We provide IT Staff Augmentation Services!

Senior Business Analyst Resume

Owings Mills, MD

SUMMARY:

Highly accomplished Business Process Consultant/Sr. Business Analyst/ Project Manager, contractor/consultant with over 30 years of diverse experience in the areas of Healthcare Administration, IT and IS; Meaningful Use - EHR, Medicare, Medicaid, CRISP/HIE, MACRA (APM, QPP), MIPS; Experience managing enterprise implementations MMIS systems; NCQA, CMS MITA Framework; Auditing, Compliance; Expert in gathering, analyzing, defining business and functional requirements; Re-engineering, Re-structuring systems, processes, workflows and technology solutions; Proven ability to lead seamless implementations and deliver next-generation technical solutions.

EXPERTISE HIGHLIGHTS:

  • Network & Systems Administration
  • Business Process Consultant/Sr Business Analysis
  • SDLC: Agile (SCRUM) and Waterfall Methodologies
  • Lean Six-Sigma Methodology (DMAIC)
  • Data Flow & Process Mapping (Visio)/Wireframe- (Snagit, Azure RP)
  • Re-engineering, Restructuring Systems, System Implementations
  • UAT Testing, Test Cases, Use Case, User Stories, Wireframes (Prototypes)
  • CMS- MMIS Toolkit/ MITA 3.0, NCQA (National Committee for Quality Assurance)
  • Clarity PPM

TECHNICAL SKILLS:

Applications: Microsoft Project, Microsoft Visio, Remedy, SharePoint, JIRA, Microsoft Office Suite, Clarity PPM Software, Axure RP Team Edition, HP ALM, AWS, Cloud Technologies

PROFESSIONAL EXPERIENCE:

Confidential, Owings Mills, MD

Senior Business Analyst

Responsibilities:

  • Ability to collaborate closely with other business analysts, developers and project and program managers on several Corporate Initiative and Enhancement projects simultaneously.
  • Ensured that Providers (Hospitals, Physicians) were following CF guidelines and worked in G&A divisions to ana lyze and identify areas of focus based upon appeals, complaints and provider data.
  • Work on deadline driven requirements (HP ALM), process flows (Visio), wireframe/mockups (Axure RP, Snagit), Project Management with Clarity PPM which allowed me to manage, secure and support agile business services.
  • Conduct JAD sessions for five or more projects for Provider and Hub Enhancements, providing support to Providers (UMM, MedStar, private facilities…) Gate keeper for MIPS (Merit-Based Incentive Payment Systems) and updates to Provider Portal.
  • S upport developers in defining, building, analyzing, maintaining and reconciling key information and business data in support of the CF policies, guidelines, procedures and regulations.
  • Create, improve and use wireframes, prototypes, style guides, user flows, and effectively communicate interaction ideas.
  • Create solutions that are aligned with business directives.
  • Create User Stories, Use Cases and Story Boards for requirements analysis and presentations to Stakeholders.
  • Present and defend my design decisions based on the overall design brand/application guidelines as well as my own design thinking and fundamental principles (i.e. color theory, visual weight, etc.)

Confidential, Maryland

Senior Business Analyst

Responsibilities:

  • Conducted in-depth analysis of County systems, operations, and procedures; worked with end-users to define detailed business requirements and resolve problems
  • Lead team of SME’s and BA’s in sessions for the translation of client requirements into system design documents
  • Worked on Clarity PPM for creating resources and generating project status reports; provided support for project control to effectively manage schedules, status, and costs
  • Analyzed and reviewed documents & requirements for accuracy; presented to project stakeholders for review/ approval.
  • Worked with vendors to coordinate system design and implementation
  • Developed needs assessment, evaluated various software and systems; identified new technology to provide successful solutions to problems, increase effective operations.
  • Worked with County agencies and provided advice, consultation, and technical assistance throughout project implementation; provided quality customer service and training
  • Documented workflows and work with SME’s during JAD sessions to gather and assess needs from internal business units
  • Participated in re-platforming and re-engineering of business and technological solutions/systems.
  • Wrote and executed test cases and plans and oversaw UAT and functional testing
  • Maintain relationship and partnerships with Vendors and Stakeholders and resolved issues relating to implementation

Confidential

Enterprise PM. Sr. Business Analyst

Responsibilities:

  • Managed accounts for City of Baltimore, managed employees time & attendance for purpose of billing; performed bi-weekly site visits
  • Conducted system tests, UAT Testing, document analysis, inspections and performed evaluations to ensure the project was proceeding according to schedule
  • Worked on Clarity PPM for creating resources and generating project status reports; viewed each project to make sure that qualified individuals were assigned to their tasks to deliver the best project service in a timely manner.
  • Monitored performance with Medicaid compliance requirements and conducted education and training of appropriate personnel on state programs compliance issues.
  • Served as the liaison and point of contact to facilitate external and internal Medicaid Regulatory Audits, while ensuring vendors were compliant with; audit preparation, collection of pre-audit materials, working with the Medicaid Operations Teams and vendors to develop, report and monitor any issues of non-compliance.
  • Determining and analyzing Provider data for Grievances and Appeals.
  • Validated requirements and proposed solutions during system design sessions
  • Worked with SharePoint for storage and management of pertinent files and documentation; and JIRA for planning, tracking progress and workflow
  • Automated previously manual, time-consuming processes to drive gains in data tracking/accuracy, workgroup efficiency and profitability
  • Used expertise to improve business processes for APM (Alternative Payment Methods), (QPP) Quality Payment Programs, MIPS (Merit-based Incentive Programs)
  • Developed business cases by identifying needs, use cases and/or wireframes
  • Understanding of compliance and regulations for Affordable Care Act (Obamacare), grand-fathered health plans and associated claims and programs (Presumptive Eligibility, MCHP, Money Follows the Person, etc.) MD-HIX (Health Exchange) and HIE (Health Information Exchange)
  • Facilitated & Lead project team meetings JAD Sessions and PMO meetings
  • Defined business /functional requirements, making changes and/or adjustments where necessary; “As Is”- “To Be” business process flows; conduct analysis of functional issues
  • Lead Project Team (Recipient, Eligibility, Benefits Admin, Provider Enrollment, Claims); served as a liaison between client and contractor to oversee day to day project operation.
  • Identified risks/issues and discuss mitigation plans, risk tolerance levels, etc.

Confidential, Baltimore, MD

Project Manager & Business Analyst

Responsibilities:

  • Developed and streamlined procedures that decreased labor time and eliminated redundancies for Nurses and Certified Nursing Assistants
  • Developed functional procedures which were compliant with state Medicaid program requirements.
  • Monitor performance with Medicaid compliance requirements and conduct education and training of appropriate personnel on state programs compliance issues, as needed.
  • Developed CBT programs for various positions which resulted in more hiring for our clients
  • Managed “Ticket to Work” Program which provided jobs and training for Medicaid and Medicare Recipients; conducted education and training of appropriate personnel and vendors on state programs compliance issues
  • Managed and supervised contracts of Nurses, Allied Health and all medical personnel (50)
  • Analyzed documents and reviewed requirements for accuracy; presented to project stakeholders for review/ approval.
  • Used Clarity PPM to align project investments with corporate goals by developing plans and communicating.
  • Understand healthcare guidelines and compliance for grievances and appeals

Confidential, Baltimore, MD

Project Manager

Responsibilities:

  • Manage major projects for the removal of several underground/aboveground storage tanks
  • Follow & manage directives from DDOE and EPA, obtain permits (WASA, Miss Utility, etc.)
  • Liaison between government agencies, vendors, subcontractors and DPW
  • Manage the environmental remediation, removal & analysis of contaminated products
  • Construction Waste Manager; managed pre-bid and pre-construction meetings

Confidential, Greenbelt, MD

Project Manager/Business Process Consultant

Responsibilities:

  • Conduct economic, root cause, gap, document analysis; performed evaluations
  • Conduct technological, market & business research; improve business processes, provided forecasting and reporting; develop business cases by identifying needs, analyzing results, making recommendations; create business case requirements, user manuals & reports; presentations, interviews and negotiations;
  • Relationship & Vendor Management for Builders/Developers & Realtors;
  • Manage home rehab/ development projects for investors

Confidential, College Park, MD

Project Manager/Network Engineer

Responsibilities:

  • Manage team of Network Administrators and techs for Presidential Libraries
  • Perform network upgrades, desktop support, client software roll-outs, systems migrations
  • Conduct product training & support, develop, maintain technical training manuals
  • Lead & manage GroupWise email system, site administrators nationally
  • System backups (Back-up Exec/Arc Serve (Remote Admin for back-ups)
  • Manage installation/configuration of routers, switches and security (NFR Network Intrusion)

Confidential, Baltimore, MD

Junior Business Analyst/Technical Support

Responsibilities:

  • Conduct product training & support, develop, maintain technical training manuals
  • Create business case requirements, user manuals & reports
  • Provided jobs and training for Medicaid and Medicare Recipients
  • Worked with Medical Healthcare Facilities in Baltimore City to enroll and assist Medicaid Recipients

Hire Now