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HomeSkip Navigation Links > About Us > Project Summaries

Placeholder imageProject Summaries

At Jimenez Consulting Solutions we have had the opportunity to work with clients on exciting and innovative projects.  Alhtough there are many more projects that those represnted below, this will give you examples of the work that we have done.  Click below to learn more:

  • Healthcare
    • Accountable Care Organizations and Clinically Integrated Networks
    • Plans and Payers
    • Providers
  • Higher Education
  • Life Sciences
  • Manufacturing
  • Public Sector
  • Telecommunications

 

Healthcare - Accountable Care Organizations and Clinically Integrated Networks

Clinical Integration IT Strategy, System Selection, and Implementation

Jimenez Consulting Solutions was engaged by a Clinically Integrated Network (CIN) to develop and implement its IT strategy.   This involved evaluating and selecting vendors for its planned Health Information Exchange (HIE), Clinical Data Repository (CDR), Population Health Management (PHM), Secure Texting, Provider Attestation, Referral Management, and Risk Management solutions.  We provided program management, planning, roadmap creation, vendor contract development and negotiation, requirements definition, implementation project management, and test management for the implementations throughout a hospital network and 170+ practices.  This allowed our client to enhance their in-network referrals and increase patient population and risk management as well as internal network communication and collaboration. 

ACO Launch and Operations

JCS was engaged by a Clinically Integrated Network (CIN), that was approved as an Accountable Care  Organization (ACO) to participate in CMS’s Medicare Shared Savings Program (MSSP), to run their daily ACO operations, develop and execute the strategy to report on the CMS-required quality measures, and develop and execute the strategy to incorporate ACO requirements into daily patient care management and the operations of the clinically integrated network.

We continue to oversee monthly processing of Medicare claims data (CCLF), quarterly processing of ACO assigned beneficiary lists, daily enrollment questions, working with tools to optimize ACO operations and incorporate care into the ACO beneficiary population, and report on ACO quality measures against which shared savings are calculated.  We helped our client successfully complete the 2014 quality reporting process and become the only MSSP ACO in Arizona to achieve CMS shared savings in the 2014 performance year.

Learn more about JCS ACO and CIN services                                                                           Top

Healthcare - Plans and Payers

Health Plan Startup

Jimenez Consulting Solutions was engaged in the foundation, ramp up, and implementation of IT and business solutions for Arizona's only health insurance co-op.  We were engaged in every part of the business in defining solutions and/or processes from sales and marketing through marketplace applications and integration, enrollment and reconciliation (individual and group), premium billing and payments, benefit and plan design, provider network operations, claims processing, medical management, customer service,  grievances and appeals, quality management, finance, human resources, accounting, and corporate reporting.

This effort included development of RFPs and RFIs as well as the assessment and selection of a variety of IT vendor partners and solutions to support enrollment, web design and implementation (including member, provider, and broker portals as well as the corporate website), CRM, medical management, electronic banking solutions, call center technologies, data warehouse, human resources, and IT infrastructure.

We served in the following roles during this effort:

  • Interim CTO
  • Strategic Advisor
  • Program Manager (business and IT)
  • Project Manager
  • Business Analyst

Health Plan Enrollment and Member Management Solution

JCS was engaged to design and implement core business processes for an enrollment and membership management platform for an insurance company. The project was an effort to insource membership in an effort to mitigate significant organizational setbacks caused by misalignment between the Insurer and the Vendor. JCS also led the integration efforts with all partners (upstream and downstream). The effort included:

  • Complex data flow management
  • Enrollment transaction processing
  • Membership and Policy management and issue resolution
  • Multiple vendor integration efforts requiring unique custom EDI development including:
    • Billing and payment processor
    • Medical, vision, and pharmacy claims processors
    • Healthcare.gov
    • Multiple online enrollment platforms
    • Prior-authorization partner

Learn more about JCS Health Plan Services                                                                              Top

Healthcare - Providers

Health Information Exchange (HIE)

Jimenez Consulting Solutions (JCS) was engaged to assist in the development of an enterprise strategy to improve interoperability between a hospital system and affiliated community physician groups. The team led focus groups comprised of  community physicians, hospital executives and information technology experts to define strategic, tactical and technical requirements for exchange of health information.  JCS  managed the vendor selection and contracting process between the healthcare organization and a Health Information Exchange (HIE) vendor.  The team also implemented the  HIE  solution at more than ten hospitals in three states. To date, the organization has identified:

  • Savings in labor related to managing calls for copies of reports and medical records
  • Reduction in costs of document production and delivery
  • Increased physician and practice productivity and satisfaction
  • Improvements in the coordination of patient care

Ambulatory Electronic Medical Record Planning

JCS led  design and planning efforts for implementation of an ambulatory electronic medical records system for 40 clinics. The team worked closely with physicians, clinic and hospital executives, and clinic personnel to:

  • Define solution scope
  • Define omplementation strategy
  • Prioritize organizational and functional areas
  • Define interfaces requirements
  • Define project and operational staffing requirements
  • Define governance model
  • Define technical infrastructure
  • Manage overall project cost and budget
  • Develop ambulatory and inpatient clinical documentation integration approach

Charge Description Master Process and Technology       

Jimenez Consulting Solutions (JCS) was engaged by a large regional healthcare organization to lead the vendor selection, planning, and implementation of Charge Description Master (CDM) software tools. The selection process included market research, preparation of an RFP, scoring of responses and ranking of vendors. A benefits analysis was performed which identified opportunities to reduce cost and improve reimbursement. JCS managed both the project and the overall program which included:

  • Process and technology-enabled improvements spanning 42 facilities
  • Integration of 7 different source accounting and billing systems
  • Training hundreds of users
  • Oversight of technology & infrastructure

Cloud Storage

Jimenez Consulting Solutions was engaged to manage the selection and implementation of a cloud storage solution which supported storage, transmission, retrieval, and viewing of digital images from picture archive and communications systems (PACS) for two large hospitals.  Images were automatically moved to fully redundant, geographically remote, backup storage facilities which are DICOM and HIPAA compliant.  Primary storage  consisted of RAID 5 disk array. Secondary storage consisted of a mobile disk array, which was used to provide rapid restoration of the archived data in the event of a disaster incident.

Enterprise Master Patient Index (EMPI) Planning

Jimenez Consulting Solutions led an effort to design and plan the implementation of an Enterprise Master Patient Index (EMPI) system for ambulatory centers affiliated with a hospital so that patient's information could be shared across all entities. The effort included:

  • Review and selection of the proposed EMPI vendor and solution
  • Confirmation of the requirements across the ambulatory clinics and the hospital
  • Definition of the implementation project scope, cost, staffing requirements, and governance model

Community Provider and Faculty Practice Integration

Developed and implemented a plan to integrate private primary care physician practices into a faculty practice in order to increase referrals to specialty clinics.  Activities included:

  • Business case development
  • Practice management system planning and implementation
  • Charge master standardization
  • Workflow redesign

IT Strategy for Ambulatory Surgery Company

A physician owned specialty hospital was seeking to expand by replicating its unique model of care in other geographies.  The organization established a steering committee to assess IT capabilities and make recommendations.  The engagement consisted of:

  • IT strategy - "make or buy"
  • System selection and design
  • Development of IT organization

IT Standardization for University Hospital & Behavioral Health

  • Conducted systems assessment of both organizations
  • Identified synergies and gaps
  • Developed recommendations and business case
  • Developed requirements
  • Designed solution
  • Implemented integrated solution and data warehouse  

Learn more about JCS Healthcare services                                                                               Top

Higher Education

Enterprise Business Requirements Definition

In an effort to to broaden student opportunities within an international university system, grow the knowledge base of the communities it serves, and advance the educational landscape worldwide, JCS led the process to define requirements for a local university that would be later used for a global requirements definition process across multiple international universities.  This process included:

  • Completing a current state review of business process documentation to identify business process improvement recommendations.
  • Developing requirements in support of a future systems selection process and establishing a standard template and level of detail for requirement documentation that was applied in a consistent manner for similar subsequent projects occurring at other subsidiaries outside the United States.
  • Providing project management by developing the detailed project plan, tracking the project budget, issues and risks, and providing weekly status reports.

SOA Strategy and Enterprise Software Evaluation & Selection

Jimenez Consulting Solutions was engaged by a large, global, higher education company to standardize, streamline, and improve their processes as well as define the information technology infrastructure and support for their current subsidiaries.  They also desired to have a standard systems and process architecture in place to more easily and quickly integrate future acquisitions into their business model.  Recognizing that the current systems' landscape would not support this vision because it was unique and varied across each of the four current subsidiaries, JCS was engaged to develop an IT roadmap and perform an enterprise system selection for a dozen core university information systems.

Current State Inventory and Gap Analysis

Jimenez Consulting Solutions (JCS) was engaged to compile and analyze the current state architecture for two universities, one in London and one in the United States.  Additionally, JCS completed a gap analysis identifying important considerations necessary for the move to a standardized future state.  This project included the following activities:

  • Gathered information from business and technical resources related to applications, databases, and interfaces currently in use.  Conducted on-site visits to both universities to hold in-person interviews and system demonstrations.  Gathered and reviewed existing client system documentation.
  • Developed a current state inventory using information gathered from university documentation and SME interviews.
  • Conducted a gap analysis mapping current state applications to future state applications. The gap analysis also provided a detailed description of migration plan actions and considerations.
  • Developed a systems diagram of the current state inventory and logical system architecture for each university.  The diagrams displayed all applications, databases, and interfaces currently in use at each of the two universities.

Major Academic Medical Center Funds Flow and Compensation Alignment

Jimenez Consulting was engaged in the development of a funds flow model, financial model, and compensation planning tools for an academic medical center seeking to change their clinical reimbursement methods and improve faculty compensation and productivity.  JCS consultants:

  • Built comprehensive financial models that supported dozens of variables that forecasted the effects of proposed changes
  • Evaluated and forecasted the impact of proposed clinical compensation and incentive plans for faculty
  • Analyzed financial, compensation, and employee performance data and developed strategies for benchmarking
  • Monitored the impact of the implemented changes and created reports and analysis

Customer & Call Center Technologies

Deployed Siebel Call Center, Siebel Marketing, Siebel Service and other modules to at a leading eLearning company.  Modules deployed included Account and Contact Management, Territory Management, Activities, Opportunity Management and Forecasting, Data Quality, Email Marketing, Workflow, Order and Quote Management, Remote, Products and Product Configuration.  The solution was integrated with the organization's legacy contract management and order management systems. Healthcare Payer

Managed the implementation of a Customer Service Reporting System to analyze multi-channel customer contact data for a national managed care contact center.  The reporting system (Broadbase) captured operational data from a Clarify Customer Service application and other customer channels including interactive voice response (IVR) and web to present a single integrated view of customer interactions.   

Learn more about JCS Higher Education services                                                                      Top

Life Sciences

Clinical Trial Imaging Core Lab

An imaging core lab, looking for cost savings and greater flexibility with their data capture tools and reporting, turned to Jimenez Consulting to develop a custom solution.  JCS consultants:

  • Developed a complex Microsoft® Excel Electronic Data Capture (EDC) tool that provided automatic calculation of outcomes and responses, as well as detailed custom reporting
  • Developed a standalone Microsoft® Access Electronic Data Capture (EDC) tool that also calculated outcomes and responses, in addition to adding security and audit capabilities
  • Created ad-hoc tools for small or non-standard trials for which no tools existed
  • Designed tools with adherence to the FDA’s Title 21 CFR Part 11 guidelines

Learn more about JCS Life Sciences services                                                                            Top

Manufacturing

ERP Selection & Implementation

JCS engaged with a local door manufacturer, which was small, growing rapidly, and preparing to expand nationwide.  They were using various custom MS Access databases for order management and reporting, using QuickBooks to support their accounting processes, and outsourcing their payroll function.  They were also in the initial phases of business out their manufacturing floors and considering the need for a more robust, integrated system to support their expansion.

JCS led the effort to assess, select, and implement an Enterprise Resource Planning (ERP) systems that focused on the following key components:

  • Order Entry and Management
  • Inventory Management
  • Production/Capacity Planning and Scheduling
  • Order Fulfillment
  • Distribution
  • Installation
  • Customer Care
  • Accounting
  • Management Reporting

Distribution Center Application Development

Managed custom development efforts to support the distribution centers of a national health products retailer.  In this effort, we defined requirements and designed, developed, tested, and implemented various custom solutions.  These projects encompassed the order-to-receipt process for goods shipped to the distribution centers and then shipped from the distribution centers to retail stores.

Learn more about JCS Manufacturing services                                                                          Top

Public Sector

HITECH Planning

Jimenez Consulting Solutions (JCS) assisted the State of Arizona's directors of AHCCCS and medical informatics with its PACeHR program.  Activities included:

  • Requirements definition
  • Development of EHR Request for Proposal (RFP) and evaluation tools
  • Management of selection and contracting processes
  • Development of an HIT Strategic Plan

Learn more about JCS Public Sector services                                                                            Top

Telecommunications

High Definition Video Conferencing

Jimenez Consulting Solutions was engaged large healthcare network to manage the effort to implement a High-Definition Video Conferencing (HDVC) solution across five (5) of their corporate offices in order to decrease travel costs.  This involved interacting with executive level management, coordinating with the technical resources, managing all issues and resolutions, and implementing the complex solution across facilities.

Call Center Technologies Implementation

Engaged by a large cable/broadband provider to lead a call center integration program the goal of which was to improve customer service. The scope of the project included Interactive Voice Response (IVR), Automated Call Distributor (ACD), Computer Telephony Integration (CTI) Middleware, Predictive Dialer, and front-end applications which automated screen pops.  The team was comprised of corporate and regional clients and several vendors.

Subscriber Management System Selection and Implementation

Managed the software selection process for a billing and subscriber management sustem to support multiple products and services in several call centers for a large broadband provider.  This effort included validating and enhance business, functional, technical, and organizational requirements, developing an RFP, gathering key vendor information, assessing scripted demos, conducting site vists, consolidating findings, and providing a recommendation to the client. Subsequently managed integration and implementation activities for the initial implementation in a 300-seat call center.  The implementation effort included configuring the solution, defining modicfications, defining interfaces, converting data, testing the application, and rolling out the solution.

Learn more about JCS Telecommunications services                                                                 Top

 


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