SUMMARY

• Twelve years of experience in health information technology, clinical research and software development focusing on healthcare policy and regulations to improve quality of life through data, outcome and evidence - based research.
• I have expertise in public health and health IT to direct stakeholders and the functional community (doctors, nurses and practitioners) with the requirements, policies and regulations to build software to meet the needs of patients, vendors, doctors, and hospitals to collect electronic health record data for claims data and quality reporting.

TECHNICAL SKILLS

• Serena Requirements Management (RM) tool utilized for Business Analysis and Software Development
• Software Development Lifecycle (SDLC)
• Microsoft Office Suite (Word, Excel, Project, PowerPoint, Visio, Outlook)

PROFESSIONAL EXPERIENCE

Confidential

CEO and Founder

Responsibilities:

• Independent subcontractor for Centers for Medicaid and Medicare Services (CMS) on the Quality Payment Program working on the development of a cost measures engine that will calculate and assess the episode grouper measures through the Agile IT process.
• Independent subcontractor for a commercial vendor developing a customized application to link to their existing electronic health record with the requirements for Centers for Medicaid and Medicare Services’ (CMS) Quality Payment Program.
• Health Information Technology and Management Consulting start-up focusing on the healthcare patients and consumers by promoting health education, public health advocacy and understanding your health data.
• Understanding how to interpret electronic health record data to improve outcomes and quality of life of healthcare patients and consumers.
• Instituting the Centers for Medicaid and Medicare Services (CMS) programs and managing software developers and vendors on the reporting requirements, regulations and compliance policies for the Quality Payment Program (QPP) (formerly Physician Quality Reporting System (PQRS), Meaningful Use (MU), Value Based Modifier (VBM) which is under the MACRA legislation focusing on the Merit-based Incentive Program (MIPS) and Advanced Alternative Payment Models (APMs) Tracks by presenting and educating the client on a subcontracting agreement.
• Create an understanding to teach HL7 Clinical Document Architecture (CDA) requirements for software development for EHR certification for Meaningful Use.
• Subcontractor to the prime CMS Quality Payment Program (QPP) Cost Plus Measures Engine Development Team. Creating a quality approach plan for the system, input, output and innovative approach to the measures engine development.

Confidential, Durham, NC

Enterprise Business Analyst

Responsibilities:

• Elicit and gather business requirements on the BCBSNC specific software development life cycle SDLC process or the business analysis management (BAM) process for the Affordable Care Act (On-FFM) Federal Funded Marketplace (Healthcare.gov) and Off-FFM (private) health insurance marketplace through BCBSNC BuyOnline.
• Work with developers, testers, and software engineers to update the current and legacy systems to support the Individual Refresh marketplace for the On and Off-FFM exchange for the purchase of Government mandated/Federally funded health insurance or private health insurance.
• Manage and track functional and technical requirements through the SDLC methodology.
• Confirm test cases and system requirements with the developers and testers on the business process updates and business needs of BCBSNC.

Confidential, Herndon, VA

Subject Matter Expert

Responsibilities:

• Business development and analysis for the ADELE vehicle of task orders for CMS quality based initiatives such as Merit-based Incentive Payment System (MIPS) and QPP based on Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) legislation.
• Research and development of the legacy programs of quality reporting: Physician Quality Reporting System (PQRS), Value-based Modifier (VBM) and the Electronic Health Record and Meaningful Use (EHR MU) programs. Understanding policy for HL7 CDA and FHIR for EHR certification for Meaningful Use.
• Usability testing of development QPP website to review design and functionality.

Confidential, Columbia, MD

Systems Analyst

Responsibilities:

• Business requirements lead for the Joint Application Development (JAD) or Joint requirements sessions (JRS)
• Requirements development based on SharePoint layout and design.
• Utilized the SalesForce application to communicate, correspond, and upload/download data for health insurance agencies to receive and to retrieve de-identified patient data from Centers for Medicaid and Medicare Services (CMS).
• Developed mock-ups/wireframes with Balsamiq tool to illustrate design of the data application collecting Enhanced MTM encounter data. The goal of Enhanced MTM Model is to create a database where the data can be analyzed to improve quality of medication delivery and monitoring of Part D Plans and beneficiaries.
• Created Systematized Nomenclature of Medicine - Clinical Terms (SNOMED CT) value sets called “starter” value sets for the Enhanced MTM Model and published them on the National Library of Medicine (NLM) Value Set Authority Center (VSAC)
• Utilized the following code sets for the Enhanced MTM participants to submit encounter data based on the specifications data dictionary: National Code Directory (NDC), SNOMED CT, Current Procedural Terminology (CPT), ICD-10, Diagnosis Related Group (DRG), Healthcare Common Procedure Coding System (HCPCS), and codes for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS)
• Utilize Health Insurance Portability and Accountability (HIPAA) provisions for enhanced encounter data collection. Also, had Centers for Medicare and Medicaid Services (CMS) HIPAA training. Reviewed policy and implementation guides for HL7 CCDA for health data exchange.
• Wrote the Request for Information (RFI) for business development (Technical Modification) to the current project that outlines the tasks to pull claim and claim line feed data (CCLF) from the Integrated Data Repository (IDR within the CMS Mainframe). This effort doubled the project’s budget by $10 Million. After the award, I led the business requirements sessions and wrote the business requirement document for the effort through completion.

Confidential, Windsor Mill, MD

Technical Writer/Project Coordinator

Responsibilities:

• Write and edit technical documents, project documentation, and business process guides
• Write original document content based on extractions from subject matter experts and stakeholders.
• Utilize SharePoint as the single source of documentation storage, review and version control
• Schedule and facilitate client meetings
• Prepare meeting minutes for client meetings and JADs
• Maintain SharePoint document repository for project
• Utilize CMS XLC Requirements and Templates for Project Management and content documentation
• Apply 508 Compliance to all documents, websites and screens

Confidential, Elkridge, MD

Subject Matter Expert

Responsibilities:

• Support for the QualityNet Helpdesk - Tier II with Remedy responding to Physician Quality Reporting Program (PQRS) inquiries encompassing calendar year specific program questions, quality measure related questions, quality data submission (XML, QRDA, CDA) and questions on the eligibility of the eligible providers, hospitals, and suppliers participating in the Shared Savings Program (MSSP) by creating or participating in an Accountable Care Organization (ACO).
• Support for Communications and Correspondence Task Team, which entails project administration, accounting, correspondence support, status reporting and planning.
• Technical writer for tasks and documents submitted on behalf of PQPMI for PQRS.
• Defines detailed requirements, analyzes business needs, and validates solutions with the client.
• Details requirements through policy development and other functions to support the project team.
• Monitors other business analysts to ensure measures development methods and communications efforts adhere to established standards, processes, and provides leadership in the implementation of those methods.
• Evaluates project requirements and assists in tailoring the development process to meet the project needs.
• Prepare meeting materials including agendas, minutes, schedules, educational references and attachments for calls with vendors and stakeholders.