Baumgartner Consulting
Stragetic Planning and Consulting Services…

Over the past 20 years we have filled a wide variety of roles and positions working with Public sector clients. Responsibilities have included systems development, integration, implementation, and management; strategic planning; customer relationship development; budgeting, forecasting, and asset management.

Select Proposal Response Support Project Contributions:

  • Iowa Medicaid Enterprise (IME) Solution Architect responsible for definition of over-all solution and coordination between the COTS sub-contractor’s technical/business support teams during response development - participated in formal pre-submission (Red/Gold Team) review sessions
  • Colorado MMIS Solution Architect responsible for definition of base-line COTS solution and ongoing management of the complete requirements matrix with coordination and input between various sub-contractors - participated in all review sessions and assisted with orals presentation development
  • Maryland HIX – Solution lead for the Health Information Exchange developed to meet the evolving Affordable Care Act (ACA) requirements - Primary areas of focus included COTS sub-contractor interface management, scope definition, and solution component selection
  • Montana MMIS response development – Solution lead and primary author for Operations Management Business Area, proposed as the Account Executive and lead three-day orals presentation of solution
  • Louisiana MMIS response development – Solution lead and primary author for Claims Management, Member Management, and Reference Business Areas
  • New York R-MMIS response development - primary author for Operations Management Business Area, support and technical liaison for other Business Management areas focusing on MITA alignment
  • California MMIS response development - primary author Takeover Approach, managed Systems Test solution development and Turn-over solution development teams, provided solution architect support for non-mainframe systems, and pricing development support

Operational Medicaid experience:

Functioned as the Solutions Architect for the California Medicaid, Denti-Cal (EDS - Delta Dental partnership). Managed the development of the EDS technical response to the Denti-Cal RFP. Acted as primary liaison between Delta Dental business leaders and EDS technical teams to assist in formulating a winning proposal that met or exceeded all technical and business requirements.

Provided Project and Team Leadership for multiple Systems Engineering teams responsible for delivering fixed-priced enhancements to California’s Medicaid systems (Medi-Cal). Projects impacted a wide variety of sub-systems and utilized various technologies including; Client-server, EDI, and BBS applications, networking, and legacy systems.

Responsible for the developing and transitioning new business opportunities from technical sales support to solution delivery. Major efforts include; Long Term Care (LTC) system to process claims and produce encounter data, Treatment Authorization Request for managed care system, and data exchange system and infrastructure accessed via a VPN over the internet.

Operational SCHIP experience:

Functioned as the Systems Director Responsible for ongoing development, enhancements, and maintenance of information systems supporting California’s Children’s Health Initiative Program (SCHIP). Primary systems and services include; eligibility screening, eligibility processing, enrollment processing with 30 health, dental, and vision plans, case maintenance, Annual Eligibility Review, and Open Enrollment.

Responsible for the management and delivery of major system enhancements including; a fully integrated Customer Relationship Management (CRM) solution, Health-e-App integration - the first-in-nation web-based system to enroll children in a public health insurance program, and the Adult Expansion project to include HF coverage for parents or legal guardians of eligible children.

Directed the original implementation of California’s CHIP project utilizing rapid application development (RAD) techniques to address the most immediate business needs first, with subsequent releases meeting the additional functional requirements, as they were defined. This allowed the teams to meet the difficult schedules and deliver the base eligibility solution in only 45 days, while at the same time deal with dynamic requirements and intense speed-to-market necessities.