Healthcare Mergers and Acquisitions | Enterprise Financial Systems | Claims Billing Systems

Healthcare M&A | ERP

An ATIBA senior program manager assumed responsibility for the management of 40+ financial project initiatives related to merger and acquisition efforts for the nation’s largest, independent Preferred Provider Organization (PPO) | Healthcare Network solutions company. The PM assessed ERP, financial applications and supporting business processes impacted by merger and acquisition efforts when the parent organization acquired five new healthcare companies.

The project portfolio included ERP systems, custom application development, infrastructure, database upgrades, business process re-engineering, process integration and organizational change initiatives. Throughout the engagement, the program manager ensured for the adequate implementation of financial controls and development of project documentation to support HIPAA and SSAE 16 audits.

Strategy and Management

The ATIBA PM was the solution architect responsible for all accounting, claims billing and finance systems; she collaborated with senior management to identify and recommend systems to be sunset, upgraded, procured or developed, and developed the IT roadmap and integration strategy for those efforts. She maintained detailed schedules for all project initiatives and developed an integrated master schedule that included cross-departmental task dependencies, phased deliverables, and milestones.

The PM was actively engaged in all change management activities and provided weekly progress reports and monthly executive dashboards. She managed and validated the completion and quality of all deliverables, managed defect prioritization, defined the SDLC roadmap, and managed system deployments.

Navigating between business and IT to facilitate communications during all SDLC phases, the PM led the development of current and future state documentation including requirements documents, gap analysis documents, architecture and technical specifications. System dependencies were identified, business processes were re-engineered, and issues, risks and changes were proactively managed. Additionally, system infrastructure was procured, implemented and relocated, and disaster recovery plans were developed, tested and rolled-out.

System access was defined in collaboration with management, ensuring system security and role-based access, with a key goal being a clear division of duties. Processes were established with HR and department managers to add and delete user access when employees were onboarded and offboarded; managers reviewed access monthly to ensure system integrity. Senior management was so impressed with the end-to-end process that was defined and implemented, they replicated it elsewhere in the organization.

Key Initiatives

Organizational Change Management:
Due to redundant roles and responsibilities across the six organizations, the PM worked closely with senior management to assess personnel and define short-term and long-term organizational plans and structures.
Oracle Financials: Managed the sunsetting of the Oracle financials suite, converting and migrating historical data to the Microsoft Dynamics GL, AP, AR and FA systems.
Microsoft Dynamics Great Plains: Managed the upgrade of COTS enterprise Microsoft Dynamics/Great Plains financial systems (GL, AP, AR) from GP v9 to GP 2010.
Fixed Assets: Implemented Microsoft Dynamics/Great Plains enterprise Fixed Assets system; sunset legacy Oracle FA and CS Thompson FA systems, integrated 5 acquired healthcare companies; migrated historical data.
Accounts Payable: Enhanced multi-company AP system with implementation of accounts payable auto-approval workflow process and intercompany software solution.
Client Billing System: Managed the re-write of a proprietary client billing and receivables system that processed fee-for-service and capitated claims. Upgraded to technology that included Web 2.0, SOA, Cold Fusion, JAVA, Oracle, Business Objects, InfoView, and Crystal Reports.

Provider Billing System: Managed the development of Web 2.0 provider billing system that supported ~5000 active accounts and processed ~2 million claims per month.
Oracle Upgrade: Managed ERP financial application testing and remediation efforts related to enterprise wide Oracle 9i to 11g upgrade.
TriZetto NetworX Upgrade: Managed ERP financial application testing and remediation efforts related to major upgrade of TriZetto NetworX core re-pricing engine.

Industry: Healthcare
Category: Mergers & Acquisitions, ERP, COTS, Financials, Billing