QUALIFICATION SUMMARY

Background:

• A career in Information Technology with more than thirty years as a contract consulting legacy business analyst, mainframe programmer/analyst, systems analyst, data analyst, and applications IT specialist, many short and long term assignments, some with project and team lead responsibilities. Primary focus government healthcare applications.
• Varied experience including Medicaid MMIS, MITA, Medical Billing Champus, Medicare, Eligibility Information Systems EIS, ISD2 Hospital and Professional Applications UB92, UB04, and CMS1500, and General Insurance Health Claims . Other: Public Utility CIS, Plant Property, Rates, Child Support Enforcement CSE, State Government DES, DHS, DSS.
• HIPAA ASC X12 EDI Transactions 270/271, 276/277, 277CA, 277PSI, 278, 834, 820, 835, 837 P,I,D, TA1 and 999 knowledge and working experience. Worked extensively in MMIS claims and payment areas.
• MITA 2.0 Experience and MITA 3.0 Knowledge.
• 4010A1 to 5010 EDI Analyst, ICD - 9 to ICD-10 Analyst
• DRG, HCPCS, CPT, NUBC, and NUCC Codes
• HIPAA compliant training current as of 2010
• Database analysis and design experience including hierarchical, network, and relational constructs. Many involved conversion and migration projects.
• Experienced using Conceptual Data Modeling and Mapping using Data Analysis techniques of Entity-Relationship E/R Mapping, Attribute Analysis, Data Flow Diagrams DFD, and Normalization of Data.
• Familiar with Project Plans, Process Flows, Procedure Documentation, Requirement and Functional Specifications, Requirements Traceability Matrixes RTM, Use and Business Case, Rules Definition, Gap Analysis, Calculation Validation, Audit Validations, Impact Analysis, Use Case Diagrams, Activity Diagrams, State Chart Diagrams, Collaboration Diagrams, Deployment Diagrams and other Business Analyst foundations like Agile and Scrum.
• Experienced using test methodologies and the software development lifecycle. Have the ability to evaluate comprehensive test strategies and plans.
• Understand and leverage existing manual and/or automated test cases where needed, design and develop new test cases in line with the test strategy and plan, and identify possible candidates for automation from existing test cases.
• Experienced with software testing strategy development including Master Test Plan, Unit Test Plan, Function Test Plan, System Integration Test Plan SIT, User Acceptance Test Plan UAT, Installation Test Plan and Test Team Leadership
• Capability Maturity Model Integration CMMI process improvement approach
• Trained to SEI Levels 2 3 CM, CMM/SQA, SCM, Project control, Project Tracking. ISO 9002 QA.

TECHNICAL SUMMARY

Hardware:

• 1990s - Current IBM 370/390 series, IBM 308X, 309X, ES9000, z Series, and System z/9 series. Also Amdahl Mainframe Series, DEC and SUN mid-range servers, and IBM or compatible personal computers.
• 1980s Unisys, Honeywell, and NCR second and third generation mainframes.

Software:

• IBM: Z/OS, OS/390, MVS/ESA TSO/ISPF, DB2, MQ Series 5.0, IMS/VS, ISPF, CICS, PROTERM, TELON, FileAid, Startool, Xpediter, Intertest, Smartest, TSO Edit, VSAM, OS/JCL, JES2, JES3, ENDEVOR, Librarian, Panvalet, FOCUS, SyncSort, IBM Utilities, FTP, NDM, Broker Data Exchange, MoveIT, and BETA42, CA-7, CA-11, OPC/ESA, TWS, Control-M, RACF, ACF2.
• Code: COBOL, COBOL II, OS/COBOL, COBOL/390, EASYTRIEVE PLUS, CICS TS, BMS, DB2 /SQL /SPUFI /QMF, FOCUS, SAS, DYL280, REXX, TELON
• PC: Windows - Microsoft Office Suite products WORD, EXCEL, MS MAIL, and PROJECT. Also SilkTest, Mercury Test Director, Remedy 7.5, IBM's ManageNow, Lotus Notes, SharePoint, Visio, ABC Flowcharter, DocuTraxx, ReqTrace, MedStat, others.

PROFESSIONAL EXPERIENCE

Confidential

MMIS EDI Business Analyst

This BA position entailed exercising subject matter expertise in Medicaid for the HIPAA mandated EDI 4010A1 to 5010 conversion. Analyze and document EDI business rules, policies and procedures for gap analysis and mapping changes for vendor development. HIPAA compliancy training completed for 2012.

Confidential

Perot Data Systems

Production Control Specialist

This production control PC position required CA-7 and CA-11 subject matter expertise for submitting, monitoring and correcting mainframe and server applications including Trizetto's Facets. Responsible for responding to Remedy tickets, contacting developers when required, and creating daily status reports.

Confidential

MMIS Technical Team Lead

This MMIS system technical team lead position encompassed the transition of a legacy MMIS application using VSAM files to ACS OmniCaid application based on DB2 with a Web Portal interface. Provided guidance and mentoring to a team tasked with implementing the MMIS upgrade. Additionally provided DB2 support for the Provider subsystem. HIPAA compliancy training completed for 2009.

Confidential

MMIS Business Analyst

This MMIS BA position entailed exercising subject matter expertise in Medicaid and MITA. Responsible for the Business Relationship Management BRM function and Team Lead for the MMIS interfaces function. Reviewed requirements and supplemented as necessary. Entered Use Cases and Requirements into a Requirements Traceability Matrix RTM software product ReqTrace. Wrote and published the Requirements Validation Document RVD . HIPAA compliant 2008.

Confidential

. MMIS Consultant with Analysts International

MMIS Technical QA Business Analyst

This QA position entailed revising a REXX program to examine both batch and online COBOL programs and reports any deviations from standards.

Confidential

CJIS Consultant with Analysts International

Business Process Consultant

Wrote the complete DCI business requirements specification BRS, and the computerized criminal history CCH functional requirements specification which were the primary documents in the final published business plan to bid.

Confidential . MMIS Contract Consultant

MMIS Programmer/Analyst and Business Analyst

Designed and programmed the National Provider Identifier NPI cross reference module and a CICS on-line NPI number lookup module. Made COBOL modifications for NPI to the Prior Authorization PA batch module.

Confidential

ERP Contract Consultant

DB2 Programmer/Analyst

Provided QMF / SPUFI / DB2, MVS TSO, JCL COBOL expertise for the Project Share ERP conversion. This position required State of New Mexico GSD legacy DB2 table knowledge to map and write DB2 extract programs to obtain legacy HR and Payroll data to populate the new ERP application.

Confidential

Contract Consultant

DB2 Programmer/Analyst

Provided MVS TSO, JCL, CICS / DB2 COBOL design and code expertise for the Private Label Self Clearing pilot. This position required Fidelity Brokerage Services knowledge of National Financials application to process trades and other transactions from a multi-company viewpoint.

Confidential

Employee, First Health Services Corporation FHSC,

MMIS Business Analyst

Provided Recipient conversion business cases and unit test expectations and entered these documents into required DocuTrax tracking software. Recorded test results into the required control software packages Remedy and Test Traxx. Executed unit and user acceptance tests. Produced validation packages for impacted business lines and obtained implementation plan approvals. Received in-depth HIPAA compliance training for 2005.

Confidential

IBM Business Analyst

IBM Global Services

Provided IBM MVS TSO, JCL, VSAM, COBOL II, CICS TS 2.2, DB2 batch, Easytrieve Plus and FTP expertise for on-going maintenance and support. ISD2 is an online integrated automated system for determining eligibility benefits for programs such as Medicaid, food stamps and TANF. Responsibilities included preparing applicable test plans and objectives, identifying major requirements and schedules for testing, problem reporting, tracking, and defect removal.

Confidential

Contract Consultant

Plant property DPRS, and Financial Systems.

COBOL, ProTerm, and CICS used with DPRS. SAS used for street light power usage analysis.

Confidential

Contract Consultant through Global

Child Support Enforcement CSE CSENET development DB2 project. Designed and wrote the pilot DB2 application using COBOL and TELON. IBM MVS/390.

Confidential

Contract Consultant

Y2K renovation and version upgrade project for OMNIPLAN interfacing programs.

Confidential

Thru MODIS

Provided MVS TSO, JCL, COBOLII and EASYTRIEVE PLUS batch, DB2 batch, CICS 3.3, and NDM production support for problem resolution as required.

Confidential

MMIS Contract Consultant through LENCO

Commonwealth of Massachusetts, Dept. of Medical Assistance, 5 Middlesex Ave., Somerville MA 02194. HCR updates to the Case and Recipient IMS databases.

Confidential

Contract Consultant through LENCO MODIS

Confidential

Contract Consultant through CDI

Allied Signal Aerospace Co., 404 Airlane Blvd., Phoenix AZ 85010

MAC/PAC and PROCUREMENT/D Support. COBOL IMS DB/DC.

Confidential

MMIS Senior Programmer/Analyst

• Project Leader - Maintenance Backlog Reduction Project. Lead a team of five employees and five consultants on a project to implement changes to over three hundred programs. Provided technical approach analysis, IBM MVS TSO, JCL, VSAM, COBOLII, EASYTRIEVE PLUS, FileAid, IMS, and CICS programming guidance or help when necessary.
• Team Leader - Recipient, Third Party Liability TPL, and the Early and Periodic Screening, Diagnosis and Treatment EPSDT subsystems. Full project life cycle reporting and tracking responsibilities. Mentored team members as required to ensure best practices and techniques were being followed.
• Team Member - Recipient subsystem development and test team. Provided IBM/MVS IMS/VS COBOL II and EASYTRIEVE Plus expertise and wrote the Recipient archiving subsystem IMS/VS .
• Technical Writer Member of team documenting and publishing the MMIS user manuals for Massachusetts.