339-364-1610 RDUGGAN@STANDARDSBASEDCONSULTING.COM Bob Duggan is a versatile, hands-on Insurance Executive and IT Project Manager with over 20 years of diverse experience across the P&C insurance and health care industries. He is a skilled manager and problem solver with expertise in the development, implementation and support of insurance applications across a variety of platforms and technologies. He is especially strong at utilizing insurance data standards such as ACORD AL3, ACORD XML and HICFA 735 to streamline processes and cut costs. Bob has presented at the annual ACORD Conference and was a founding member of the IIABA Agents Counsel on Technology. His insurance experience covers P&C Personal Lines, Workers Compensation, along with Life & Disability. Bob has held senior level line management positions in Information Technology, Marketing and Casualty Claims. Additionally Bob has serviced the insurance industry as a management consultant. Bob healthcare experience encompasses the management of a no-fault auto medical claims division with a Northeast based auto insurance carrier as well as serving as the VP of Operations and COO for a New England based medical cost containment company. Bob is well respected within the insurance industry and has a great rapport with clients and co-workers alike. He is a leader who can be depended upon to take charge of a project to ensure it is completed on-time, on-budget with a high degree of quality and customer satisfaction. Insurance & Healthcare Professional Experience Professional Summary Executive / IT Project Manager Personal Lines 19 years Commercial Lines 19 years Workers Comp 3 years Life and Disability 1 year Healthcare 5 years Policy Admin, Rating, Billing Agency Management & Policy Download Extensive Claims experience Litigation Management Medical Cost Containment Medical Billing Managed Care experience Catastrophe Planning Management Data Conversions, Interfaces, ISO System Architecture Web Services & Vendor Integration Custom SW development/implementation Packaged SW selection/implementation Mail Distribution & Order Fulfillment Forms and Reports Business Process Redesign Product Development Budgeting & Forecasting P &L Management, ROI, & Pricing Strategies Mentoring & Professional Development CSC, CGI, Guidewire, Inspire, Agency Portal, Applied, Vertafore, WinRater, Ingenix, Fair-Pay, Mitchell, Vector Standards Based Consulting LLC Northeast US 2010 2011 Principal Consultant Served as the Lead Analyst and also provided Technical Analyst support for the design of a marketing portal for a personal lines carrier in Massachusetts. Conducted one-on-one user interviews and led numerous sessions with marketing and product management to elicit the business requirements related to the on-line delivery of product manuals and commission reports. StandardsBasedConsulting.com Page 1 of 6
BMEGateway Northeast US 2008 2010 Vice President of Operations Provided operational leadership and domain knowledge to staff of 4 directors and 50 staff for this medical cost containment organization. Had P&L responsibility for $12 million in revenue and a $2.7 million budget. Managed the day-to-day delivery of medical cost containment services to the P&C personal auto, commercial auto, and workers compensation marketplace. Services included independent medical exams, peer reviews, medical training, and physician testimony and managed care services. Ensured staff was versed in Workers Compensation, No-Fault Auto and Liability Claim case law as it pertained to IME, Peer Review and other medical cost containment services. Of especial importance were Medical Bill Review Case Law, NY WC Regulations, MA & NY No-Fault Statutes, NJ Decision Point Review and PA No-Fault Act 6. Managed the expansion into the Life & Disability Insurance marketplace. Product offering included disability and life medical reviews and a three level pharmacy review program. Wrote business plans and sales brochures. Managed the Medical Bill Review product offering. Expert in Ingenix data and PPO (preferred provider network) usage. Product included First and Third Party Record Reviews. Managed outsourced system environment. Implemented vision to improve customer integration and increase market share. Served as Project Manager for infrastructure upgrade which included server hardware, security, telecommunications lines and backup plan. Employed vendor partners to execute Windows Server and database upgrades. Directed the creation of test plans for business applications. Directed the design and implementation of an XML Web Service to fully automate the referral process with the company s largest customer. Acted as Project Manager to personally design the web service and a corresponding point-of-sale customer portal. Responsible for working with Sales Representatives to respond to pricing requests and Requests for Proposals (RFPs). Led consulting engagements. Engaged in client meetings and sales presentations. Managed the Physician Recruiting and Credentialing process. Negotiated rates with physicians and physician groups. Negotiated service contracts with clients and service providers. CGI Inc. Northeast US 2007 2008 Director of Consulting Directed business development strategy for multi-state, multi-line P&C insurance software and service suite targeted at CGI's $40 million MassAuto Business Process Outsourcing business. Developed and documented detailed product plan for the CGI large carrier insurance product suite. StandardsBasedConsulting.com Page 2 of 6
Served as Engagement Leader for a proposal to outsource an enterprise premium billing and collections system for a large northeast based multi-line insurance company. Proposed two scenarios, a custom designed software solution and the implementation of the Guidewire Billing System. Led JAD sessions and requirement gathering process. Championed the creation of an ACORD XML rating service product offering. Acted as the Project Manager for the implementation of the rating service with various agency rating software vendors. Safety Insurance Northeast US 1992 2007 Director of Claims Operations 2003 2007 Reported to the CIO and the VP of Claims in a matrix-managed organization to lead various Claims Division Projects for both personal and commercial auto business lines. Responsible for managing a $200 million claims reserve and a $2.1 million budget. Served as Project Manager for the the end-to-end re-engineering of the Casualty Claims business processes subsequent to company IPO. Directed the design and implementation of business intelligence and work flow systems to control bodily injury claim evaluation and pricing. Cut claim settlement and expense payments by 10% over three years. Directed the re-engineering of the Personal Injury Protection no-fault medical claim process. Implemented a web hosted imaging system to streamline the medical cost containment process. Outsourced the medical bill re-pricing process to a service provider. Championed and designed an automated claim file review system that integrated management file reviews with adjuster performance criteria. Acted as Project Manager for the design and implementation of an automated appraisal assignment system targeted at the company s independent appraisal partners. Created a fully electronic system that reduced repair cycle time by a full 4 days. Led the effort to create a browser based Claims Management Dashboard that allowed for the ad-hoc review of operational claim data. Acted as Project Manager for the review and selection of a Third Party Administrator to handle the company s national claims needs. Analyzed proposals and managed vendor implementation. Led the company s Catastrophe Planning process. Implemented a third party loss reporting vendor, designed web site and agent training literature. Championed an ACORD AL3 integration module to integrate with vendor partners. Interfaced with the various regulatory bodies for the annual claim and data reporting audits. Responded to audits. Safety consistently received high grades on its regulatory audits. StandardsBasedConsulting.com Page 3 of 6
Director of Agency Systems Delivery 2002 2003 Reported to the VP of Marketing to lead a staff of 6 account representatives to introduce and train Safety s 625 independent agencies on company systems and corresponding operational procedures. Expert on Independent Agency operations. Managed the delivery of web-based CRM systems to Safety's 625 contracted agencies. Defined requirements and implemented applications. System included management reporting, pointof-sale rating & policy processing, ACORD XML & AL3 policy download and claim reporting procedures. Interfaced with Applied Systems, AMS/Vertafore and other agency management systems. Represented Safety at the annual ACORD Conference and other regional conferences. Also represented the company on the IIABA Agents Counsel on Technology and the Insurance Technology Coalition. Information Systems Director 1999 2002 Reported directly to CIO to lead 40-member system team and $9.5 million budget that included work flow process consulting, application development, application outsourcing, telecommunications, mail services and customer relationship management. Managed numerous systems projects on multiple platforms. Set development priorities and managed the system development life cycle (SDLC) for various systems initiatives. Directed service provider relationships related to the procurement and delivery of various business applications. Served as Project Manager for the creation and ongoing operation of 525 node telecommunications network to provide free internet access to Safety s independent agent channel. Managed the vendor relationship with Verizon to maintain network. Acted as Project Manager to outsource the development of a web-based industry standard (ACORD AL3 & XML) point of sale application, e-power Express to CSC. Transferred 99% of new business and policy change processing requests to Safety's web site within 1-year of application rollout. Enabled the company to grow by 100% in 30 months without adding staff. Managed the mail services process for the company. Outsourced billing, claims and underwriting correspondence to vendor partners. Implemented online forms management solutions targeted at independent agents. Championed and managed the development of a business intelligence application called E-View. Concept was to replace all agent correspondence with transactional data. Information Systems Manager 1992 1999 Led staff of 10 project managers and business analysts on various personal and commercial lines projects. Served as the Project Manager and Business Analyst on a project to select a new Policy Administration system for its personal and commercial auto lines of business. Worked with key StandardsBasedConsulting.com Page 4 of 6
stakeholders to identify potential gaps and conversion strategy. Negotiated and managed outsourcing relationship on an ongoing basis. Managed the data conversion effort, including custom conversion programs. Managed the vendor developers in creating hundreds of forms and reports. Developed AL3 Agency Download Software. Worked directly with agency management system vendors to certify and implement solution. Worked with the corporate training department to utilize a train the trainer approach. Established a central training room and managed the training effort. Provided post-implementation support, resolved issues, and revised procedure documents. Acted as Project Manager and led the design process for an enterprise billing system enhancement. Led JAD sessions to identify current and future needs. Resulted in fully configurable custom billing system. Billing software maintenance was cut by 95%. Acted as Business Analyst for the design of rating modules for affinity group rating. Led the users through JAD sessions to identify key rating issues. Developed rate maintenance tables and integrated with the Policy Administration system. Served as Project Manager for the development and implementation of client server based Homeowner and Commercial Auto Rating Software. Included the integration with Marshall Swift/Boeckh. Managed the custom development team through detailed design, programming, unit testing, system testing, integration testing with the existing policy management system, and user acceptance testing. The team consisted of client IT personnel, and several independent contractors in multiple locations. Led the periodic technical product management process to incorporate regulatory and product development components into the rating software. Interfaced with ISO and local regulatory agencies. Other Professional Experience Independent Consultant DaVinci Group Medford, MA IT Consulting Independent Consultant Integre International Wayland, MA IT Consulting Project Manager Pioneer Investments Boston, MA Investments Accounting Supervisor Pioneer Investments Boston, MA Investments Staff Accountant Bank of Boston (Bank of America) Boston, MA Banking StandardsBasedConsulting.com Page 5 of 6
Systems and Software Experience Insurance Systems: Languages: Environments/Tools: Databases: Methodologies: Project Management: Insurance Standards: Miscellaneous: Custom Development of Policy, Billing and Claims Administration Systems, CSC (PMSC), Guidewire (Billing) CGI (Edge, & Ratabase), Inspire, ChoicePoint, ISO Claim Reporting, Marshall & Swift /Boeckh, Xactimate, CCC Pathways, IVANS Transformation Station, Applied, Vertafore, Ingenix, Mitchell XML, HTML,.NET, Java, JavaScript, C~, Visual Basic, MS Access, DB2, SQL, COBOL II, RPG Web, Windows, Client/Server, i5 (AS/400), Unix, WebSphere, MVS/ESA, OS/390, VM/SP, CICS, i5/os (OS/400), J2EE, Microsoft Office suite, SharePoint, Crystal Reports, Workflow, CRM, Call Center, EDI DB2, SQL Server, MS Access Agile, RUP (Rational Unified Process), UML (Unified Modeling Language), Waterfall, JAR, JAD, Six Sigma, BPR MS Project, MS Visio, Project Workbench, Drupal Wiki ACORD AL3, ACORD XML, ISO, HCFA 1500, HCFA 735, CPT 2010, ICD- 10 Sarbanes-Oxley, OFAC, MA 201 CMR 17.00: Standards for the Protection of Personal Information of Residents of the Commonwealth, and HIPAA Credentials MBA Suffolk University 1994 BS Westfield State University 1985 StandardsBasedConsulting.com Page 6 of 6