Summary
Overview
Work History
Education
Skills
Timeline
Generic

Abbey Wood

Brantford

Summary

Medical / Insurance Systems Medical Director - Project Management. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.

Overview

14
14
years of professional experience

Work History

Health Insurance Systems Implementation Project Manager

Nano Health Suite
02.2015 - Current
  • Developed and implemented a comprehensive insurance management system comprising over thirty standalone and interconnected modules to facilitate internal manual and automated operations for health insurance companies, pharmacies, hospitals, government agencies, and clinics
  • Constructed and organized brand-congruent, customer-focused systems that effortlessly interlink with payment platforms, banking institutions, and government regulatory bodies.
  • Analyzed and formulated Business and Medical Rules for clients, automated claims processing, and pharmacy adjudication systems
  • Collaborated with the internal finance and reinsurance teams to assess demands and customization requirements for software solutions
  • Ensured accurate recording, calculation, and reporting of accounting information to the relevant operational departments of the International Insurance Company
  • Additionally, it provided seamless communication and integration with HSBC Bank across multiple countries and currencies.
  • Customized backend and customer-facing modules, such as Medical Necessity Check Points, Drug Database Knowledge, Pharmacy Benefit System, IR/AR DRG Grouper System, Coding and Billing Services, Dashboards and Analytics, Revenue Cycle Management, HR System, Finance and Reinsurance ERPs, Marketing and Communication Applications
  • Conducted extensive research, analysis, and design of communication and configuration modules, including suites, to meet technical, medical, and billing solution requirements set by government bodies
  • Ensured compliance with HIPAA regulations, global technology policies, and security benchmarks
  • Utilized Project Management Waterfall, Agile, and Scrum methodologies
  • Implemented systems for healthcare market companies in the Middle East and North African (MENA) region, including insurance companies, third-party administrators, multiple hospitals, pharmacies, clinics with various specialties, and government regulatory branches across more than 10 MENA countries
  • Developed and conducted comprehensive training programs for employees, ranging from product owners to end-users, in MENA countries, covering multiple currencies and languages, in collaboration with an International Insurance Company.

Project Manager

Blue Health Services
06.2020 - 01.2021
  • Responsible for opening a new 15,000-square-foot surgical medical facility with multiple specialties, including pharmacy, operating, and treatment rooms during the COVID-19 pandemic's ever-evolving mandates
  • Led the preparation for a successful pass of an Ontario Health Insurance Plan (OHIP) Level 2 OR Inspection
  • Collaborated with contractors, HVAC, marketing, associates' employees, medical departments, pharmaceutical sponsorships, suppliers, and owners to review and resolve any missing elements before the OHIP inspection
  • Created policies and procedures manual for all departments and specialties of the facility to define the quality standard of medical care for efficient operating rooms and best business practices
  • Coordinated construction, marketing, medical professionals, employees, and owners to ensure a standard of care for treatments and surgical procedures, including pre-and post-op care.

Manager

Carrot Eye Surgery Clinic
02.2009 - 02.2015
  • Successfully led and managed a medical facility's day-to-day operations and business development roadmap
  • Oversaw and guided a team of staff and associates, conducting performance evaluations, providing coaching and mentorship, and driving practice growth across three facilities in the Greater Toronto Area
  • Collaborated directly with the Medical Director, Associates, and Owners to evaluate and enhance organizational systems, processes, policies, and procedures
  • Managed and maintained inventory control for surgical medical supplies, equipment, and products
  • Skillfully managed external communications, resolving conflicts with patients, hospitals, and referring offices, while maintaining a solid reputation for the facility
  • Collaborated with renowned hospitals, including Brampton Civic Hospital, Credit Valley Hospital, Kensington Eye Institute, St
  • Michael's Hospital, Sick Kids Hospital, Oakville Trafalgar Hospital, and Trillium Health Partners Hospitals on on-call schedules, surgical schedules, educational events, knowledge transfer, pharmaceutical studies, and research projects.

Education

Graduate Masters, Master of Business Administration -

Athabasca University

Post-Graduate Diploma - Business Administration

Algonquin College

Project Management Professional (PMP) - undefined

Career Training College

Skills

  • Systems Implementation: Coordinated deployment of healthcare operation and insurance software solutions encompassing a range of standalone modules, incorporating tailored unified suites Facilitated seamless communication between technical and government regulatory entities, bridging the gap between new and legacy systems within the organization's existing software solutions deployed on-site and in remote network environments Spearheaded rebranding and modernization of customer-facing applications and internal processes while enhancing financial and security protocols Built and customized various automated, semi-automated, and manual modules, including interactive applications for public markets, backend operations, and medical claims adjudication across multiple countries, accommodating diverse languages, currencies, and medical code sets
  • Training Programs: Conducted comprehensive surveys and formulated and implemented training programs tailored to cater to the needs of businesses ranging from small enterprises to large corporations, spanning multiple countries with diverse languages, medical codes, and billing sets
  • Human Resources: Supervised and upheld the onboarding process, project projections, requirements, contracts, work visas, payroll management, staff performance reviews, training initiatives, and Key Performance Indicators (KPIs) for in-house and overseas associates across all employee departments
  • Procurement: Established, managed, and provided regular updates on financial project projections and budgets
  • Health Operations and Administration: Conducted a comprehensive healthcare market needs analysis and identified pain points across multiple countries Aligned the roadmap for the health software solutions system's development strategies and long-term goals to address these needs and challenges

Timeline

Project Manager

Blue Health Services
06.2020 - 01.2021

Health Insurance Systems Implementation Project Manager

Nano Health Suite
02.2015 - Current

Manager

Carrot Eye Surgery Clinic
02.2009 - 02.2015

Graduate Masters, Master of Business Administration -

Athabasca University

Post-Graduate Diploma - Business Administration

Algonquin College

Project Management Professional (PMP) - undefined

Career Training College

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