SUMMARY:

• Articulate, client facing, Business Analyst professional with 15+ years of experience in the information technology field. Previous roles include claims analytics manager, technical project manager, project portfolio management and administration responsible for creating business solutions utilizing all facets of the system development life cycle.
• Technical expertise with mission critical systems for Federal and State government, healthcare and retail industries and providing cost - effective technology solutions for small businesses.
• Diverse technology background with knowledge of strategic alignment issues and organizational matters.
• Knowledge of agile and waterfall methodologies, decision support systems, knowledge management concepts, strategic planning/development and technology resource planning.

TECHNICAL SKILLS:

Operating Systems: AS/400(iSeries), IBM MVS, z/OS, Windows 2010, Windows 8, Windows 10

Tools: /Languages: Microsoft Office 360, DbVisualizer, Toad, Oracle Business Objects, Cognos, COBOL, Natural, Focus, Python, Java, Microsoft Project, Microsoft Visio, XML, Daptiv PPM, HP ALM, SQL, EDI (Transaction sets 837, 835, 997), AS/400 Query, Jira, DevTrak (proprietary version control tool), OnTrak (proprietary QC tool)

PROFESSIONAL EXPERIENCE:

Business Systems Analyst

Confidential, Washington, DC

• Supports Plan Code implementations through requirements management, report development and configuration management. Participates in implementation meetings and change summary presentations.
• Develops and maintains Functional Specification Documents and Mapping Documents, Reference Data Documents and Use Cases.
• Manages project requirements using HP ALM tool to load and baseline business, users and functional requirements.
• Resolves issues with invalid post-adjudication voucher claim processing
• Interacts with internal development and testing teams to establish requirements and set testing goals.
• Develops documentation and statements of procedure for team processes.
• Participates in annual corporate trainings.

Claims Analytics Manager

Confidential, Linthicum, MD

• Liaised with Medicaid Behavioral Health team, facilitated monthly meetings, resolved technical issues that were causing claim errors, project managed required system changes, collaborated with internal claims processing, EDI, IT and Finance teams
• Interacted with Federal agencies for guidelines on submission of eligible claims, meeting timely filing requirements
• Interfaced with client, claims and finance departments as well as IT and EDI teams to identify and resolve technical claims issues, communicate the status of established goals and project managed resolution tasks.
• Provided recommendations to client regarding resolution of claim errors in the MMIS system.
• Gathered requirements and led JAD sessions in collaboration with claims, system configuration, EDI and IT teams.
• Liaison to DHMH for the Federal Funding Participation (FFP) program.
• Managed the reduction of outstanding Federal match from $10 million to $4 million in 2016.
• Prepares for annual reconciliation and accountability of dollars recovered/forfeited.

Corporate Business Systems Analyst/Technical Project Manager

Confidential, Reston, VA

• Configures system based on organizational requirements
• Supports and provides user training
• Monitors data quality, maintains user profiles and resolves system issues
• Develops management reports to support project resource management and budgeting
• Presents data to CTO to aid in organizational decisions related to resource allocation and project costs
• Interacts with CIO leadership to determine reporting requirements
• Partners with Project Managers to resolve issues, conduct meetings and seminars
• Supports Vice President and Director in preparation of special reports, presentations and research projects
• Auxiliary support of vendor management process assisting team with consulting staff and vendor contracts.

Corporate Business Systems Analyst

Confidential, Reston, VA

• Coordinated configuration and implementation of new clients and modifications for all automated member and provider correspondence
• Developed and maintained relationships with various internal business units as well as external clients
• Interpreted CMS Federal requirements for the implementation of ICD-10
• Provided technical support of Federal contract for Military OneSource claims
• Project management with responsibilities for facilitating process improvement meetings
• Developed functional specification documents, through requirements gathering, developed use case matrix and performed user acceptance testing
• Help ticket management and support for correspondence and CAS Claims application issues
• Coordinate job scheduling tasks for new batch processes

Business Systems Analyst II

Confidential, Linthicum, MD

• Supported internal and external users on suite of organizational applications through training and problem resolution
• Supported the implementation on SAMHSA.gov program data collection requirements for patient encounters to meet Federal requirements
• Responsible for leading user acceptance testing (UAT) effort for service center and development of formalized process including development of test cases
• Provided data mapping for extract development and reporting
• Developed business requirements and functional specification documents from organizational templates.

Survey Operations Analyst

Confidential, Columbia, MD

• Provided analysis of performance of radio markets and return rate planning
• Planned sample for diary and electronic meter system services
• Utilized understanding of methodology and business rules for both services
• Provided guidance for questions related to data integrity, areas of responsibility
• Participated in implementation of departmental quality management system: document and records control.

IT Programmer Analyst II

Confidential, Baltimore, MD

• Provided detailed data analysis for Maryland State Legislature resulting in appropriations to support drug utilization oversight by staff physicians
• Provided timely and accurate ad hoc reports for Maryland Medicaid Pharmacy Program using FOCUS reporting software and Business Objects
• Analyzed data trends and provided feedback to users
• Supported programs for pharmacy services following CMS Federal policies
• Reviewed state and federal legislation and provided impact analysis to data
• Utilized Medicaid Management Information Systems (MMIS) tool
• Performed SQL queries to research utilization issues with Oracle Business Objects

Programmer Analyst (Specialist)

Confidential, Sacramento, CA

• Maintained and provided troubleshooting of job abends
• Provided support of IDMS to DB2 conversion
• Production Support Team member, providing coverage and solutions for complex issues with batch jobs

Software Engineer

Confidential, West Sacramento, CA

• Coordinated development standards for COBOL community of practice
• Provided maintenance of online/batch programs for logistics and transportation team on mainframe system
• Designed and developed web-based application enhancements using Java to reduce labor costs while complying with bioterrorism laws
• Participated in on-call rotation
• Participated in task force to improve technical support processes by developing help desk employee best practices guidelines