SUMMARY

• Highly motivated, results - driven individual with extensive experience in Health Informatics, Analysis and Health IT. Keen critical thinking talents to identify and resolves system issues, Strategic solutions contributor. Ability to create practical solutions to business problems and create innovative ideas, Articulate communicator with strong oratory and writing capabilities complemented by IT technical and business knowledge in multiple methodologies.

TECHNICAL SKILLS

• Microsoft Project and Visio.
• Microsoft SharePoint, Windows 7, MetaVance (Members Edge Systems). Webclient. SQL Basics.
• FileZilla, Data Mining, Data Analytics, VPN access. Sharepoint, Deltek time log. ALM,
• HICS (Health Information Casework Systems)
• ACA (Affordable Care Act) Systems and applications.
• SOA (Service Oriented Architecture) Testing, debugging, and Intel mapping
• EDI Transaction code sets 834, 835, 837, 276 and 277
• Agile and SAP applications
• Agile and scrum tools Version 1, Confluence, JIRA and Rally
• GTES systems, EDOs (EMM and Non EMM file systems)
• SQL databases. (production and test environments)
• Product Lifecycle Management
• XML, UML and XLS understanding.
• Rally Software for Agile Implementations.
• CINCOM ELOQUENCE Software for form creation, data mapping and XML logic.
• Enable Now (SAP Workforce Performance Builder)
• Utilization Management, Care Management, benefit management, reporting and analytics
• Webservices and data analytics with User Interfaces.
• Service Now applications
• Microsoft Dynamics 365
• Compass systems
• PriZem claim systems
• Microsoft Team Foundation Server (TFS systems)
• WGS Systems
• NASCO Systems

PROFESSIONAL EXPERIENCE

Confidential

Sr Business Systems Analyst/Business Process Engineer

Responsibilities:

• Work directly with and serve as the liaison between business units, technology teams and support teams.
• Elicit requirements using interviews, document analysis, requirements, workshops, business process descriptions, use cases, scenarios, business analysis, task and workflow.
• Designs new system enhancements by analyzing requirements; constructing workflow charts and diagrams; studying system capabilities; writing specifications.
• Critically evaluate information gathered from multiple sources, reconcile conflicts and decompose high-level information into details.
• Create and maintain workflows, approval processes, and validation rules based on internal stakeholder requirements.
• Create training materials and documentations for internal claims system
• Perform a thorough gap analysis of existing to potential functionality for the claim processing systems
• Regularly meet with business users to have a better understanding of the operations
• Perform analysis and identify gaps in functionality for system integrations
• Securing sign-off on requirements documentation to manage project scope
• Collaborate with developers and subject matter experts to establish the technical vision and analyze tradeoffs between usability and performance needs.
• Improves systems by studying current practices; designing modifications
• Assist in quality assurance of new software or enhancements to existing software as needed
• Deliver informative, well-organized presentations
• Maintain awareness of and ensure adherence to our standards regarding privacy.
• Using Dynamic 365 for ERP client management

Confidential Systems

Project Manager/ Sr Business Systems Analyst

Responsibilities:

• Electronic eligibility analyst: working (60-100/120 new electronic eligibility files a month, get assigned a group of electronic eligibility clients that are going through testing process to implementations
• Work with the vendor, client that is submitting electronic eligibility to Confidential understanding 834 (HIPAA) EE file
• WellPoint (WGS) common formatted file analysis
• Responsible for ownership of entire process, as Project Lead.
• Taking test file through EDI, run through, analysis of results
• Testing: getting a 834 file from vendor as a test file - visual inspection to make sure data elements look ok, production preview, can only preview (not updating of test data), then look at types of test areas (may see common errors)
• Work with EDI partners to move client to production
• Performed UAT testings with the developers and engineers for code validation.
• Lead Scrum Meetings to get updates on multiple clients as implementation process begins for OE (Open Enrollment)

Confidential

Sr Business Systems Analyst

Responsibilities:

• Works with business partner to elicit high-level requirements and capture business needs.
• Clearly articulates and documents business requirements.
• Assesses the risks of various solutions and prioritizes competing business demands.
• Manages ongoing relationship with business partner to drive satisfaction with IT.
• Develop, maintain and share expert knowledge of assigned business processes, workflows, systems and technologies.
• Coordinates project delivery by participating in design reviews and walk-through to communicate systems designs and validate proposed solutions.
• Obtains key inputs from enterprise architecture teams and identifies solution interdependencies.
• Proactively resolves customer satisfaction issues.
• Partner with QA team to development tests plans and lead testing cycles.
• Learn new systems, processes and technologies such as Cincom Eloquence
• Produce source-to-target data mapping specifications for Insurance-related forms covering various lines of business from the Delphi Oasis system to the Cincom Eloquence system.
• Coordinate with business owners and form users to ensure that form language, design and version control is accurate.
• Perform forms authoring in the Cincom Eloquence system utilizing advanced MS Word tools to replicate form design, formatting and specifications.
• Partner with Underwriters to ensure that appropriate coverages, risks, exposures and limits are populated into forms.
• Coordinate with Delphi representatives to define data mapping timelines, develop form process work flows and ensure accuracy of data mapping.
• Perform XML data field mapping in Eloquence to ensure that variable data is mapped to forms correctly.
• Utilize Delphi SharePoint site to upload/download forms, manage work flow and forms inventory.
• Ensure form production tracking spreadsheets and updated with accurate versions, consolidations, discontinuations, batches and form template IDs.
• Develop global form standards to ensure form consistency and adherence to organizational standards.

Confidential

Sr Business Systems Analyst

Responsibilities:

• Liaising extensively with external or internal clients.
• Analyzing clients' existing systems and business models;
• Mapping and documenting interfaces between legacy and new systems; and performing data analysis on logistical reports
• Translating client requirements into highly specified project briefs.
• Identifying options for potential solutions and assessing them for both technical and business suitability.
• Conducting requirements analysis and preparing specific proposals for modified or replacement systems;
• Producing project feasibility and costing reports;
• Working closely with colleagues, developers, testers and a variety of end users to ensure technical compatibility and user satisfaction.
• Ensuring that budgets are adhered to and deadlines are met;
• Overseeing implementation of a new system including data migration;
• Planning and working flexibly to deadlines.
• Supporting users on change control and system updates in addition to testing of updates before deployment to production.
• Providing training and user manuals to users of the GTES system.
• Support for GTES enablement validation and Integration (ODM + Third Parties /Warehouse / GTRP) effort under the guidance of the client
• Validate GTES enablement files and perform data analysis
• Review the sample files and resolve any issues before sending to clients
• Comparison to PID (product Identification data) list to prevent having gaps
• Data file configurations and testing of files in GTES systems
• Conducting work with offshore developers and analyst in Paris and India to perform analysis of issues and perform testing and deployments.

Confidential

Senior Business System Consultant

Responsibilities:

• Responsible for translating most highly complex and varied business needs into application software requirements.
• Provides expertise to lower leveled consultants. This is the highest level in a career progression.
• Provides expertise to lower level consultants on the analysis of business needs to determine optimal means of meeting those needs.
• Determines specific business application software requirements to address the most highly complex and varied business needs.
• Lead teams of analysts assigned to the most complex projects, typically those of highest importance and impact to the way in which we do business.
• Analyzes and designs solutions to address varied and highly complex business needs
• Worked closely with Developer’s and DBA’s to analyze and verify all data results to ensure a successful Implementation.
• Leads Scrum meetings to get current updates on client implementation, and participate in Sprint Planning.
• Leads Care Management team with application support for clients, and patients.
• Work with team for sprint planning, deployments and post production.
• Performed UAT testing with the developers and engineers for code validation
• Performed data analytics using Microsoft Dynamics CRM tool in addition to business intelligence gathering, facilitation of communications and customer information storage.
• Lead daily Scrum Meetings to get updates from team mates to report to Director.