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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