SUMMARY

• Sr. level Business Analyst with 10+ years’ experience working in Healthcare, PBM, and Government industries.
• Experience working on Web related projects. Most recently at confidencial , was as Lead Systems Analyst for a myPrime website implementation for a large multi - state client. Additionally, has been on web related projects while working with UHG on their Internal Web Portal and with Express Scripts on their POS interfaces
• Experienced working with application integrations and API’s while with Prime Therapeutics, UHG, Confidential, and Express Scripts.
• Worked on Medicaid Healthcare Claims / Claims adjudication sub-systems for a large PBM.
• Developed and executed test cases for UAT and functional system testing including data validation edits, pricing logic, EDI interfaces, claims entry screens and correction processing.
• Responsible for IT components of a case including data intake, claims processing program customization, interactive and static websites, IVR setup, scanning, and distribution

TECHNICAL SKILLS

Tools/Methods: TFS, SQL 2008, MS Project, Payroll, Medicare, Medicaid, Agile, SDLC, SharePoint, UNIX, JDE

PROFESSIONAL EXPERIENCE

Confidential

Systems Analyst

Responsibilities:

• Systems Analyst for the confidential  website, a portal that allows members to find information about medications, to find pharmacies, and to access their current medications and claims.
• Lead Systems Analyst on an implementation project for a large multi-state client. Duties included creating systems requirements for client configuration and customization requests. Participated in client requirements meetings. Worked with networks, eligibility and benefits teams to ensure setup was correct. Created test cases and identified data for QA testing and external client UAT. Validated database configuration and setup for new plans. Troubleshooting and research of issues.
• Systems Analyst on a project to create API's for client shopping experience. Assisted in identifying needed new cross-department procedures to implement and manage this new process. Assembled data for input into a XREF file to control access. Provided UAT support to clients implementing the new API's.
• Participated in planning and verification for quarterly releases. The most recent Q4 release was one of the largest, as well as the most successful releases for MyPrime.

Technical Environment: AQT, JIRA, Confluence, RxClaim, WS02, Java, Agile

Confidential

Lead Business Analyst / Project Manager

Responsibilities:

• Project Manager/Lead business analyst on a project to create new skills matching tool to assist user identifying their skills and matching them to various potential careers. Created and managed the project plan. Participated in off-site User Research with the product owners. Managed the business requirements process and created associated documents.
• Lead Business Analyst on a project to create a new youth-focused Occupation Profile tool. This tool displays information about an occupation including wage, employment projection, education and typical tasks. Lead second project to update the full version of the Occupation Profile too for a general audience, updating the too to use a new card-based interface, and adding much more occupation information.
• Lead Business Analyst on a project to convert essential career portal tools to responsive format for automatic mobile device support, and updated associated Google Play and Apple Store apps.
• Created Business Process, Business Requirements Documents and Project Task Plan
• Validated the implementation of new online eTools Standards, including compiling a detailed gap analysis.
• TFS was a new tool for this team; assisted them in organization and standards
• Organized and participated in UAT for monthly releases for CareerOneStop Portals
• Created TFS items, or work requests, for support and enhancement items for existing CareerOneStop tools including Job Finder, Salary Finder, Training Finder, Vets Job Finder, Unemployment Insurance, and American Job Center Finder.
• Created Business Requirements document to convert the State Services Tool to responsive format.
• Participated in planning for user research and usability studies
• Participated in subgroup to prioritize work requests
• Planned and executed functional and UAT testing.
• Data Source: Bureau of Labor Statistics, O*Net, SOC, IPEDS

Technical Environment: Microsoft .NET, TFS, SharePoint, Agile, Workfront, AppMachine

Confidential

Lead Quality Analyst / Business Analyst

Responsibilities:

• Lead Quality Analyst for the Lawson Platform Upgrade Project and Workbrain Time Management Implementation Project.
• Created Overall Test Plan for Lawson Platform Upgrade Project
• Created Testing Strategy documents for Workbrain Time Management Build Iterations, End to end and Dry Run (Parallel) testing.
• Created detailed system testing test scripts for both projects.
• Responsible for Developing and Maintaining Testing Metrics and Daily Testing Defect Log for both projects during System and UAT test phases.
• Created numerous supporting requirements documents for the Workbrain Time Management Project including Report Analysis, Security Role Access, and detailed Overtime and Override rules
• Coordinated daily test meetings in partnership with the vendor, technical and business resources. Technical Environment: Lawson, Workbrain, SharePoint
• Quality Analyst on a large JDE migration Project. Several roles including QA for system testing on a line of business, assisting another subproject with UAT testing, and coordination of regression testing across 8 additional LOB’s. Technical Environment: JDE 9.0, SharePoint
• Quality Analyst on a project to upgrade merchant processing. Quality analyst on a project to create a customer portal for loan advances. Lead Quality Analyst on a new expense reporting project. Technical Environment: Microsoft.net, SQL2008, TFS, SharePoint, Agile, Concur

Confidential

Lead Business Analyst

Responsibilities:

• Lead Business Analyst for a new release of an internal web portal used by all employees of the company. Key components of the release include a new single sign-on, adaptive authentication security system and the implementation of sections of PeopleSoft’s Manager Dashboard.
• Responsible for Requirement Gathering and Management
• Led numerous Focus Groups with key stakeholders to obtain requirements
• Primary liaison between the business stakeholders and technical teams during the design phase
• Business Process
• Participated in System and Regression testing of the release, including test case creation and execution
• Coordinated support for Usability sessions completed by an external UIX vendor
• Participated in planning of UAT testing, including use case creation and defect management
• Technical Environment: SharePoint, PeopleSoft, Quality Center

Confidential

Lead Business Analyst

Responsibilities:

• Lead Business Analyst for a new physician portal containing Clinical and Quality information.
• Responsible for coordinating all technical changes with three separate technical partners, as well as internal business stakeholders
• Responsible for support of test and demo systems, and production change management
• Worked with business stakeholders to obtain, prioritize and schedule requirements
• Authored requirements documentation and managed ongoing defect and enhancement lists for the product
• Managed project from late in the requirements phase, through the pilot, initial implementation and subsequent enhancement releases
• Coordinated with QA lead to create and execute UAT test plans and individual test cases
• Participated in Usability and Alpha workshop planning
• Presented numerous system demonstrations for internal stakeholders
• Technical Environment: Microsoft SQL Server 2008, .Net, Microsoft Access, SharePoint

Confidential

Lead Business Analyst

Responsibilities:

• Lead Business Analyst for the Consumer Niche of a Class Action Suite Administrator.
• Responsible for IT components of a case including data intake, claims processing program customization, interactive and static websites, IVR setup, scanning, and distribution.
• Worked with business partners to obtain data and claims processing requirements, and to create project plan and implementation schedule.
• Managed technical resources, including data analysts, application programmers, web programmers, and quality assurance throughout the life of the project.
• As a member of the Web Standards Team created a standards document outlining current standards and recommendations for future development.
• Technical Environment: Microsoft SQL Server 2005, .Net, HTML, Microsoft Access, SharePoint, Kofax

Confidential

Business Analyst/Project Lead

Responsibilities:

• Senior Business Analyst in the Payroll and E-Recruiting Systems areas for a large ERP Software provider.
• Lead Analyst for the E-Recruiting Project.
• Project was an e-recruiting application utilizing a new fourth-generation development platform. This application was the first to be built in the new platform, thus the requirements for the application not only affected the application itself but were used to build new functionality for the underlying environment in simultaneous development.
• Responsibilities include project planning, functional and technical specifications, use case development, and managing the development of the product in a new programming language.
• Lead Analyst for the Offshore Payroll Initiative, providing training schedules, mentoring, and metrics for evaluating readiness of offshore team to take over maintenance duties.
• Lead Business Analyst for the UK Payroll year-end Project.
• Responsibilities included gaining product knowledge from counterparts in the UK, working with a third-party vendor to update year-end programs, and transfer of knowledge to team to begin maintenance in-house.

Confidential

Business Analyst

Responsibilities:

• Business Analyst for a company specializing in Medicaid Healthcare Claims systems.
• Project was implementing HIPPA compliance for a state Medicaid system including new EDI transactions, claims entry screens and claims processing engine.
• Developed and executed test cases for functional system testing including data validation edits, pricing logic, EDI interfaces, claims entry screens and correction processing. Updated and maintained instructions for entry of claims tests and identification and creation of valid claim test data.
• Updated system help and user documentation.
• Performed end user training.
• Key participant in special high-profile cross-function team created to complete detailed analysis of parallel test claims.
• Team was quickly able to identify and resolve problems, resulting in a very successful system implementation.

Confidential

Information Systems Manager

Responsibilities:

• Systems Manager in the Claims and Pharmacy Systems areas of a large Pharmacy Benefit Management company.
• Managed teams of five to ten developers responsible for various claims adjudication subsystems, including Indemnity, Prior Authorization, and Pharmacy.
• Responsible for hiring, MBO’s, appraisals, managing incoming work, internal training, status reporting, audit requirements, career development and budgeting.
• Worked with internal stakeholders to obtain and manage business requirements, and ensure sign-off for all software development lifecycle artifacts
• Projects included system support and client enhancements, Y2K, and Field Size Expansion. Successfully managed many small to medium-sized projects related to the consolidation of two adjudication systems onto one platform.
• Acted as key department liaison for implementation of new change management, problem management, prioritization processes, life cycle development methodology, and source code management and implementation procedures.
• Managed development area, implementations and common API’s for all areas with Point of Sale interfaces.

Confidential

Technical Project Lead

Responsibilities:

• Managed the technical resource for a Y2K project for the retirement services area at confidential .
• The application included the record keeping system for retirement plans -401k, profit sharing, ESOP, and associated management reporting and interfaces to IVR, distributed systems, and various other internal and external systems.
• Duties included coordination with the factory renovating the COBOL code and internal resources renovating Pacbase and Easytrieve code; program change management; preparation and support of a Y2K testing environment, and liaison with the centralized Y2K technical resources and business resources conducting the UAT tests.
• Project Duration: 11 months.
• Assigned to the Human Resources Lawson project team, which provides customization for companies which have purchased the Confidential Application Package.
• Duties include creating proposals and project estimates, requirements gathering, functional and physical system design, system testing and implementation of software modifications.
• In addition, provided second-line phone support for the Confidential Human Resources Suite at Lawson’s Center of Excellence with duties including troubleshooting using Animator, resolving procedural problems, researching error conditions, and applying patches. Project Duration: 11 months.
• Assigned as lead for the first Outsourcing Management Team at Cargill. This three-person team was responsible for all mainframe application support for the Human Resources and Payroll Department.
• Applications included a TesserAct payroll system on a DB2 platform and all accompanying interfaces.
• Duties included managing all requests for support and maintenance, monitoring of the Help Line and 24 X 7 support, quality assurance ensuring all development followed company standards and methodology, development implementation, and management of the test environment.
• Major accomplishments included creating procedures to manage team turnover and training; creating an APPROACH database to record all support items and create statistics for reporting and planning, successfully supporting the environment during a major conversion which doubled the size of the database and created 15 new interfaces, and tuning the batch payroll schedule in order to complete it in the required batch window. Project Duration: 21 months.
• Assigned to analyze the legacy accounts payable invoice matching system at 3M. Determined severity of problems with the system, identified solutions and work-arounds, and estimated amount of time needed to implement solutions. Results of this study were used to schedule maintenance requests and aid in planning major functional enhancements to the system. Project Duration: 3 months.

Confidential

Systems Manager

Responsibilities:

• Managed department responsible for development and maintenance of all mainframe applications including mission critical billing, premium processing, and financial and statistical reporting systems.
• Supervised staff of 14 systems analysts and application programmers.
• Responsible for all planning, staffing, and budgeting items.
• Major accomplishments include implementing a new Management by Objective measurement system, and planning and providing support for moving the data center to another site.
• Lead process analyst for a project that reviewed all systems for both American Hardware and a recently affiliated company with the goal of determining how best to integrate the systems of both companies.
• Used the ADW CASE tool to develop high-level process models of the companies' data flows. Lead user interview activities.
• Led effort to take the affiliate company's project methodology, ADP, and move it into American Hardware's current system development workflow.

Confidential

Project Leader/Data Analyst - Financial Reporting

Responsibilities:

• Project leader for a project to create a Financial Reporting Data Base using data warehouse concepts.
• Duties included working with the customer to determine whether the system met their needs, coordinating user testing of the prototype to verify correctness and completeness, and creating and conducting user training programs and accompanying documentation.
• Responsible for all scheduling as well as implementation planning including migrating from the current to new reporting system using batch QMF; ad-hoc query capability by the end-user; and downloading data from mainframe to LAN-based Lotus spreadsheets.
• Created specifications for new data base tables and edits; worked with end users and managers to create business rules and procedures; and determined system changes needed to ensure data accuracy.
• Project Leader for all Commercial Lines policy processing system applications, consisting of two rating/policy issuance systems on networks in three regional offices, with branch offices and sales representatives nationwide.
• Duties included scheduling all programming for maintenance and new projects, analysis of proposed system changes, release management, troubleshooting in production environment, and being the primary user, vendor and management contact.
• Major projects include organizing the take-over of maintenance previously programmed by an outside vendor, standardizing all programming documentation and creating a cross-training program.
• Selected as one of the few original Project Leaders in the company’s MIS department, began work on this project before it was determined what hardware or vendors to use.
• Duties included creating company specifications, setting up structured test procedures, determination of hardware and personnel needs, creating release management standards, creating programming standards, scheduling of tasks to be completed, training and supervising programmers, and being the primary user, management and vendor contact.
• Received a Special Merit Award for the project, which was recognized as one of the company’s most successful, with enhancements consistently delivered on time, a very low problem ratio, and high user satisfaction.