PROFESSIONAL SUMMARY:

• Highly dedicated, results driven & innovative Project Management Professional & QA BA armed with over twelve (12) years of strategic and tactical planning experience in all facets of telecommunications and a broad range of health - care information technology life-cycle development from conception to implementation.
• Leverage various project management philosophies & business analytics principles and concepts to achieve project success, implementing best practices & workflow processes for systems to achieve strategic business goals in parallel with developing training material for resources for the adoption of new product release features, platforms, integration and functionality while increasing efficiencies of daily operations and tangible Confidential .
• Over twelve years’ experience managing projects in a portfolio for state governance regulations, health care, coupled with strong telecommunication release implementations.
• Strong telecommunications and clinical IT project manager with extensive experience as a project manager & quality process business analyst, including product delivery and implementation of the overall product solution.
• Practical experience with compliance to regulatory requirements and governing bodies, State Exchange for Health Care Reform, for Medicare & Medicaid (CMS) including Joint Commission (JCAHO), and Health Information Portability and Accountability Act (HIPPA).
• Led the effort to ensure system readiness and business readiness
• Conducted product research, data collection and product analysis, and adverse reaction data for product comparison.
• Primary area of expertise: Facets upgrade ( ), Confidential /HER, decision support system(informatics) implementation.
• Performed Analysis of ICD 9 Performed Analysis of ICD 9 Procedure and Diagnosis Codes in accordance with ICD 10 CM and ICD 10 PCS Conversion Compliances
• Performed clinical business process mapping/re-engineering; developed and executed a detailed project plan and blue print to be integrated between BCBSM & NASCO NPS & MembersEdge solution for system integration capabilities ( Confidential ).
• On-Board to triage and assist clinicians and end user’s with new data functionality for Confidential & Confidential and upgrades and developed a user adoption training manual to create synergy with the team and ensure metrics and reports were captured for traceability and UAT.
• Led Confidential interoperability projects connecting disparate systems using data exchange, while providing a single patient portal for the patient to access their individual patient health records
• Political savvy in working with functional work stream groups; excellent in diffusing conflict issues and creating symbiotic relationships

CORE COMPETENCIES:

• PMBOK (project management book of knowledge - PMP Certified, SDLC (Java & Web environments).
• CMS Governance and compliance, Risk Mitigation and contingency plans
• Share Point SharePoint, MS Project, BABOK, Waterfall, Agile, Accenture, Delottie, Confidential Requisite Pro(requirements managing & reporting), Gap Analysis & AT& Confidential, Microsoft Project Server 2007, Microsoft XP Office 2003,
• Excellent customer facing; written and communications skills, reporting analytics (PS financials), documentation, and Testing Tools & SQL queries.

TECHNICAL SKILLS:

• Windows XP; HTML, Microsoft Suite of Applications, SAP, Facets Core Administration, Product Lines: Medicaid and Medicare:
• Medical Management, Medical Management, Utilization Management, Provider, Claims and Payment systems
• Oracle, SQL Server, Oracle, SQL Server, .NET. People-Soft Financials, Clarity, Share-Point Administrator,
• Data Mapping - Evaluate data values in data sources to discover complex mappings between Data sets.
• Black box, White box, Integration, Functional, System, End to End, Regression, Load Compatibility, User Acceptance,
• Alpha, Beta Testing, Waterfall; Agile, PMP Testing Methodology and Compatibility,
• Data Mapping - Evaluate data values in data sources to discover complex mappings between
• Developed and executed a plan and approach which encompassed and describe activities that occurred during each state of the Test Phase:
• Test Planning
• Test Preparation
• Test Execution
• Test Monitoring
• QT 9.2, Quality Cente(MQC) 9.2/9.0/8.0, Win Runner 8.0, Load Runner 8.2, 8.2- Test Director.

PROFESSIONAL EXPERIENCE:

Project Management/Business Analyst

Confidential

Responsibilities:

• Outstanding leadership skills; able to motivate others to appropriate action
• Possesses strong problem resolution skills, with proven expertise in automation/process improvement, requirements gathering, functional specifications, protocol design, and application/equipment testing.
• Political savvy in working with functional work stream groups; excellent in diffusing conflict issues and creating symbiotic relationships.
• Executed best practices for reengineering processes within the PMO. Managed project documentation, coached & mentored junior project managers for large IT projects(enhancements & new functionality).
• Developed detailed SOW documents, project deliverables, project plans, and critical path milestones.
• Simultaneously managed, developed, and implemented multiple projects and programs.
• Worked with all levels of business and technical management and staff to prioritize goals and objectives.
• Utilized available resources to ensure project implementation success on-time and on-budget.
• Logged, tracked, analyzed, and coordinated resolution of issues with management and team members.
• Performed SME consultation, identification and documentation of business, functional, and system requirements, lead JAD sessions, and developed use cases and workflow diagrams.

Confidential

Responsibilities:

• Gathered requirements to create test strategies and scenarios based on business requirements for system validation.
• Created documentation for testing plans, criteria, and results to enhance process effectiveness
• Documented and tracked all issues; analyzed problems and recommended solutions as appropriate.
• Worked closely with team members to provide necessary research to understand issues and assisted with debugging where suitable and reported issues and findings to the appropriate teams.

Computer Application Training and Developer

Confidential

Responsibilities:

• Conducted training for hospital-wide clinic-specific applications, including pathology, food services, lab, PT/OT, transcription, HIM, and cardiology, along with Windows-based computer applications, and soft skill courses.
• Applied adult learning principles to develop and present materials via formal classroom instruction, one-on-one coaching, OJT, and CBT instruction.
• Mentored other instructors, super users, and train the trainer users in effective training techniques.
• Worked closely and shared knowledge with project stake holders, upper management, and the members of the training team.
• Developed system awareness campaigns, training curricula, lesson plans, visual aids, and quick reference guides to assure successful training and user (adoption)facilitate user acceptance.
• Created computer-based tutorial programs tailored to multiple user group levels
• Assisted with National User Group conference coordination including database design/maintenance/reporting, product demonstration.

Technical Support

Confidential

Responsibilities:

• Customer-service oriented and enjoys working with end users to triage and solve system related issues.
• Assisted in software implementations, upgrades, deployments, go lives, and migrations
• Monitored Help Desk tickets and provide technical support to end users over the phone and in person.
• Documented issues and resolutions in the help desk knowledge database software.
• Actively interfaced with business and technical teams to resolve issues.

Confidential

Sr. Project Manager & QA Delivery Lead

Responsibilities:

• Executed best practices for reengineering processes within the PMO. Managed project documentation, coached & mentored junior project managers for large IT projects(enhancements & new functionality). - Care Advanced Enterprise Implementation
• Executed a process improvement road map and plan for IT Governance for change management across the enterprise.
• Performed analysis and Gathered requirements and reviewed Use Cases for the applications that used SSN and DOB as unique identifiers.
• Created a comprehensive QA framework, which would test the implementation of the new claims rule engine for any specific Carrier from all possible angles.
• Validated displays of Patient Screen to include masked SSN & DOB Information
• Claims Process validation - Identified Claims Matching Scenarios upon which millions of Claim records were matched daily based on Patient's Information
• Involved in writing Test plans, creating Test scripts, and Team Coordination
• Organized meetings and led JAD sessions to ensure legal and compliance deadlines of CMS (Centers for Medicare and
• Medicaid Services) are met * HIPAA Conversion Analysis - Involved in the documentation of HIPAA 5010 changes to EDI 837, 834, 835, 276, 277 Transactions.
• Defined the approach & process for automating significant parts of the QA framework:
• Developed System Requirements Specification(SRS) & Functional Requirements Specification(FRS) and use cases using DOORS, Requisite Pro, Visio and Rational Suite.
• Proficient in creating Use Class Diagrams, Sequence Diagrams, and Collaboration Diagrams, Activity Diagrams, and Class Diagrams.
• Developed requirements for user interface, and application rules based on specific:
• Client Server Testing
• Web based Application Testing
• GUI Testing
• Functional Testing
• Integration Testing
• Regression Testing
• Load Testing
• Stress Testing
• Interface Testing
• Database Testing
• Interfaced extensively with developers and business analyst regarding testing status, defect & change tracking using Test Director(Quality Center)
• Developed a traceability matrix and workflow diagram to ensure application standards & best practices.
• Developed & Analyzed test scripts based on solid testing application functional scenarios captured from the business.
• Responsible for developing an approach and plan for manual & automation testing during various phases of test cycles which included executing a strategy & program test plan:
• Interacted with dev. & various members to discuss and resolve defects based on
• Priorities.
• Developed and Maintained Test Schedule for Quality assurance deliverables.
• Responsible for working with application team in UAT and Production Release.
• Tracked defects in HP Quality Center and provided test execution progress updates.
• Strong communication skills - liaison between business, IT and other stakeholders. Delivery focused by improving execution and also by implementing new process and procedures in coordinating large scale Assessment & Planning efforts with multiple stakeholders from different time zones.
• Executed and prepared dashboards, to publish Progress and Project Health, financial and effort estimation; prepared contingency plans. Defect Management Activities included communication plan etc. Extensive experience in capacity planning, estimating, scheduling, risk planning, team leadership, interfacing with executive management, and CMS to elicit governance and standards for HIPAA and Compliance processes
• While leveraging this opportunity, this will enable BCBS to standardize QA framework for products within the portfolio while executing best practices and processes across work streams.

Senior Health Care Business Clinical Analyst

Confidential

Responsibilities:

• Developed a defect tracking process to mitigate issues and risks. This process will be used for future upgrades.
• Modules & Functional Areas Included: claims, underwriting, enrollment, accounting, dental, customer service, payer, business rules, workflow, clinical(disease management, wellness, utilization review)and subsystem, integration, and data feeds( Claims & PCHM) which the team was successful in eliminating bottlenecks, automation of work, and streamlining costs systematically while optimizing operational efficiency.
• This effort was an upgrade from Facets which included developing a road map for planning and execution for elicitation of requirements, definition, & configuration of content) workflow and care products and plans for Case Management, Disease Management, Wellness and Utilization Management from clinicians, doctors and the business.
• Modules & Functional Areas Included: claims, underwriting, enrollment, accounting, dental, customer service, payer, business rules, workflow, clinical(disease management, wellness, utilization review)and subsystem, integration, and data feeds( Claims & PCHM) which the team was successful in eliminating bottlenecks, automation of work, and streamlining costs systematically while optimizing operational efficiency.
• The Facets (integration) workflow application enabled seamless real-time delivery for Clinical Applications and Medicaid and Medicare lines of business.
• Managed and monitored workflow processes for HIPPA gateway for integration and ensured we were CMS compliant.
• Managed all phases of the project with Microsoft Suite of Applications (Excel) and was the administrator for Share-Point. Reported & delivered Microsoft PowerPoint Presentations & Metrics to IT Directors, Executives & Sr. Project Managers inclusive of proof of concept to planning, analysis, design, construction, testing, controlling, and managing the implementation of BI Modules.
• Managed and monitored daily operations which included, scope, schedule, cross functional resource deliverables, estimates, & budgets. Developed a process & plan for JAD sessions, and UAT.
• Sharp focus on business solutions & outcomes through frequent stakeholder touch points, allowing the business to react rapidly to changing business priorities. Developed project charter, risk, communication, mitigation & contingency plans.
• Established guiding principles leveraging PMBOK methodology process standards; process definition, process refinement/transition, and key performance indicators to ensure process consistency and best practices and provided post implementation audits.

Confidential

Principle Consultant

Responsibilities:

• Strategically led, coordinated, and tracked tasks and activities for cross functional/off-shore teams and vendors to deliver complex IT solutions that included software integration, workflow order management, realignment of processes, & UAT compilations which included testing scenarios; defect management & testing software.
• Developed, tracked, and coordinated a Quality Assurance Process Plan between IBM/ Confidential to ensure accurate data scripts were tested in the test environment, compiled in development and executed into production.
• Developed a Road Map to indicate how tools, project techniques, and threads, will be implemented systematically to achieve project success.
• Extensive reporting on project metrics(PS Financials), project deliverables, impact analysis, and key performance indicators(KPI)which included variances, cause & effect, status of project schedules and other relevant scenarios.
• Created synergy between cross-functional teams by implementing tailored seamless techniques which included up to date communication plans, project reporting, shared communications (SharePoint), and templates.

Confidential

Project Manager & BA Consultant

Responsibilities:

• Developed project charter, and tracked deliverables including timelines, resources, tasks, budget forecast, and activities. Applied a variety of methodologies from inception to implementation to Shepherd the project to success. Achieved repeatable program & project success by providing training, mentoring & guidance to team members as needed.
• Established a frame work to achieve program & project success by interviewing the business resources including business managers, end users & directors to conceptualize & prioritize business needs. Performed formal reviews and signoff process on all critical project/program artifacts and tollgate reviews through DMAIC phases.
• Reported Metrics and balance score card to PMO on a weekly basis and identified major risk factors and the effect of contingencies on costs and timelines and reduced the risk of cost and schedule overruns.
• Gathered functional requirements, analyzed data for gap analysis and deeply involved in the UAT process including regression and end to end testing.
• Spear-headed JAD Sessions with cross-functional teams to develop a prototype which was used as a catalyst for functional capabilities and technical requirements.
• Identification and elimination of non-engineered data redundancies data quality and platform performance enhancements standardization of tools back-end ETL, front-end reporting, and metadata management led user adoption / change management process between cross functional teams to ensure synergy & identified upstream and downstream system impacts.

Confidential, Atlanta GA

IT Release Project Manager

Responsibilities:

• Planned, Shepherd, and managed full Project Lifecycle projects (SDLC) which encompassed meeting with the business to capture high level business and system requirements and downstream system impacts.
• Managed and developed a detailed project plan and managed the project with Confidential Clarity & SharePoint.
• Coordinated with cross functional teams and vendors. This included JAD sessions and working with the development teams and business analyst and testing teams to ensure successful implementation.
• Strategy Management included: gap analysis, evaluation against strategic objectives and provided project management functionality to close the loop between strategy and execution.
• Provided dashboards and Scorecards for visibility and control to directors for delivery of project success. This included an-overall view of compelling daily operations and business performance across the enterprise. The snapshot included financial and ad hoc reporting of operational data
• Developed a training methodology for user adoption.
• Complied with SOX regulations and Six Sigma methodologies.