Global Health Sector Leader, EY
Jim has over 32 years of experience in the health care/health insurance industry, ranging from full life-cycle systems development through capacity planning, implementation, maintenance, and operations. He has extensive experience managing the design, development, and installation of the industry’s leading Managed Health Care packages.
Jim’s experience includes large scale business transformation for all aspects of health plan organizations including claim adjudication, membership, billing, ID cards, coordination of benefits, provider, capitation, dental, explanation of benefits, EDI, provider payments, risk pools, new product definition, benefit plans, accounts payable, general ledger, eligibility, enrollment, claims inquiry, retail sales, and pharmacy.
Jim’s professional background includes health plan operations prior to entering the consulting profession. For over a decade, he held various management positions with health plans. Jim has lead Information Technology, Claims, Membership, Billing, Call Center, Enrollment, Provider Relations, Vender Management, Mail Room Operations and managed a major product line for a leading vendor of health plan software.
Jim earned a BS in Computer Science and Business Administration from Mount Union College.