SUMMARY:

Results - oriented, high-energy, hands-on professional, with a successful record of accomplishments in Finance and Healthcare domains. I have a good balance of both technical and business intelligence, as well as proficient skills and know-how with many Business Analysis tools. I enjoy being able to deep dive into the ins and outs of my projects. From this, I’ve learned how to keep my projects aligned with an organization’s overall goals.

More than the depth of a specialty or number of years experience, the scope of my involvement developed my proficiency in different business areas as well as my BA and PM knowledge and skills set fully compliant with CMS Federal Regulations, HIPAA accreditation, IIBA, PMI, ITIL methodologies, and state laws.

Major strengths include strong leadership, excellent communication skills, competency, strong team player, attention to detail, dutiful respect for compliance in all regulated environments, as well as supervisory skills including hiring, termination, scheduling, training, budget, and other administrative tasks. Critical thinking skill and my ability to understand business problems as well as opportunities that arise from requirements and then, recommend solutions that enable the business to solve the problem and achieve its project goals. I accept the responsibility for my project success. My work ethic is ambitious and driven toward success with my assigned projects. I keep an optimistic outlook while being flexible and adaptable.

I have excellent interpersonal communication skills. One of my greatest strengths is my ability to build relationships within and outside an organization. I’m a Team Player and can work without supervision. I’m organized, a good listener, a logical and analytical thinker with an eye for details. I’m a hard worker and quick learner who want personal gratification from the work I do. I believe in self-improvement and growth.

TECHNICAL SKILLS:

• Agile/SCRUM Methodology
• MS Dynamics SL, IBM Maximo, Bassets Assets Mgmt., MS Office, MS SharePoint, SmartDraw
• ECW, SQUIDS Application Lifecycle Management
• HP Application Lifecycle Management (ALM), Service and Request Tracking System (SRTS)
• Data - Flux, SQL scripting, Oracle scripting
• MS Access, MS Excel, Facets Healthcare Mgmt
• Mirth Connect Interface, Covisint DocSite, Open EMR
• HL7, XML, EDI
• Siemens Soarian Clinicals, Soarian Financials, NextGen, Openlink
• Remedy incident management system
• UNIX os, MS Project, MS Visio, eClinical Works, GE Centricity
• IBM AS400, DB2, ITIL, MS Dynamics GP Financials, American HealthCare, Point Click Care
• RicohDocs Document Management

PROFESSIONAL EXPERIENCE:

Business Analyst

Confidential

• Responsible for analyzing business needs to determine optimal means of meeting those needs
• Elicited requirements and documented workflows
• Delivered Excel Pivot Table spreadsheets for the current system workflow
• Worked with Quality Assurance team to ensure elements get incorporated into system design and testing
• Represented as liaison with users of the pivot tables to direct questions/issues
• Day-to-day duties included creating look-ups/pivot tables/extracting data from multi-databases
• Worked with healthcare data range from claims data, provider data, member data, and diagnosis codes

Business Analyst

Confidential, Washington, DC

• Responsible for driving customer engagement and advocacy in support of new business and customer retention and growth.
• Efficiently delivered AGILE/SCRUM methodology projects for process improvements.
• Helped the Operating Agencies stakeholders envision the future and how their work will need to change to support the future.
• Facilitate JAD sessions for the negotiation of requirements among various stakeholders.
• Elicited requirements and documented applications.
• Delivered BRD artifacts for the current system workflow (as is/to be) to create functional specifications and wireframe diagrams of the Operations activities.
• Gather risk-related data from internal or external resources.
• Assist internal tester/QA steam with DOT Operating Agency teams documenting ITSS requirements
• Experience in accumulator analysis, Level of Effort process and adjudication.
• Develop and nurture customers to become advocates on behalf of ITSS
• Understand Section 508 compliance requirements.
• Interact with Director/Manager Level stakeholders to drive value realization from ITSS
• Deliver technical presentations either via web or onsite to reinforce the value of ITSS’s service
• Consistently meet and exceed daily and weekly call deliverables for providing touch points for existing Operating Agencies
• Understand customer pain points and help drive escalations by coordinating between Operating Agency and ITSS.
• Good understanding of Security fundamentals such as Firewalls, Proxies and Web Security Gateways.
• Familiarity with Network Architectures and network routing concepts.
• Highly motivated self-starter with competitive personality and strong attention to detail
• Team player who possesses a desire and ability to work in a fast paced, goal oriented environment
• Exceptional communication skills, both oral and written, coupled with excellent listening skills

Business Analyst

Confidential, Baltimore, MD

• Efficiently delivered AGILE/SCRUM methodology projects for process improvements.
• Helped the business stakeholders envision the future and how their work will need to change to support the future.
• Facilitate JAD sessions for the negotiation of requirements among various stakeholders.
• Elicited requirements and documented current Maximo financials application.
• Delivered BRD artifacts for the current Maximo system workflow (as is/to be) to create functional specifications and wireframe diagrams of the Operations activities.
• Gather risk-related data from internal or external resources.
• Experience in accumulator analysis, work order claims process and adjudication.
• UML documents were used for technical specifications for development teams to identify, evaluate, and document system requirements used to design & develop the MS Surface Pro Tablet web base process and MS Dynamics financial & system implementation specifications.
• Project documentation maintained in MS SharePoint app. Agile/Scrum methodology used for work orders processing adjudication process project. Proctor for UAT sessions. Provided Production Support assistance to end users while also identifying any issues in production.
• Maintain the quality standards in existing projects.
• Report to PMO with the status of existing projects, documents, and ensure communication of, key risks to the leadership team of the projects status for Change Management. Project successfully achieved the project’s scope, under budget and improved productivity and the efficiency of MdTA financial management.

Business Analyst

Confidential, Lexington, KY

• Successfully delivered BRD Vision, Scope and Requirements documentation for Cardiologist, Hospitalist, EClinical Works (eCW) billing and coding projects.
• Responsibility included requirements gathering, functional requirements definition, business rules, and business analysis testing. Document, and ensure communication of key risks. Maintain input or data quality of risk management system for Change Management.
• Planned Joint Application Development sessions (JAD), user workshops, interviews, and conference calls to keep management staff and the team members apprised of BRD status and resolving workflow modeling issues.
• Provide analytic support by coordinating data extraction from various databases and data interpretation. Translate business and functional requirements into technical specifications for development teams.
• Created Use Case diagrams of the workflow activities.
• Participate in Integration Testing and Functionality Testing Imported Test requirements into SQUIDS application for project management, development and testing.

Business Analyst

Confidential, Washington, DC

• Productively maintained projects aimed at enhancing claims adjudication process application MQ Direct.
• Agile projects designed to improving the current claims adjudication processing application MQ Direct.
• Project Team Lead to develop collecting high-level requirements and break down into UR, FR, and nonfunctional requirements.
• Utilize multiple methods such as JAD Sessions, Interviews, and smaller work groups.
• The current screen had an absolute limitation regarding pending claim instead of deferring a request into the resolved deferral section of MQ Direct.
• Created designs for technical solutions to address business problems and try out components of new systems for efficient Change Management.
• Knowledge of healthcare claims lifecycle from receipt through payment.
• Experienced with the adjudication of EDI 834 (Benefit Enrollment claims).
• Exposure to HIPPA transactions, HIPPA 837, 835, CMS-1500, UB-04
• HP ALM app was used for requirement management and traceability.
• Facilitate professional and constant communication with overall users on the status of production problems that might arise and inform them about ways of resolving issues.
• Carried out research on how IT systems are used and suggest ways for systems improvement and efficiency.
• Project’s scope was achieved by delivering process methodology development strategy.

Data Analyst,

Confidential, Columbia, MD

• Managed preparing new client patient claims data files for BI reporting.
• Planned JAD sessions and created sample mock up reports, source to target mapping documentation.
• Worked with the business subject matter expert (SME) to identify data mining requirements and the end business goal they were trying to achieve by mining the provider - patient claim data.
• Process Provider claims data files using Data-Flux to provide data management capabilities.
• Perform data mapping to the identified information the Finance analyst needs.
• Create tables with various constraints including primary key, foreign key, etc.
• Create Oracle or SQL queries to interpret results using a variety of techniques, ranging from simple data aggregation through statistical analysis to complex data mining.

Quality Analyst

Confidential, Hanover, MD

• Successfully supported production project deliverables to produce and submit HEDIS reporting for Commercial plans to NCQA entities by deadlines.
• Developed supporting HEDIS benchmarking efforts to ensure accurate HEDIS rates are reported, completing the HEDIS roadmap, working with the manager on preparing for the on-site audit, and creating sample and case information for Quality staff.
• Facilitate JAD sessions, conference calls and business interviews with Provider’s business resources and EMR Vendors.
• Define the functional specifications, usability and support requirement of the Provider EMR systems.
• Gather risk-related data from internal or external resources.
• Create MS Access data marts contain existing patient EMR data from FACETS database.
• Used MS Access database to analyze HEDIS measures, provider and patient claims data to ensure HEDIS measures are in compliance with HEDIS technical specifications.
• Provide comprehensive GAP analysis of HEDIS measures, barriers, and opportunities.
• Participate in the HEDIS post-mortem analysis (lessons learned) to increase rates and evaluate and analyze annual HEDIS rates.
• Ensures Analyst project plan timelines achieved; milestone schedules met, and all deliverables were completed on-time.
• Create efficient and profitable EMR data extraction solutions for provider systems.
• Facilitate professional and constant communication with overall users on the status of the project.
• Ensured the technical solution was developed to satisfy the Change Management needs of the business.

Business Systems Analyst

Confidential, Trenton, NJ

• Completed Agile/SCRUM project to allow a direct exchange method to send and receive secure patient EMR data between care providers to support coordinated care.
• This project scope was to implement a health information exchange (HIE) system between local hospitals and local clinics. Function as Team Lead between IT and business units.
• Provide a single point of contact for business units into IT and acts as a conduit between facilities.
• My role included wearing many hats. Lead joint workshops for all the stakeholders and SME for projects. Analyze business processes ensuring best practices were captured and implemented consistently.
• Implement associated workflow activities, including training, testing to meet Meaningful Use Certification criteria and standards for the successful implementation.
• Define, establish and manage security risk metrics and track effectiveness.
• Collaborate with business units to determine continuity requirements.
• Establish disaster recovery testing methodology.
• Determine testing requirements to develop and reviewed scripts for current and negative test scenarios, conducted baseline testing.
• Created Use case diagrams of the workflow operations activities.
• Coordinate with end users in performing User Acceptance Testing (UAT).
• Create Gap Analysis, Data Mapping and develop Data Conversion specifications.
• For the HIE Master Patient Index (MPI), identified source systems, connectivity, tables, and fields, ensure data suitability for mapping.
• Assisted Interface Development Team, IS Support Group, hospital personnel and HIE application vendor to analyze, design, document, test, and troubleshoot interfaces.
• Design, code, test and debug custom SQL queries.
• Created SQL scripts to test the data integrity and gap analysis among the various sources and targets.
• Create the HL7 interface specifications.
• Perform the HL7 interface integration testing of business scenarios and XML data transfer.
• Use Crystal Reports and MS Excel to develop pivot tables for Steering Committee reviews, management reports and ad hoc quantitative and qualitative analyses.
• Created useful training materials, conducted one-on-one, live group. Provided training to Clinic teams effective Change Management of processes, tools, and resources. Provided Production Support assistance to end users while also identifying any issues in production.
• Achieved project’s goal of successful launching the secure HIE and replaced the existing clinic EMR system and mission to improve clinical healthcare for patients in Trenton, NJ.

Business Systems Analyst

Confidential, Malvern, PA

• Assigned to contribute in auspicious implementation and enhancement of Siemens Soarian Healthcare Information Management System (HIMS) to new hospitals customers. Provided Production Support assistance to end users while also identifying any issues in production.
• Each project used AGILE Methodology for EHR implementation to achieve successful Soarian implementations.
• Create project documents compilation at each assigned facility.
• My deliverables included Technical configuration to provide direct quality care to patients including daily monitoring, recording, and case management of medical conditions:
• System/User security access documentation.
• SSRS Report Writing, Critical Care, Form Adaptability Tool (orders and assessments)
• Participant in multiple committees to analyze and improve Soarian assessment, Soarian order entry
• Managed Soarian Clinicals report catalog of +300 reports for Soarian business analysis
• Managed the ongoing maintenance of new and existing Soarian orders and evaluation forms
• Supported Soarian OMS and troubleshoot all printing related issues
• Experience with workflows and rules engine
• Knowledge of healthcare claims lifecycle from receipt through payment.
• Experience with system updating and testing with CPT, HCPSC, ICD9 coding, fee schedules and benefits plans
• Experience in claims processing, computer operations, data analysis, database management and creation of custom reports
• Compiled comprehensive troubleshooting documentation for IT support staff for effective Change Management.
• Developed end-user training material to conduct training sessions for various clinical user groups
• Assisted in go-live launch of Soarian Clinicals applications
• Participated in post implementation support 24/7
• Assigned analyst to Remedy incident management system for help desk trouble tickets resolution
• Worked with Siemens Support to isolate and resolve system issues