H. Winston Pirtle, Jr

Over twenty-nine (29) years of experience in healthcare systems analysis and implementation. Skilled at providing business value and improving systems performance through analysis and efficient systems design in complex operating environments. With knowledge of numerous health payer systems, draws on considerable experience with numerous vendor and client developed software packages to successfully integrate technology solutions for all core health plan functions including provider management and contracting, enrollment, medical management, health product configuration, claims processing, financial applications and data warehousing.  Implementation Program and Project Management and SDLC management is a specialty. Adept at leading teams through complex implementation and integration planning along with issues resolution that result in efficient system design and business processes. Expert in SDLC methodologies including Agile, Waterfall and mixed approaches. Expert in technological support for governmental plans including enrollment, provider network and encounter processing to support compliance. 

Experience

  • Supported a project that was one pillar of a full core systems transformation due to an acquisition of a Medicaid health plan
  • Provided Project Management for ICD-10 system configuration readiness
  • Functioned as Program Manager and Consultant for System Build and Readiness
  • Provided support as a Senior / Lead Application Configuration and Business Consultant
  • Served in many roles across a health plan in the south as an employee, including Financial Analytical Services, Product Analyst, and claim utilization analysis

Qualifications

  • Healthcare System Analysis and Implementation
  • Program and Project Management
  • 29 years of healthcare experience 

Education

  • Bachelor of Science in Accounting, Auburn University, Auburn, AL
  • Bachelor of Science, Health Administration, Indiana University