Mark Shishida, Executive Vice President of Cognosante, is an expert in health and human service programs and supporting systems. He has 30 years of experience with federal, state and county Medicaid, Medicaid Waiver, Medicare, Aid to Families with Dependent Children/Temporary Assistance for Needy Families (AFDC/TANF), child welfare, child support enforcement, social services, managed care, public health, mental health/behavioral health, WIC, and developmental disabilities programs.
He has planned and managed large, complex system implementation and operational projects; developed system requirements and design; led system and business outsourcing procurements including RFP development; improved workflow and business processes in preparation for a new system; provided Independent Verification and Validation (IV&V) services; prepared and conducted acceptance test plans; monitored implementations and fiscal agent changeovers; and assessed compliance with the Health Insurance Portability and Accountability Act (HIPAA) regulations and implemented HIPAA remediation solutions.
As examples of his program experience, Mark served as Project Client Executive for the design and implementation of new Medicaid Management Information Systems (MMIS) for the states of North Dakota, Tennessee, Michigan and others. Mark also served as Joint Application Requirements (JAR) facilitator soliciting requirements from state staff. He played the same role for the Bureau of TennCare, performing IV&V for the transfer and implementation of EDS’ Interchange client/server MMIS for the TennCare Program.
Mark was Project Client Executive for the team that implemented the Sybase HIPAA translator technology for L.A. Care, the largest Medicaid health plan in the country with more than 900,000 members. The team performed TCS assessment and gap analysis, developed Sybase and CSC MHC 17.3 transaction maps, performed code set mapping and analysis, implemented a HIPAA data repository, managed trading partner transaction test planning and schedules, oversaw end-to-end testing, developed training plans and Companion Guides, and identified policy and procedure impacts of HIPAA.
Prior to its merger with Cognosante, Mark served as the Chief Executive Officer of Fox Systems. He is a member of the American Public Human Services Association (APHSA) and the National Association for Medicaid Program Integrity (NAMPI).