Kevin Coonan

Large healthcare insurance payer

• Managing an initiative to identify how our client can expand delegated capitation FFV models across geographies, and government and commercial lines of business

Large healthcare insurance payer

• Led a four-year, $26 million, large scale business process improvement and software implementation project for one of the nation’s largest healthcare insurance companies
• Implementation of a technology platform to improve medical claim fee-for-service processing and associated performance based financial settlements between payer and providers
• Key role in functional design of the technology platform to allow business flexibility and extensibility
• Oversight of testing strategy to verify that over $35 billion in gross hospital charges are reimbursed accurately
• Implemented solution included the following components:
  -Custom Java based applications for production operations and modeling “what if” scenarios
  -Rules based (IBM JRules) calculation engine and rule authoring and monitoring application
  -SAS analytics engine
  -Legacy system/future-state system data conversions, integrations, and cut-over processes
  -Business intelligence capabilities including 100+ Cognos reports and self-service analytics data mart

Large healthcare insurance payer

• Led a project designed to update contract reimbursement systems to be ICD-10 compliant, which included:
  -Deriving new identification rules for ICD-10 based claims
  -Assist the business with managing contract updates
  -Analyze reimbursement impacts due to ICD-10
• Designed and managed implementation of business processes and technology to manage new provider network and contracting scenarios including:
  -Narrow and tiered networks
  -Global risk agreements
• Designed and developed a contract inventory methodology, application and data base to deconstruct and store contractual pricing terms
• Managed requirements and development of a ILOG JRules based proof of concept to demonstrate rules based pricing
• Testing design, planning and execution of a large data conversion and testing effort, which converted over eight years of medical paid and reimbursed claims data.

Healthcare compliance

• Created a technology roadmap for mid-size heath care compliance firm with technology initiatives designed to improve and scale our client’s business
• Managed the implementation of key technology initiatives identified on the roadmap, including:
  -Creation of a customer facing web portal for reporting and document management
  -Custom medical record and claim auditing tool
  -Implemented governance practices

Major derivatives exchange

• Managed a project to build a software application and testing capability for a new financial derivatives model
• Managed a team of 15 client, vendor and consulting resources
• Incorporating systems development lifecycle (SDLC) methodology to provide project structure and control

Major credit bureau

• Designed and implemented a custom software application to derive annual pricing increases for a set of over 50,000 customers based on a large number of client dimensions
• Assisted our client to derive pricing methodology to increase price and transaction volume across subscriber base. First year increases were greater than $2 million.

Manufacturer of heavy mining equipment

• Managed project which focused on capacity planning and throughput improvement in a major manufacturer of large scale mining equipment
• Led a team, which built a suite of models designed to quickly test loading scenarios in each of our clients’ manufacturing areas, from fabrication, welding, machining, to assembly.

Compliance and due diligence

• Internal auditor preparing clients for information system assessments for Sarbanes-Oxley compliance.
• Assisted clients with due diligence and reverse due diligence to assess the technology capabilities in an organization

Large telecommunications provider

• Managed the development of detailed test metrics tools to track distribution workforce efficiency.
• Assisted telecommunications clients with improving and consolidating their application testing organizations.
• Designed and executed performance and concurrency testing of large-scale load balanced systems using Mercury LoadRunner and TestRunner toolsets
• Implemented large-scale custom-built information technology solutions for large telecommunications clients.