Richard Moore

Achievements

Examples of Consulting Experiences

Other Work Experience

Examples of Consulting Experiences

Comments from Clients

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Richard Moore

Qualifications
  • Over Thirty years Experience in Healthcare Information Systems.
  • Independent Consultant specializing in Healthcare Information Systems – 15 Years
  • Medicaid Medical Information Services Implementation – 2 years
  • Implementation Specialist for Anthem Inc., Managed Care Systems, Computer Information Technologies – 5 Years
  • Consulting, Implementation, Training and Support Services to select Alcohol, Drug and Mental Health Services (ADAMHS) Providers, Regional Boards and ODADAS – 5 Years.
  • Technical Consultant to a Community Healthcare Information Network (CHIN) implementation. – 1 Year
  • HIPAA Training and Consulting Services to Medical Provider Community. – 9 Years
  • Regional Health Information Organization and strategic health information technology policy for Ohio. – 8 Years

Achievements
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  • Project Manager for Market development and implementation of MACSIS compliant billing and information systems for an Ohio statewide network of 89 behavioral health providers, regional ADAMHS boards and the Ohio Department of Alcohol and Drug Addiction Services (ODADAS).
  • Consultant to the Ohio Corporation for Health Information.  Project Manager to develop electronic data interchange (EDI) services for the non-profit community healthcare information network (CHIN).  
  • Implementation Specialist for Anthem Health Inc., Managed Care Systems. Coordinating resources for multi-site nationwide implementation of a managed care payer system. Lead on finance, enrollment and billing issues.
  • Business Analyst, Functional Architect, Team Leader Support Services and Support Services Representative; assisting Health Insurance Companies implement, use, modify and maintain their Managed Care Health Claim Processing System. Clients included Anthem BC/BS, BC/BS of Connecticut, Health Network Ventures of NY and Acordia National of WV.
  • HIPAA Compliance Training and Consulting. Training ADAMHS agencies and health providers on Electronic Transaction and Code Set requirements and implementation of ANSI 837 and 835. Consulting on HIPAA Privacy and Security.

Examples of Consulting Experience
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- Ohio Alcohol, Drug Addiction and Mental Health Services (ADAMHS) Agencies, Regional Boards and Ohio State Government - Consultant to a software development firm, Cybertech, Inc., expanding the market for their behavioral healthcare software to public funded ADAMHS agencies. Designed strategic software modifications that gave the product line unique capabilities in the marketplace and helped expand the product line from 1 to 5 products.  In 2 years, achieved client growth from 19 clients in 9 counties to 89 clients in 40 counties, secured clients at the Ohio State Government and ADAMHS board levels.  Achieved over 120% annual revenue growth.  Services included market development, sales, product demonstration, project management, software implementation, and training. Performed 42 onsite implementations, 37 system conversions and trained 180 users.

- Project Manager to The Ohio Corporation for Health Information, Community Healthcare Information Network. Performed project management to develop electronic data interchange (EDI) services for a non-profit community healthcare information network (CHIN). Oversaw the design and development of CHIN applications to be used on a secure intranet for the exchange of health information between providers, payers, governmental entities and employers. Managed vendor's development of browser-based direct data entry XML applications to assure compliance with ANSI X12 EDI standards for the Ohio Bureau of Workers Compensation, Ohio Medicaid and Ohio Medicare. Performed testing and troubleshooting of ANSI transactions with Foresight EDISIM software. Managed the procurement and installation of the Ethernet TCP/IP local/wide area network equipment and T1 installation. Advised client on vendor web site development.

- Implementation Specialist for Anthem Health Inc., Managed Care Systems. Coordinated business analysts, programming staff and end-users for multiple site implementation and conversion. Node sites at Houston, TX, Atlanta, GA, Sacramento, CA, Charleston, WV and Piscataway, NJ connected over Anthem's nationwide private TCP/IP WAN. Lead on finance, enrollment and billing issues. Helped define conversion fields, validated system-to-system business function and verified data after conversion. Coordinated the release and testing of software modifications and testing of converted data on new system. Performed end-user training, environment stabilization and gave post-implementation support. Technology involved DEC VAX client servers, IBM mainframe, Microsoft Windows PC connectiviy, Cobol programming, unit/functional/integration testing and multi-version release control.– Claim processing, Enrollment, Billing and Finance Processes.

- Co-Consultant on an extensive operations analysis of BC/BS of Conneticutt managed healthcare division's claim, enrollment and financial processes. Revealed key bottleneck areas that kept the client from processing claims on a timely basis. Eliminated 2,000 + claim backlog in 3 months with existing staff. The company also incorporated recommendations to the enrollment and billing management to improve turn-around on membership changes and financial adjustments. Acted as interim VP of Operations.

Other Work Experience

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- The First Community Church, Grandview, OH; Director of Business Administration & Information Systems - Overseeing the Finances, Physical Assets and Human Resources of a 5000 member Charitable Organization and Foundation. Financial tracking and analysis for 18 departments with $2.5 million budget. Secretary to the Governing Board and the Foundation Board of Trustees and Statutory agent to the First Community Village.
- Community Mutual Insurance Company, Worthington, Ohio; Business Information Systems Hospital Coordinator of hospital electronic claims service for Ohio hospitals. Coordination of electronic claims software, communication devices, computer systems and support services.
- Pioneer-Standard Electronics, Inc., Dayton, Ohio; Field Sales Engineer, Client development for and delivery of end-user Digital Equipment Computers, ethernet network solutions and associated peripheral equipment. Also delivery of IBM compatible personal computers, Intel and Motorola multi-user computer systems.
- The Ohio State University, Dept of Physiology and Anesthesiolgy, Columbus, Ohio; Medical Research Assistant investigating respiration physiology. Held full time faculty appointment as a research team member and participant on publications.

Affiliations
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  • Healthcare Information & Management Systems Society,(HIMSS) Central and Southern Ohio Chapter 2001 - 2011; RHIO Liaison 2007 - 2009, Chapter Advocacy Chairman; 200 - 2009, Treasurer/VP 2009 - 2010, President 2010 - 2011
  • HIMSS National Chair RHIO Liaison Roundtable, Advisor to the HIMSS RHIO Steering Committee 2008 - 2009
  • eHealth Ohio/Ohio HIPAA Implementation Organization for EDI, 2002 - 2011; Transactions Testing Site Administrator; 2002 - 2009; President 2006 - 2011
  • Liberty Alliance Health Identity Management SIG/Kantara Initiative Healthcare Identity Assurance Workgroup 2008 - 2011; Co-Chair 2009 - 2011
  • HIMSS RHIO Federation Task Force GSA e-Authentication Pilot 2006 - 2008
  • Health Policy Institute of Ohio, OHHIT Steering Committee; 2005 - 2008

Education
  • The Ohio State University, BS Biophysics
  • Microsoft Certified Systems Administrator (MCSA) training
  • Microsoft BizTalk Server 2000 training
  • AMA Managerial & Team Building Skills for Project Managers
  • HIAA Health Insurance Associate, Insurance Education Program





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