Kim Demichele
Healthcare Payer IT Delivery Leader | PMP, ICAgile Certified Product Owner | 15 Years Payer Systems, Migration, and Platform Modernization”
- Role
- Healthrules Payor Implementation and Optimization Consultant at DXC Technology
- Location
- New York, NY, US
- LinkedIn followers
- 500 followers
About Kim Demichele
Experienced healthcare technology delivery leader specializing in payer system migration, implementation, and operational optimization, with deep expertise in HealthRules Payer configuration, benefit architecture, and enterprise delivery. Certified Project Manager (PMI) and Product Owner (IC Agile)I partner with business, IT, and vendor teams to translate complex product and benefit requirements into effective system configurations and implementation strategies. I am known for bridging business and technology—helping organizations move from ambiguity to execution while protecting delivery timelines and outcomes.With 30+ years in the healthcare industry, I bring a rare combination of project and program leadership, advanced business analysis, and hands-on technical delivery to complex transformation initiatives. My work focuses on modernizing payer platforms, improving operational performance, and ensuring solutions are scalable, compliant, and aligned to business strategy.I am an entrepreneurial, highly adaptable utility player who thrives in fast-moving and evolving environments. Colleagues rely on me for structure, clarity, and momentum on high-risk initiatives requiring strong stakeholder engagement, analytical rigor, and delivery discipline.Core strengths-Health Insurance Operations: Claims, Enrollment, Benefits, Provider, Accumulators, Medicare & Medicaid-System Implementation & Integration: configuration, data conversion, EDI (834/837/27x), API & batch interfaces-Technical Delivery: Scaled Agile execution, system analysis, parallel testing, defect triage, release readiness-Tools & Platforms: MS Office Suite, SQL Server Management Studio, Visio, Project, Azure DevOps, JIRA/R4J-Regulatory & Compliance: CMS, Medicaid, state/federal audits, public/private partnerships-Business Analysis & Process Re‑engineering: Requirements, workflow design, operational readiness
Experience
Healthrules Payor Implementation and Optimization Consultant
Jan 2023 — Present
Education
California State University
BA, Psychology
1985 — 1990
Isenberg School of Management, UMass Amherst
MBA and MS, Management and Clinical Psychology
1990 — 1995
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