partners including FISA, Wells Fargo, Caremark and Davis Vision.

  • Managed QCSI aQDen (QMACS) application running on Microsoft SQL Server 2000 and spearheaded the migration to Trizetto QNXT healthcare payer enterprise application software.
  • Improved data quality which increased claim adjudication rates by 40%, eliminated an 18-month reporting backlog and enhanced operational efficiencies.
  • Designed and implemented a Medicare Part D retiree prescription software system that enabled the capture and transmission of key data points, resulting in the receipt of over $20M annually of retiree drug subsidy (RDS) center payments to the Union not previously realized.
  • Project manager for legacy accounting software migration to Microsoft Dynamics GP.
  • Led initiative to outsource the printing and mailing of provider and member checks, EOB’s and predeterminations to a third-party vendor resulting in annual savings of over $80K.
  • Combined financial data from 3 separate financial systems and generated over 5,000 1099’s using Convey Compliance Systems, Inc software, which resulted in a 97% error reduction over prior years.

ERP/COTS Solutions

Project manager responsible for the implementation and management of  an enterprise SAP solution  (ERP/COTS) in the pharmaceutical industry.

  • Managed Back Office Associates data migration team to convert data into SAP COTS Orders to Cash system.
  • Coordinated, designed and executed extract, transform and load (ETL) processes from several heterogeneous platforms (IBM DB2, IBM IMS, HP3000 Image and Oracle databases) into a single SQL Server “staging” database to support data analysis, scrubbing and conversion of master and transactional data into SAP R/3.
  • Created, maintained, documented and monitored over 150 SAP batch jobs including program variants and report layouts, monitored IDoc transmissions between SAP and webMethods.
  • Created accounts receivable interface file from SAP to Schering Plough Animal Health division using ABAP and FTP.
  • Designed a critical contract-pricing interface capable of processing transmissions of over 1 million BDC sessions.
  • Supported and enhanced GxP Customer Service System on HP3000 MPE/iX using Cobol, Image and View.
  • Proactively identified opportunities to improve compliance with FDA regulation 21 CFR Part 11 and implemented DBAudit, Security3000 and VEAUDIT for Sarbanes-Oxley compliance.
  • Maintained all application interfaces between HP3000 and Warehouse Management System (WMS) via NRJE and FTP.

Data Warehouse | Data Analytics

  • Implemented a data warehouse solution and managed a data warehouse team consisting of developers, dba’s, analysts and business subject matter experts.
  • Developed a real-time sales operational data store (ODS) from HP3000 Image database (Ecometry/MACS system) to Microsoft SQL Server as the initial phase of a corporate data warehouse.
  • Automated over 150 sales reports resulting in cost savings of over $60K per year.
  • Designed and implemented a star schema and generated OLAP cubes for sales analysis, evaluated several business intelligence tools including Business Objects and ProClarity.
  • Created operational concept x documents, proof of concept documents, system requirements documents, system design documents, system test plans and system implementation documents.
  • Conducted system design facilitative sessions with business and technical groups; conducted design and code reviews; coded database reconciliation and re-synching routines.
  • Designed and coded data extract and data cleansing programs.
  • Developed an interactive eligibility reporting system.
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Phone: +1 570-842-8144