PM_HealthInsurance

If you are a Health Insurer you know how many players have to be taken into consideration when implementing a complex
technology project. Besides the obvious impact on customers, the needs of many other internal and external areas must be
accommodated. Does it affect Providers, Eligibility Maintenance, Underwriting or Finance Depts.? How about HIPAA? Have
Brokers, Benefit Managers and PBM’s been considered? Will it impact the Customer Service Area?

We are keenly aware of those interactions and, although focused on the technology aspects of a project, we weigh the
impact of a decision in other areas of the organization.

Some of the most recent Projects that we have managed are:

Establishing Electronic Eligibility Maintenance for Major clients (such as large banks and Pharmaceutical
Companies). This entailed many subprojects such as:
Field mapping among disparate systems
Setup of transmission and encryption mechanisms
Data validation and synchronization
Coordination with local personnel, US headquarters and third party Benefit Managers
Testing, deployment and auditing
Coordination of Technology tasks in the implementation of an additional PBM.
Coordination of Special projects with Government Regulatory Agencies
Implementation of an external COB data validation service

Project Management - Health Insurance