Management Data

Shouqiang (Frank) Wang, PMP

(System Vice President, Decision Support Analytics, Health First Health Systems)

**** ****** *****, *********, ** 32955 Cell: 412-***-**** E-mail: actnhx@r.postjobfree.com

Strategic executive with success in providing exceptional strategy management and technical thought leadership in the areas of consulting and advisory, EMR implementation, data warehousing and BI, actuarial predictive modeling and Analytics, early warning & prevention, Healthcare IT management, HIE, population health management, Adjustment Risk actuarial analytics, Contract & Network management, System Integration.

Education

Carnegie Mellon University, Pittsburgh PA Heinz School, Master of Science in Information Technology

Specialties

Information Technology, System Integration, Information Security, Internet Architecture, Identity Management, Federated Identity, risk management, information systems, Security Policy, Public Policy, Online Fraud, Healthcare Analytics, Population Health Management, Application Development and Implementation, Program Management.

Professionals Summary

A technical executive with a big picture perspective and focus on execution, senior technical executive who has partnered with business executives for over 20 years to solve business challenges by leveraging technology solutions. A strong technical and operational background with proven success delivering and maintaining systems solutions in a variety of industries including: healthcare payer and provider, managed care and healthcare insurance organizations, financial, software product development and support organizations, Healthcare IT consulting. Consistently recognized for the unique balance of technical and business process knowledge to drive decisions, add value and support the mission of the business with hands-on working experiences in healthcare analytics, data warehousing, clinical business intelligence, data modeling & integration, actuarial risk analysis and predictive analytics.

20+ years of experience in IT/IS strategy management and data driven healthcare solution implementation

15+ years of design and development healthcare analytical Healthcare Information Systems, BI reporting and Enterprise Analytics system and EMR implementation.

Provide strategic direction and support to clinics, physicians and staff along with budgetary compliance, human resource management, and quality improvement initiatives.

Planning, delivering, and supporting clinical, research, financial, and analytical systems to support large integrated health care and hospital systems in UPMC hospitals, UPMC Heath Plan, Cancer Centers, and treatment facilities.

Set up strategy for Healthcare Analytics and build data warehouse with clear vision to support current and future business growth needs in business intelligence

Leading corporate wide effective project and program management and business process improvement initiatives.

Provide vision and leadership in developing and implementing patient care information technology initiatives

Strategic technology planning, execution, and policy development in enterprise wide systems including SAP, SAS, Cognos, SSIS and other major tools to build OLAP cubes and subject data marts. Accountability for optimizing operational functions of network strategies and development for the hospital.

Hands on experiences working on the insurance payer industry, including the commercial insurance, MediCare, MediCaid/CHIP insurance policies.

Set up strategy to build the Pharmacy Analytics programs including drug usage and outcome analytics, clinical trials management, population health management, etc.

Lead continuous quality improvement (CQI) utilizing the Lean, Six Sigma, CMMI, and other TQM approaches to further improve care quality and foster the data driven Quality Improvement process.

Lead the initiative to establish DW/BI vision and strategy for a platform to support clinical and business services through adopting innovative technologies in healthcare industry: built and implemented the re-admission risk prediction system, hospital infection early detection and alert system, clinical outcome visualization, etc. Ensure adherence to policies and incorporate services within the strategic priorities of the organization.

Utilizes combination of healthcare IT knowledge, technical expertise, and business acumen to provide strategic guidance and direction across the organization to meet the big data challenges, and move to the data driven decision making process via building analytical systems.

Support the Managed Care payer decision system for adjusted risk pricing models, risk contracting and strategies to ensure contract optimization. Developed solutions to ensure practices optimize the value of their managed care contracts including tiered drug fee schedules, value-based contracts, risk contracts and preferred provider agreements.

Leadership in architecting and utilizing innovative technologies to meet big data challenges.

Working experiences of implementing the CMMI process, quality and process performance improvement

Promote and oversee strategic relationships between internal IT resources, vendors and partner organizations, including the state and government health care management, and healthcare policy advisory and to maintain awareness of market conditions, the competitive landscape,services, and industry trends

15+ combined years working experiences in EMR systems including Cerner, EPIC and ARIA clinical analysis and reporting application development and implementation.

Keeps abreast of government regulations applicable to systems operations and ensures corporate compliance.

Notable Achievements

Build and create the insurance payer data warehouse, including the mental behavior health, to support the payer side analytical decision support.

Advisory to PA state health department to influence the policy making and process re-engineering to provide higher quality healthcare service and insurance coverage with the target budget.

Implemented the Healthcare eCommerce to provide patient care and consulting to extended patient profile utilizing TeleMedicine, online visit, patient-physician portal, etc.

Integrate the 3rd party application into Cerner system to build the foundation to support predictive analytics and also provide the quick snap shot for seeing a patient current health status.

Implemented the architect of UPMC Cancer Centers revenue cycle management system and data driven billing strategy to improve the revenue by 30%.

Built and implemented the UPMC Cancer Centers data architecting and the financial analytical management system to reconcile daily claim, billing records with the payments associated to provide timely processed information for decision support utilizing all the core UPMC systems including EPIC, MediPac, Cerner, ARIA, Lantis, Cirius, VIS, etc.

Implemented the Healthcare Payer analytics system in UPMC Community Care in UPMC Health Plan and built the architect of healthcare insurance data analytical processing system supported by data warehousing in Community Care in UPMC Health Plan utilizing the MC400, PshyConsult, etc.

Advisory to PA DPW to set up the IT strategy and healthcare policy & regulation implementation supported by IT initiatives including the design, developed system to support the management of PA CHIP, PA FIDM and AdultBasic programs from application assessment to audit and reporting of the claim data from insurance providers.

Implement and customize EMR systems and implemented in the inpatient hospitals and outpatient facilities.

Built and Implemented research data analytical system to support all tiers of clinical and pharmaceutical research activities.

Build and implemented the predictive analytical modeling to support population economic analysis, re-admission risk management, clinical outcome analytics, hospital infection early detection and alert system to guide the decision making process in both provider side and the payer side.

Certification

-PMP® (ID#: 2676486E1)

-Cognos BI Development programming

-SAP BI and Analytical Design & reporting

-Cerner EMR, CCL application configuration and development

-SAS DI and Analytics

-Business Object (BOXI) admin and report

-Data Visualization - QlikView

-ISO Quality Auditor

Membership

-HIMSS member (700557003)

Volunteer Experiences

-Director of Newsletters in PMI Long Island Chapter (May, 2014 to May, 2015)

-Board member of Long Island School of Chinese (May, 2014 to May, 2015)

Professional Experiences

Health-First Health Systems (Orlando, FL) May, 2015 – Present

System Vice President, Decision Support Analytics (May, 2015 – Present)

Health First is Central Florida's only fully integrated health system. Health First with $1.3B revenue offers the latest technological advances and quality care at four hospitals and through many Outpatient & Wellness Services, as well as the area's only Trauma and Heart Centers. Health First also offers multiple commercial and Medicare health plans.

Provide leadership to Health-First in system integration, program management, information technology and information system, healthcare analytics, data integration and predictive analytics to transform the care delivery model to value based purchase. Lead the organization in data governance, data quality, and Business Intelligence. Provide the vision for building the integrated data system to support the integrated delivery network.

North Shore-LIJ Health Systems (New York, NY) May, 2014 – Apr, 2015

AVP, Healthcare Analytics (May, 2014 – Apr, 2015)

Provide both management and technical leadership in building the Enterprise Data Warehouse and healthcare analytics to support population health management, risk stratification, clinical trial management, and outcome analysis.

Manage the Data Integration and analytics program with the funding of $40M for 4 years from 2014.

Provide leadership in enterprise data warehousing.

Manage the relationship with the vendors.

Build expertise internally and set up the strategies for adopting new solutions in the organization

Oversee the project and program management in the data warehousing and data analytics.

University of Pittsburgh Medical Center (UPMC) (Pittsburgh, PA) March, 2005 – June, 2014

Director of Healthcare Analytics (March, 2012-June, 2014)

Cerner EMR system implementation and customization with addition of innovative analytical functions

Revenue Cycle analytical management – population economic, insurance management, outreach strategy set up, physician contract review and performance management. Utilization smart management system, drug margin management, revenue prediction, and benchmarking with other hospitals to improve.

Set up the vision and strategy for IT functions focusing on the data warehouse, reporting, BI and predictive analytics

Lead the Lean, Six Sigma, and other TQM approaches to further improve clinical care quality and foster the analytical data driven Quality Improvement activities.

Leading integrated delivery system Cerner EDW with over two dozen acute care hospitals to build the analytical ODS system focused data repository to support the clinical and business, and life science analytics needs.

Implemented the financial reporting system and implemented the financial forecasting systems utilizing the predictive analytical models.

Partner with clinical and business team including the Product Management and Service Delivery to communicate technology product enhancements critical to delivering solutions values.

Built and implemented the innovative analytical systems including re-admission risk prediction system, hospital infection early detection and alert system, clinical outcome visualization, etc.

Build and lead a team to develop health care actuarial predictive modeling systems and implement the systems in the healthcare delivery platforms.

Provide solution-specific advisory and thought leadership SME support to clinical units and business teams and Service Delivery teams as part of business opportunity development and complex implementations.

Lead the PHIS/PHIS+ and CHIPRA grant research programs with the funding amount $1.5M and provide the analytic and data mining services.

Project Director of Data Warehouse and Analytics (Jan, 2012 – Mar, 2012)

Manage and lead the innovative healthcare initiatives utilizing predictive modeling

Set up the strategy for health care BPM road map to further improve process & clinical workflow the efficiency.

Created the physician performance metrics and help to improve the performance of care and revenue cycle.

Reporting and data analysis using EPIC Clarity

Created the predictive data model for Pediatric Analysis, and early warning system.

Designed, built and managed the Pediatric data warehouse and the applications for mining, analyzing the data to provide the timely information for decision making.

Convert the data warehouse platform from Cerner Power Insight to physical data warehouse.

Applications Development Manager (Feb, 2010 – Jan, 2012)

Manage the clinical application development division include Web team, programming, DBAs, Server admin functions to automate the clinical workflow

Created the Cancer Centers data warehouse and modeled the data structure to support clinical analytics and trail management.

Implemented the agile SDLC approach and the CMMI

Created reports and data analysis using the EPIC Clarity data

Designed and created variety of data driven applications and analytical application including on-line schedule and appointment, nursing workload analysis and management, mobile patient treatment and service guide

Built the Online marketing and advertisement optimization and outcome analysis

Created the analytical Revenue Cycle intelligent system by automating the ETL process to integrate multi data sources including MediPac, EPIC, Cerner, Aria, treasure System (VIS) and a variety of scheduling systems.

Built the Executive decision support Dashboard to include the core KPIs

Built and implemented the data analytical system to support the three tires of clinical and pharmaceutical research activities.

Built the Cognos team and guide the team to provide analytical reporting & Business Intelligence

Created the enterprise architect of Cancer Centers’ information architecture

Built the Cancer Centers’ financial report systems

Evaluate the Oncology EMR system vendors and implemented the interface with billing system

Lead the RFP process for new EMR system focusing on assessing the application functions

Data Warehousing Applications manager (Jan, 2008 – Feb, 2010)

Set up DW/BI strategy for Insurance Analytics and predictive modeling.

Implemented the platform to cover the regulatory reporting including the HEDIS.

Lead a team to build systems to improve member engagement outcomes focusing on quality metrics, preventive health, condition management, clinical monitoring, adherence, risk assessment, wellness programs.

Build the insurance analytics team and mentor the team to grow in DW/BI, predictive modeling and actuarial analytics.

Created Managed Care payer analytics system to provide the decision support.

Created the population health system to support outreach.

Built the physician outcome measurement system to support audit, contract management.

Built the payer data warehousing team and created the payer data warehouse for the insurer of CCBH

Built the clinical analytical reports and programs including population economics, fraud analysis, pricing scenario analysis, etc.

Built an Analytical BI system for Managed Care management

Created the SAS analytical applications and SAS DI process to refresh and load payer data

Adopted the CMMI process in the Quality Assurance

Senior Programmer (Mar, 2005 - Jan, 2008)

Created reports using CCL programming tool in the areas of FirstNet, SurgiNet, CareMobile & Careadmin, iVew, PowerChart Office, PowerForm, CareNet, PharmNet, ChargeNet, MAR, etc

Automated the donor and recipient matching processing in UPMC transplant center to improve the matching efficiency and accuracy.

Created reports and programs for SmartTemplates, Meaningfull use, regulatory reporting, etc

Built the interface from Cerner ChargeNet to billing system to support the revenue cycle process. Created the automated audit programs to ensure the items are billing correctly and timely.

Worked in the each step of the process in cerner configuration and implementation, QA and testing.

Deloitte (Pittsburgh, PA) July, 2001 – March, 2005

Strategy Management, Application System Architect, Healthcare BI system design

Work closely with clients focusing on clinical care outcome improvement- improve care delivery by creating incentives for both providers and members and develop the solutions to help providers and members to be better connected timely and securely.

Lead cross-functional teams to design and drive the overall health insurance solution set that best resonates with our clients in support of CHIP, Medicare, Commercial and Medicaid markets.

Provide advisory services to clients as a subject matter expert (SME).

Work with Department of Public of Welfare (DPW) application for PA Department of Public Welfare to review health policy and manage the strategy of Healthcare eligibility review/management & health insurance claim management and audit, mainly responsible for the application system architect design, application development, data security, Design and Development, operation support and the whole SDLC including the CMMI process.

Health plan business model strategy advisory - help a client to create organizational strategies for addressing the reform and market shift; help to identify the opportunity to growth revenue and explore ways to reduce cost and improve clinical outcomes.

Work with PA DPW to manage the process of data matching system for a national financial institution responsible for the Design and Development, Database Architecture, and System Design Methodologies, including the CMMI process.

Healthcare organization process improvement consulting to help clients to further improve administration efficiency. Work closely with clients to improve organization to lower cost from workflow enhancement, utilization optimization, efficient billing, claims and new technologies adoption.

Work with PA DPW to set up the strategy to manage the CHIP program in PA state and built the process and applications to help the collaboration with the healthcare insurance providers to manage the CHIP implementation in the state. Helped DPW in setting up the process to manage the claims, monitor the performance and find room to improve the CHIP program.

Work with 30+ healthcare insurance provider to build the state health CHIP insurance program and implement the program.

Ericsson Co August, 1994- August, 1999

Director of IT

Manage the client and account relation;

Influence the policy and build the strategic cooperation with the telecom accounts

Provide the technical support to the clients in Asia region.

Interacts with both internal and external clients to evaluate and implement information system infrastructures designed to achieve more productive, efficient and valuable use of information resources within the organization.

Prepares and manages annual departmental capital and operational budgets; advises other organizational departments regarding IT-related budgetary

Oversees and evaluates system security and backup procedures.

Senior IT Manager

Managed the IT team to provide LAN Administration, Data and Network management, and Windows NT Administration to the 3000+ users in the Ericsson firms in Asia region.

Responsible for the Operations and Technical support and budgeting planning and IT management.

Designed and implemented the firm’s WAN and LAN networking which covers 28 sites

Managed an IT call center to provide technical support to the users focusing on the MS Office Product Suite.

Managed an application team to fix application issues and manage releases of the applications which included data of inventory, sales/marketing, employee information, reporting

Training, support and troubling shooting.

Designed/Implemented the corporate LAN & WAN infrastructure to support 1000+ users.

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