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TriZetto

Novalis

Tertius

Gene Simons, Inc.

Frederick G. Eaton III

Major Project Involvement

2014- Mar 2015 MVP Health Care - Sales Automation / CRM

            Enterprise Architect

2014- Mar 2015 MVP Health Care - Creation and operation of the Architectural Review Board

            Enterprise Architect

2014- Mar 2015 MVP Health Care - Member Identity

            Enterprise Architect

            In Exchanges, Edge-server reporting, Partner interfacing

2014- July 2014 MVP Health Care - Caremark (PBM) Implementation

            Enterprise Architect

2013- Mar 2015 MVP Health Care - Hudson Health Consolidation

            Enterprise Architect

2013- Mar 2015 MVP Health Care - ACA Exchanges

            Enterprise Architect

            Vendor selection and JAD and work with state exchanges and internal business units

2012- Jan 2015 MVP Health Care - Coordinate Facets upgrades

            Enterprise Architect

2012- Jun 2012 MVP Health Care - Re-architect EDW

            Enterprise Architect

2011- Mar 2015 MVP Health Care - Combined Project Portfolio Planning

            Enterprise Architect

2011- Jun 2012 MVP Health Care - ICD-10 Readiness and Code deployment

            Enterprise Architect

            Vendor selection, Integration, Automated Policy (code list) deployment

2009- Oct 2011 MVP Health Care - Miscellaneous Projects[3i Infotech]

            3i Infotech – Contract developer

            Database Developer, Analyst, Tools Developer, Facilitator, Trainer

Member Identity front end for Tivoli TIM/TAM, NY HCRA tax calculation,  conversions of source language repository and deployment system, indexing of documents in the file shares.

2007- Feb 2009 MVP Health Care - Datamart development[3i Infotech]

            3i Infotech – Contract developer

            Database Developer, Analyst, Tools Developer, Facilitator, Trainer

            TriZetto Facets, Sybase SQL, SQL Server SQL, Oracle SQL, Sagent dataflow, VB

2006 APS Health Care - Cavion Conversion[HPTI]

            HP Technologies Inc – Contract consultant

            Testing coordinator, Assistant project manager, Business analyst, Facilitator, Document archivist

            TriZetto Facets, Sybase SQL, SQL Server SQL, VB, Sharepoint

2005-2006 Oregon Dental Services – Provider Conversion [Synergy]

     Synergy – Contract Consultant

            Business Analyst, Sub-project Coordinator, Workplace Automation, Conversion Programmer

            TriZetto Facets, Sybase SQL, VB

2004-2005 Trizetto Group – Customer support

TriZetto Group - Hosted Business Intelligence - BCN support

Business Analyst, Support Architect, Document Archivist, Support Programmer, Internal Consultant, Facilitator

TriZetto(Erisco) Facets, Brio, Business Objects, SQL, VB, Sharepoint

2003-2004 BCBSM / BCN[Trizetto]

TriZetto Group - Business Integration Consulting

Business Analyst, Data Store Designer, Program Designer,  Internal Consultant, Relationship Manager, Facilitator

TriZetto(Erisco) Facets, Brio, Business Objects, Vitria, SQL, VB

2003-08 HealthNet[Trizetto]

TriZetto Group - Business Integration Consulting

Business Analyst, Interface Designer

TriZetto(Erisco) Facets

2003-05 UHC Dental[TriZetto]

TriZetto Group - Business Integration Consulting

Business Analyst, Internal Consultant

TriZetto(Erisco) Facets, Seibel

2003-05 Harrington Benefits[Trizetto]

TriZetto Group - Business Integration Consulting

Business Analyst, Program Designer, Conversion Programmer

TriZetto(Erisco) Facets, MS Access, SQL

2003-04 PacifiCare Dental[TriZetto]

TriZetto Group - Business Integration Consulting

Business Analyst, Program Designer, Conversion Programmer, Internal Consultant

TriZetto(Erisco) Facets, VB, toolset

2002-3 M Plan Conversion[TriZetto]

TriZetto Group – Payer Integration / Business Integration Consulting

Business Analyst, Program Designer, Conversion Programmer, Internal Consultant

TriZetto(Erisco) Facets, VB, SQL, IDX

2002 WHA Conversion[TriZetto]

TriZetto Group – Payer Integration

Tool Developer, Conversion Consultant

TriZetto(Erisco) Facets, VB

2002 Coventry Conversion[TriZetto]

TriZetto Group - Transformation Services

Consultant, HCPS resource

DEC VMS (COBOL), TriZetto(Novalis) HCPS, IDX

2001-4 Capital Blue Cross Conversion[TriZetto]

TriZetto Group – Payer Integration

Business Analyst, Program Designer, Tool Developer, Conversion Programmer

TriZetto(Erisco) Facets, VB, SQL

2001 QualChoice of North Carolina Conversion[TriZetto]

TriZetto Group - Transformation Services

Project Planner, Business Analyst, Programming Team Leader, Program Designer

DEC VMS (COBOL), Erisco Facets, D2K ILN

2001 QualChoice of Virginia Conversion[TriZetto]

TriZetto Group - Transformation Services

Project Planner, Business Analyst, Programming Team Leader, Program Designer

DEC VMS (COBOL), Erisco Facets

2000 Development Consolidation[TriZetto]

TriZetto Group - ASP

Trainer, Technical Resource, Planner

DEC VMS (COBOL)

1999 Backplane System Design for Multi-platform Integration [Novalis / HNA]

Novalis, Albany, NY - Infrastructure provider to HMOs

Designer, Analyst

Forte / DEC VMS (COBOL)

1999 AdminiSource Connections[Novalis / HNA]

Preferred Health Network, Baltimore, MD - HMO
Olympic Health Management Systems - Insurance Carrier

Consultant, Designer, Programmer

DEC VMS (COBOL)

1999 Compensation Policy Development [Novalis / HNA]

Novalis, Albany, NY - Infrastructure provider to HMOs

Committee Chair, Analyst

DEC VMS (COBOL)

1998 - 2000 Y2K Compliance Project [Novalis / HNA]

Novalis, Albany, NY - Infrastructure provider to HMOs

Designer, Technical resource

DEC VMS (COBOL)

1998 - 1999 Managed Care System - Local Development of Three-tier client/server replacement for HCPS [Novalis / HNA]

Novalis, Albany, NY - Infrastructure provider to HMOs

Designer, Technical resource

DEC VMS (COBOL), Forte

1998 Plan Accumulations Exchange with another Payer[Novalis / HNA]

QualChoice of Virginia, Charlottesville, Va. - HMO

Designer, Consultant

DEC VMS (COBOL)

1998 Integration of HCPS legacy claims system with MACESS imaging and workflow system[Novalis / HNA]

Preferred Health Network, Baltimore, MD - HMO

Designer, Technical resource

DEC VMS (COBOL)

1998 MediCare Compliance revisions to HCPS legacy claims system [Novalis / HNA]

Novalis, Albany, NY - Infrastructure provider to HMOs

Designer, Technical resource

DEC VMS (COBOL)

1997 HIPPA Compliance - Phase I: Reporting in HCPS legacy claims system [Novalis / HNA]

Novalis, Albany, NY - Infrastructure provider to HMOs

Analyst, Designer

DEC VMS (COBOL)

1997 Base Incentive replacement for Withhold in Risk / Reward Model [Novalis / HNA]

Preferred Health Network, Baltimore, MD - HMO

Analyst, Designer, Consultant

DEC VMS (COBOL)

1996 - 1997 Managed Care System - Three-tier client/server replacement for HCPS [Novalis / HNA]

Novalis, Albany, NY - Infrastructure provider to HMOs

Technical resource

VB, C++, Oracle

1996 - 2000 Prescription drugs into Capitation Model [Novalis / HNA]

Health Care Plan, Buffalo, NY - Insurance carrier

Designer, Analyst

DEC VMS (COBOL)

1995 HMO Blue Design - Simplified business model [Novalis / HNA]

Blue Cross Blue Shield of New Hampshire, Manchester, NH - Insurance carrier

Consultant, Analyst, Designer, Programmer

1995 - 1997 NorthEast Managed Care Initiative - Integration of all NE Blue plans into single HMO for provider / patient use[Novalis / HNA]

Blue Cross Blue Shield of New Hampshire, Manchester, NH - Insurance carrier

Consultant, Analyst, Designer, Programmer, Trainer

DEC VMS (COBOL)

1995 Redesign of Novalis Model (HMO design for benefits, and risk-reward system)[Novalis / HNA]

SelectCare, Troy, MI - HMO

Analyst, Designer

1994 - 2000 Develop, Implement, and Support 'Automated Claim Adjudication' - A user-maintained rules-based Electronic Claims front-end to the HCPS legacy claims system[Novalis / HNA]

Novalis, Albany, NY - Infrastructure provider to HMOs

Analyst, Programmer, Business Consultant, Trainer

DEC VMS (COBOL) / Server (Mercator, MACESS)

1994 - 1997 Joint Development Support with Clients [Novalis / HNA]

QualChoice, Cleveland, OH
Blue Cross Blue Shield of New Hampshire, Manchester, NH - Insurance carrier

Technical Resource, Trainer, Project Manager

DEC VMS (COBOL)

1993 - 1994 Design and Implementation of Automated Referral Correspondence Module for HCPS legacy claims system [Novalis / HNA]

Novalis, Albany, NY - Infrastructure provider to HMOs

DEC VMS (COBOL)

1993 Restructure Capitation Reporting for Speed Improvement [Novalis / HNA]

Novalis, Albany, NY - Infrastructure provider to HMOs

Analyst, Programmer

DEC VMS (COBOL)

1993 - 1994 Develop and Support Actuarial Reporting from HCPS legacy claims system[Novalis / HNA]

Novalis, Albany, NY - Infrastructure provider to HMOs

Analyst, Programmer

DEC VMS (COBOL)

1993 Convert 4GL routines to COBOL for Efficiency Improvements [CMA / Tertius]

Health Networks of America - Infrastructure provider to HMOs

Programmer

DEC VMS (Quiz, COBOL)

1992 - 1993 Support Roll Stock Inventory system [Tertius]

Macaran Printed Products, Cohoes, NY - Label and Specialty Printer

Consultant, Programmer, Data Recovery Specialist

PC (DBase programming)/ Programmable scanners (Proprietary Basic)

1991 Predict impact of proposed work rules changes [Bongartgen Associates / GSI]

National Railroad Passenger Corp., Philadelphia, PA - (Amtrak)

Consultant, Data Analyst, Modeler

PC (Harvard Project Manager, BASIC programming)/ DEC (Data download)/ IBM3081 (MTS Tape exchange utilities)

1991 Computerization of Production Planning and Control [TERTIUS NEMTC)]

Globe International, Buffalo, New York - Woven textile conveyer belts

Lead consultant

DG CS40 (COBOL)

1991 Course in management of programming projects [GSI]

MapInfo, Troy, NY - Cartographic Statistical Software

Course development, presenter

PC (Harvard Project Manager, Project Workbench, PS5) / Mac (WORD, MacDraw, MacFlow)

1990 - 1991 Provide evaluations of commercial project management software [TERTIUS]

NEMTC , RPI, Troy, NY - Federal Program

Technical specialist

PC (Timeline, PS5, Project Workbench, TEXIM Project, others) / Mac (Mac Project II)

1990 Redesign Factory Layout for Capital Avoidance [TERTIUS (NEMTC)]

Bobrick Washroom Equipment, Clifton Park, New York - Grab bars and toilet compartments

Lead consultant, Layout specialist

PC (Framework, Enable, DBASE III+, FORTRAN, QuickBasic, CRAFT - own package) / Mac (Word)

1990 Technical Program Management Course [GSI]

GE Plastics, Pittsfield, Massachusetts - Plastics

Course development

Mac (WORD, MacDraw, MacFlow)

1990 Program Management [GSI]

Governor's Office of Employee Relations, Albany, New York - Public Sector

Course development

Mac (WORD, MacDraw, MacFlow)

1990 New Product Development Project Management [GSI]

IBM, Poughkeepsie, New York - Computers

Course development

Mac (WORD, MacDraw, MacFlow)

1990 Layout proposed new facility [TERTIUS (NEMTC)]

Macaran Printed Products, Cohoes, New York - Specialty printers

Consultant, Layout specialist

PC (Framework, Enable, DBASE III+, FORTRAN, QuickBasic, CRAFT - own package) / Mac (Word)

1990 Provide an interactive version of the CRAFT layout program for PC platforms [TERTIUS]

NEMTC, RPI, Troy, NY - Federal Program

Programmer/Analyst

PC (FORTRAN, QuickBasic)

1989 Evaluate plant for relocation [GSI]

Consultant, Layout specialist

1989 Evaluation of ARES/LARS (locomotive monitoring electronics) [Bongartgen Associates / GSI]

Burlington Northern Railroad, Overland Park, Kansas - Freight Hauler

Consultant, Data retrieval and Simulations programmer

PC (QuickBasic) / Wang (COBOL, BAL)

1989 Welding Facility Redesign [GSI (NYS Science and Technology Foundation)]

Garden Way Manufacturing, Troy, New York - Power Garden Equipment

Layout specialist

PC (Framework, CRAFT - own package) / Mac (Word)

1988 Redesign Factory Layout for Short Cycle Manufacturing [GSI]

Allied Signal Friction Materials, Green Island, New York - Brake shoes and linings

Layout specialist

PC (Framework, CRAFT - own package) / Mac (Word)

1988 Productivity Improvement in Textile Treating [GSI (NYS Science and Technology Foundation)]

Globe International, Buffalo, New York - Woven textile conveyer belts

Data analyst

PC (Framework, CRAFT - own package) / Mac (Word)

1988 Implementation Plan for Factory Layout for Short Cycle Manufacturing [GSI]

Prestolite Electric, Arcade, New York - Car and truck alternators

Layout specialist

PC (Framework, CRAFT - own package) / Mac (Word)

1987 Productivity Improvement Program on Alternator Manufacture [GSI (NYS Science and Technology Foundation)]

Motorola, Albany, New York - Car and truck alternators

Layout specialist

PC (Framework, CRAFT - own package) / Mac (Word)

1986 Student Master Scheduling Software Package [GSI]

Hudson Valley Community College, Troy, New York - Community College

Lead consultant

Prime (FORTRAN)/ Burroughs (COBOL)

1986 Set up reduction on Coil-Fed punch presses [GSI (NYS Science and Technology Foundation)]

Weber-Knapp Furniture, Jamestown, New York - Hinges & metal stampings

Technical specialist

1984 Develop, install, and train a computer based contract tracking system [GSI]

New York City Housing Authority, New York, New York - Public Sector

Lead consultant, Programmer, Trainer

IBM 43-series (CICS, COBOL)

1981 - 1989 Provide computer software for personal financial planning system [GSI]

AYCO, Albany, New York - Financial and legal services

Site manager, Consultant, Programming manager, Systems analyst, Programmer, Hardware evaluator, Trainer

Wang Minis (COBOL, BAL, WP, WPPLUS, BASIC)

1981 Provide computer system for tracking urban renewal projects[GSI]

Albany Urban Renewal Agency, Albany, New York - Public sector

Lead consultant, Programmer

Wang (COBOL, WP) / IBM Mini (Comm routines)

1981 Operations audit and effectiveness study [GSI]

Albany Urban Renewal Agency, Albany, New York - Public sector

Lead consultant

1980 Study customer opinion on utilities division services [GSI]

General Development Corp., Miami, Florida - Real Estate Developer

Data coordinator, Data Analyst

Prime (FORTRAN, DATAAN - own package)

1980 Established staffing standards for State mental hospitals including in-patient and out-patient facilities [GSI]

State of New York, Office of Mental Health, Albany, New York - Public sector

Computer operations coordinator, Systems analyst, Data analyst, Programmer

Univac (COBOL, DATAAN - own package)

1979 Develop and install computer-based project management system for Modernization Program [GSI (US HUD Modernizations program)]

Albany Housing Authority, Albany, New York - Public Sector

System analyst/programmer

DG (BASIC, PMS - own package)

1979 Design and install a centralized maintenance planning and control system [GSI (US HUD Modernizations program)]

Buffalo Housing Authority, Buffalo, New York - Public sector

Interviewer, Data analyst

Updated 05/03/05

 

Mail Me

Home

TriZetto

Novalis

Tertius

Gene Simons, Inc.