PROFESSIONAL EXPERIENCE

Confidential

Sr. Business Systems Analyst

Responsibilities:

• Acted in the role of program manager for “Medical Devices program” within PIPC CDO - Contracted Provider services.
• Managed all project efforts and initiatives associated with any medical device that uses, process and stores PHI data.
• Performed inventory management, documentation, tracking, auditing, risk management, and regulatory compliance related task.
• Lead efforts to research, plan, identify and implement work efforts to support medical device integration.
• Lead Medical Devices Program to plan the overall program.
• Defined the program controls, the processes, the procedures, reporting and etc.
• Performed the role of Security Lead for all “IT Access Security Compliance” for the department.
• Responsible for coordinating all internal and external access audit inquires.
• Responsible for security access audits, end user security tracking, remediation, reporting, department communication and user access audit implementation regarding all EPM/EMR Systems and other dispersed applications within the CDO.
• Applications that fall within my purview/scope are: Aetna-Coventry-Direct-Provider, Ramsoft, eClinical Works EPM/EMR, Availity, ClaimRemedi, DIT Vault, Quiqmeds, Virtual Merchant, Wellcare, RevenueMaxPro - Clearvision, Chameleon, Data link, and My Medical Direct.
• Created specific policies and procedures that align with PIPC CDO strategic security compliance initiatives for PHI and HIPPA.
• Responsible for including new APIs into access governance process and sunsetting API support for decommissioned applications.
• Performed security access controls and compliance audits on all application within the CDO.
• Provided documentation to Human’s Program & Compliance Governance team for operational EOR for the EIP strategic initiatives.
• Performed Risk management and compliance control task related to SOX, HIPPA and Security.
• Mentored others on policy, process, procedures and implementation to support security access audits.
• Created automated scripts within the ACCESS database and excel for security access audits.
• Performed the role of a Sr. Business Reporting Analyst within PIPC CDO by for filling the existing reporting needs and developed reports, tools, automated scripts and processes which accurately evaluate performance against intended business strategies.
• Perform big data analytical analysis using ETL of data generated out of the CA Technologies Service application which tracks ticket Incidents and Change Orders for internal End Users, support and the call center personnel.
• Provide summary reports and presentations of the statistical automation data out of Avaya Call Management System (CMS) which help the CDO track customer call routing and agent selection for the CDO multi-site centers.
• Provided IT Architectural environmental weekly, monthly, quarterly, annually and ad hoc dashboards to executive leadership, leaders and peers for visibility into operational impacts and outages using Microsoft power point and excel.
• Created and implemented standardized reports and presentation for Audits, the CDO Support environment and Call center activities.

Confidential

Sr. Business Analyst Consultant

Responsibilities:

• Manage Urgent Care and Primary Care Practices acquisition vendor application IT support for the EPM/EMRs.
• Performed and managed software vendor updates, ad hoc patch implementations, track warranties vendor contract negotiations and security compliance needs for Allscripts MyWay, eClinicalWorks, GE Centricity, Greenway, DocuTap, MOMs PMS, and Aprima EMR systems.
• Performed business reporting analyst to effectively summarize findings and articulate clear analysis of findings and results using data mine from the different EPM/EMR systems.
• Manage and facilitate external vendors, internal vertical stake holders and cross function relationships and meetings.
• Perform decommissioning, network VPN connectivity and vender solution projects as they presented themselves during the course of operational activities.
• Perform UA testing, risk management, and provide detail plans to support data transformation.

Confidential

Sr. Project Manager/BA Consultant

Responsibilities:

• Establish business process for requirements, development, quality assurances, change management, production and configuration management.
• Performed procurement for software, hardware and business services related to the day to day operations of the business.
• Established templates to use for project and client information extractions as it relates to projects.
• Provided presentations to potential clients and managed on site efforts to ensure the video part of the services was being executed per the project plan parameters to ensure accurate website development and client needs.
• Met with different stake holders to ensure that all requirements were gathered, report status and provide feedback to the owner.
• Performed project planning, scheduling, monitoring and controlling and execution of projects and closing.
• Used Microsoft CRM to help managed project workflow for different cross functional teams, establish project workflows, standard processes and procedures; as well as, system management.
• Used Microsoft CRM to manage software plugins for Web application support.

Confidential

Sr. Project Manager/BA/Quality Assurance

Responsibilities:

• Types of project in which I have worked - enterprise PBM projects within Healthcare problem domain, Ecommerce, data warehouse (Oracle, SQL, and PeopleSoft), enterprise application communication portal interface send/receiving data, adjudication (commercial and center for Medicaid/Medicare), clients custom solutions, drug master data refresh/updates/new product loads, provider and prescriber load implementation projects, financial transaction oriented projects, SAP, Kronos, Security Access, directed and managed new application development and enhancement within RxClaims AS400 adjudication platform environment
• Elicited requirements to support business objectives through interviews, focus meetings and research.
• Map business processes, diagram work flows, develop and modify use case diagrams, performed conceptual/logical data model documentation; as well as, create business system architecture diagrams and state models.
• Performed business need analysis to support application change management.
• Perform systems analysis to identify application limitations, support upgrades, identify opportunities for change management and implementation of new business strategic initiatives.
• Performed testing, lead JIT training sessions and created technical support manuals.
• Generated patient claim information to support Quality Assurance and User Acceptance Testing.
• Act as an agent for change within clinical PBM problem domain to identify and improve patient outcomes that support Confidential business partners, physicians, pharmacist, nurse practitioners and patients to achieve excellence in healthcare outcomes.

Confidential

Sr. CM Project Manager

Responsibilities:

• Perform CM for the entire SDLC from executive client support, BA, Development, QA/Test, Release management and production support.
• Maintain metrics, status and facilitate meetings throughout each phase of the project based on project needs and included relevant project stakeholders to ensure accurate and timely communication as it relates to project(s).
• Create and maintain project plan and tracking data for query use by leadership, cross functional team, interested stakeholders and PMO.
• Coordinated build efforts with various teams and lead Performing system builds for all CIS related code, identifying build problems and reporting the problems with builds to the development team.
• Developed and established migration, source code management and system maintenance procedures for Retail group and provide training.
• Generated a Clear Case and Clear Quest training class that streamline Retail CIS Group Processes and procedures.
• Lead the team to perform code cutovers, baselines, generating configuration specs associated with the cutover.
• Managed, created and supported User Acceptance, Marketing, QA, development and production environments.
• Lead efforts to resolve Oracle environmental and database related issues.
• Managed resources to run Batch jobs that supported the uploading and downloading of accounts information to ERCOT.
• Managed projects that brought in revenue in excess of 10M plus that support retail energy needs.
• Managed resources to define and documented strategies for long-term system configuration management.
• Performed Unix Scripting, software release labeling, VOB Views security, and related CM Clear Case solutions.