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Professional Service Analyst Resume

SUMMARY:

Professional Service Analyst, with twenty - six years of experience in commercial and Medicaid Management Information System healthcare. Applications experience includes the functional area for a large Healthcare as well as participating in the development of a new Medicaid Management Information System for multiple states. I provided fiscal agent services that supported the Confidential after the implementation of the Health Enterprise System. I am very quality conscious, enjoy challenges, and will do what is needed to get the job done.

FUNCTIONAL TECHNOLOGY:

  • Commercial System including Eligibility, Enrollment, ID Cards, Letters, Reports, Billing, Payment Processing, Maintenance.
  • MMIS Member Management System including Manage Member Information, Member Care Management Program, Manage Member Communication, Manage Member Interfaces, Manage Member Buy-in Information, Merge Duplicate Member Record, Unmerge Multiple Member on one Record, Member Confidential Outreach and Tracking. Health Enterprise system including Member and Third Party Liability functional areas.
  • Implementing projects, unit testing, functional testing, system testing and user acceptance testing.

TECHNICAL SKILLS:

Languages: COBOL, C, Java.

Databases: Oracle, DB2, IMS DB.

Operating systems: IBM os390, UNIX, Windows (XP, 7 Enterprise).

Testing Tools: Rational Manual Tester, Rational CQTM, Xpediter

Development Tools: Rational RequisitePro, Rational ClearQuest

PROFESSIONAL EXPERIENCE:

Confidential

Professional Service Analyst

Responsibilities:

  • Provided analysis support for the various components of the Member and Third Party Liability functional areas.
  • Supported the Preliminary and Final Payment processes while executing on call responsibilities.
  • Collaborated with Operations Support to provide instructions on jobs to be executed during the Preliminary and Final Payment processes.
  • Executed Oracle SQL queries to identify ghost claims and provide payment data to the Confidential while supporting Preliminary payment.
  • Executed Oracle SQL queries to provide payment data to the Confidential while supporting Final payment.
  • Created high level documents to support required system changes and forwarded those documents to the state.
  • Manually updated system data on an as needed basis.
  • Provided testing support when required.
  • Identified OCR claims that required XML corrections and forwarded them to the group responsible for performing the updates.

Confidential

System Development Senior Specialist

Responsibilities:

  • Participated in executing the Member functional test and verified the related configured test cases actual results.
  • Created defects to support failures identified during testing of the configured test cases.
  • Modified configured test cases to adhere to new or updated requirements.
  • Reviewed and modified System test cases to adhere to new or updated requirements.
  • Led the Member System test team of five people that completed the system test on time in order to start user acceptance testing.
  • Executed Member System test cases and verified the actual results.
  • Provided analysis and testing support for identified Production defects after Go Live.

Confidential

Business Analyst

Responsibilities:

  • Traveled to New Hampshire and participated in DSD walkthrough sessions.
  • Provided analysis of the existing DSD and modified use cases based on agreements reached during the walkthroughs.
  • Participated in Comment Review sessions with the State and provided analysis for issues identified during the sessions.
  • Created test cases to support the identified testing strategy.
  • Executed the test cases and verified the actual results.
  • Created test cases for all Confidential use cases and verified the actual results after executing the test cases.
  • Created defects to support failures identified when testing Member and Confidential test cases.
  • Provided analysis support to correct the identified defects in order to advance the test cases to successfully executed statuses.

Confidential

Senior Programmer Analyst

Responsibilities:

  • Provided analysis, design, coding, testing and debugging of multiple parts of a healthcare system utilizing IMS DB/DC and DB2 including both batch and online components.
  • Provided on-call Production support and communicated daily with internal and external customers.
  • Performed analysis, design and programming of a batch system which provided data to a Vendor Online Health Advice System by generating the system with the use of an Application Interface Engine utilizing DB2 and COBOLII.
  • Implemented major enhancements of an IMS on-line/batch Composite Rating System on schedule and on budget.
  • Performed programming and analysis efforts for a Insurance Identification Card System which allowed for the streamlining of necessary enhancements by reducing the coding cycle from several weeks to several days.
  • Performed coding, testing and debugging during the development of the Community Renewal system which consisted of online/batch program designed to automate the existing manual system.

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