Jeffrey Sekera
Groton,MA
Summary
Professional with strong background in product management, and usability ready to drive innovation and achieve strategic goals. Skilled in agile methodologies, market analysis, and stakeholder communication. Known for fostering team collaboration and adapting to dynamic environments. Consistently focused on delivering high-quality results and meeting business objectives.
Overview
28
28
years of professional experience
Work History
Sr. Product Owner: TruCare Cloud UM Rulesets and UM Automation
Cetnene
09.2018 - Current
- Responsible for vision, roadmap, and delivery of custom enterprise automation rules engines and algorithms.
- These products serve to augment human UM workflows by cleaning and updating authorizations entering the system, freeing up human focus for more complex evaluations.
- Managed Rulesets: 7
- Evaluation Algorithms: 6
- Delivered Value Highlights:
- Automation to Reduce Human Effort for UM Intake: Automated data correction, and real-time auth required/not required info., and eliminated duplicate entries, for all auths entering the system. (47 plans)
- Automation to Aid Complex UM Processes: Auto-approvals implemented for qualifying authorizations, automated auth splitting logic, real-time vendor routing logic. (Across 5 plans)
- Regulatory Compliance: Delivered a ruleset to calculate regulatory due dates (CMS, NCQA, State) by auth, by line item, ensuring prioritization of work and compliance for completion. (Across 5 plans)
- Delivered a Common Experience for Improved Ruleset Maintenance (5 rulesets):
- Sandbox-Style Editing: A protected environment where users can edit and verify rules.
- Simulated Testing: Enables users to test and validate rules in the sandbox before promoting them.
- Gated Validation Workflow: A multi-step validation and approval workflow ensures compliance.
- Automatic Workflow When Linked Resources Change: When outside data is modified, all rules that use it are moved into the approval workflow.
- Savings Examples:
- Auth Required Dataset: Reduced rule maintenance cost from 1.4M/ year to 100K/year.
- Auto Approval Rules: Reduced setup time from 72+ hours to 4 hours /plan.
- Enabled Real-Time Changes: Sandbox and workflow enable emergency changes in minutes.
Product Management Consultant
naviHealth
09.2017 - 05.2018
- Successfully designed and delivered blueprint for modular widget-based KPI dashboard (BPCI) for implementing widgets, shortening delivery time, and enabling drag-and-drop configuration.
Agile Product Management Consultant
AIG
02.2017 - 07.2017
- Drove process improvement in the policy admin system and agile adoption through pain point discovery.
- Devised a system to capture pain points leveraging Tee-Shirt sizing, to facilitate elicitation and improve user buy-in on the final solution.
Product Owner / Analyst
SPH Analytics
11.2015 - 12.2016
- Delivered blueprint and designs for multi-tenant PQRS / QCDR Clinical Provider dashboard & CMS reporting solution.
User Experience Design Manager
Allscripts
06.2015 - 11.2015
- Designed and delivered a multi-tenant solution for QMD a non-regulatory measures, provider dashboard from the ground-up in eight weeks.
Expert Business Analyst: Usability
Allscripts
08.2013 - 06.2015
- Designed and delivered:
- A modular system to capture state regulatory reporting linked to 837 output.
- A hot-key system enabling Sunrise Financial Manager users to program direct links to any area in the app.
- Designed and delivered integrated experience Sunrise financial manager user interface.
Senior Usability Product Manager
Allscripts
03.2008 - 08.2013
- Conceived and delivered a fully re-architected 2nd generation UI for patient flow application in 18 months.
- Drove voice of customer collaboration beta with six hospitals to design and deliver.
- Delivered hospital electronic bedboard: A census view for real-time status on all units, beds, and patients.
- Designed Smartphone APP, IVR replacement, Smartphone APP, Nurse/Unit dashboard.
Owner
jellyhat.com
01.2002 - 01.2008
- Designed and delivered innovative marketing campaigns and online solutions.
- Clients: Disney, ESPN, Versus (OLN), CINTAS, United Way, and Web.com.
Design Director
Outpost.com (Cyberian Outpost Inc.)
01.1997 - 01.2002
- Managed design and content group (~ 20 people)
- Successfully designed and launched 1st , 2nd, and 3rd generation award-winning websites
- Enabled growth from one to seven lines of business (B2C and B2B)
- Pivotal in taking the company public with a 4-year growth from $500k annual sales to $350M+ annual sales
- Responsible for all digital content, digital and print advertisement campaigns
Education
Executive Certificate - Business Analysis
John Cook School of Business at Saint Louis University
01.2014
BFA -
Tufts University
Medford, MA01.1992
Skills
- Product Management
- Communication
- Customer Centric
- Strategy & Roadmapping
- Leadership & Team building
- Technically minded
- Healthcare Domain Knowledge
- Utilization Management (UM) workflow
- Care Management (CM) workflow
- Post-Acute Care Coordination and BPCI reporting
- Analytics for CMS measures based reporting (PQRS/QCDR)
Blog
https://interactiveconversation.wordpress.com/
Timeline
Sr. Product Owner: TruCare Cloud UM Rulesets and UM Automation
Cetnene
09.2018 - Current
Product Management Consultant
naviHealth
09.2017 - 05.2018
Agile Product Management Consultant
AIG
02.2017 - 07.2017
Product Owner / Analyst
SPH Analytics
11.2015 - 12.2016
User Experience Design Manager
Allscripts
06.2015 - 11.2015
Expert Business Analyst: Usability
Allscripts
08.2013 - 06.2015
Senior Usability Product Manager
Allscripts
03.2008 - 08.2013
Owner
jellyhat.com
01.2002 - 01.2008
Design Director
Outpost.com (Cyberian Outpost Inc.)
01.1997 - 01.2002
Executive Certificate - Business Analysis
John Cook School of Business at Saint Louis University
BFA -
Tufts University
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