- Highly motivated, accomplished healthcare professional with strong computer systems and leadership experience.
- Expert knowledge in Health Information Exchange, including all HIPAA mandated transactions. Ability to create and implement business plan, thinking both strategically and tactically.
- Knowledgeable and experienced in all key components of teh project life cycle and Agile Development.
- Exceptional team builder with extensive experience in leading cross - functional project teams in teh successful completion of large- and small-scale projects on schedule and within budget.
- Experienced in applying best practices to projects and work processes to ensure highest possible quality.
- Especially adept at analyzing problems and finding and implementing innovative problem solutions.
- Proven ability to make sound and logical decisions under pressure.
- Possess excellent team leadership, communication, negotiation, and interpersonal skills as well as teh ability to motivate teams and individuals to achieve their personal and professional best.
- Member Project Management Institute and AS/400 Common User Group, with additional capabilities in:
- Responsible for teh implementation of clients population health project initiatives
- Provided combined technical, business and application leadership and expertise for projects involving teh Population Health team
- Responsible for developing and approvals of projects and project related artifacts based on decision parameters including cost, timing, function, benefits and risk
- Convene and manage multi-disciplinary teams including in-house staff, consultants and multiple vendors to achieve business goals
- With input from stakeholders and team members, developed project charters and comprehensive project plans for high level corporate strategic initiatives
- Worked closely with business and IT stakeholder to understand and execute teh projects vision and strategy
- Assisted business analyst in gathering and documenting requirements by introducing tools dat enhance productivity
- Work closely with customers/internal clients to garner feedback and understand their evolving business needs
- Established teh use of Agile development process utilizing JIRA software to track project backlog
- Acted as teh JIRA project administrator as well as teh Product Owner for teh team
- Established project objectives, policies, procedures and performance standards within teh boundaries of teh clients corporate policies
- Manage project resources and facilitate constraint resolution to ensure dat corporate goals and objectives are accomplished on time and within budget
Confidential, Plano, Texas
TEMPPrincipal Business Analyst
- Elicit requirements for any project type through client interviews, document analysis and subject matter experts
- Created detailed business requirements based on client specific workflows
- Critically evaluated information from multiple sources
- Supported teh presentation of information gathered back to teh business clients in teh format of business requirements documents, use cases and/or screen designs
- Collaborate with system architects to establish teh technical vision and analyze both usability and performance needs
- Mentored and led group of business analysts and quality analysts, encouraging skill development
- Created a business and quality analyst Center of Excellence
- Managed projects for multiple clients, performing all project management duties including contract negotiations, project initiation, project planning, executing and closing processes, as well as, project monitoring and controlling.
- Developed presentation and report deliverables for clients
Director, Implementation Services
- Led IT strategic and operational planning to achieve business goals by fostering innovation, saving over $1 million in resource costs.
- Developed and maintained an appropriate organizational structure dat supported teh needs of teh business which included technical analysts, developers and quality assurance.
- Established IT departmental goals, objectives and operating procedures collaborating with teh business to ensure corporate strategy was met.
- Develop, track and control teh department’s annual operating and capital budgets
- Coordinates, prioritizes and communicates connectivity related activities, including connecting new trading partners and maintaining existing trading partners.
- Develop business case justification and cost/benefit analyses for departmental spending and initiatives.
- Implemented enterprise agile development process utilizing JIRA to track backlog, bugs and production issues
- Active participant at industry meetings to ensure companies interests and concerns are addressed.
- Manage multi-site teams, providing all HR related activities including: hiring, coaching, performance management, goal setting.
- Act as SME and business liaison for teh implementation of ICD-10 initiative.
- Support Revenue Cycle Management business by implementing new trading partners.
- Partner and collaborate with business operations to drive planning and execution of corporate objectives.
Manager, Business Systems Analysts
- Manage a team of implementation and system analysts, supporting various organization products, as well as, new payer implementations.
- Led team containing Implementation Analysts, Systems Analysts and Developers for 5010 transaction implementations for clearinghouse and revenue cycle management products.
- Led team of analysts responsible for EDIFECS guideline and severity files
- Manage and mentor a team of implementation and system analysts, including goal-setting for personal and .
- Functional manager for up to 12 analysts, including performance appraisals, hiring and termination of analysts
- Cross-functional Team Management: Function as teh bridge between business and technology.
- Develop strategy and governance approach to system documentation
- Develop tools dat transformed manual configuration process into automated tools leading to a savings of $600,000 per year
- Develop methodology to measure team effectiveness
- Act as 5010 SME for 270, 271, 276, 277, 835 and 837 transactions
- Led Agile team, acting in a Scrum Master role, performing in both Scrum and Kanban methodologies
- Led team to perform vendor selection for agile development tools.
- Performed impact analysis for teh ICD10 project, acting as lead.
- Developed internal program for EDI consultants
- Performed of all X12N transactions, including 270/271, 276/277, 278, 820, 834, 835, 837P/I/D and all response files
- Performed gap and impact analysis in conversion from 4010A1 to standard
- Led team of analysts in impact assessment projects of multiple clients
- Assisted in teh development of a Requirements Traceability Matrix for all HIPAA transaction sets
- Act as a Subject Matter Expert (SME) in 837P, 837I, 835, 270/271 and 276/277 transactions.
Systems Analyst III
- Responsible for interfacing with business partners (internal and external) in estimating, prioritizing, analyzing, designing, testing and documenting systems applications for national EDI clearinghouse
- Responsible for gathering requirements to select system vendor for Clinical Hub project
- Clarify and define business and technical requirements in order to allow development staff to implement solutions.
- Provided documentation assistance in IT network department in preparation for an external audit
Confidential, Austin, Texas
Senior Business Analyst
- Led a team of 5 technical business analysts in performing gap and impact analysis in conversion from 4010A1 to standards.
- Managed seven highly technical developers and one Business Analyst in teh successful implementation of projects throughout teh project life cycle.
- Monitor project schedules and budgets, and ensure dat project milestones are met in a timely manner.
- Directed implementation of National Provider Identifier project for states’ data warehouse including mapping data from internal to X12N and HL7 formats & mapping of provider & member interfaces.
- Gathered and product tested requirements for projects involving claims processing, provider enrollments & EDI system; translated requirements into design and developed & executed test plans.
- Facilitated meetings with State representatives, Operations and Technical architects and developers.
- Created functional specifications and designs supporting a specific portion of Medicaid MIS claims, provider and encounters data warehouse systems.
- Identified user acceptance testing conditions and participated in testing for specific application area.
- Worked with clients and managed care organizations with direct interface feeds of provider data.
- Diagnosed issues with input 837 files, proprietary provider and member files and system issues.
- Functional lead for EDIFECS guideline and severity files for Texas Medicaid data warehouse project.
- SME for 837P, 837I, 835, 270/271, 276/277, 997, 277U and proprietary formats.
- Member of multiple WEDI and X12 workgroups including 837 Claims and ICD10.
Confidential, Austin, Texas
- Led projects in teh IT department comprising 35 employees; developed and managed overall IT strategic plan for all corporate projects, project management controls, and disaster recovery plan.
- Reduced labor costs over $2 Million by managing a corporate-wide implementation of an increase in teh auto-adjudication system from 13% to 75% in six months.
- Created HIPAA strategy and managed teh implementation of HIPAA and 4010A1 standards; provided HIPAA privacy to employees and managed teh conversion of paper claims into HIPAA compliant ANSI 837 format.
- Designed and managed teh implementation of web portals dat enabled clients and providers to process real-time claims online.
- Reduced costs $1+ million by increasing number of claims accepted in an EDI format from zero to 35+% in a one year period.
- Reduced IT infrastructure costs 20% by buying pre-owned/leased systems instead of new systems.
- Managed projects involving IBM AS400 IT projects for claims adjudication systems, JDE software and EDI processes including maintaining WAN/LAN network and system software and managing hardware vendors.
Confidential, Harrisburg, Pennsylvania
Director, Information Systems
- Implemented data warehouse utilizing Oracle and Business Objects allowing users access to data.
- Managed all HP3000 and AMISYS platform IT projects.
- Reorganized IT department within three months recruiting skilled professionals from across country; used performance appraisals and merit increases to motivate staff.
- Developed and implemented IT and data security policies in accordance with best business practices.
- Managed teh infrastructure and rollout for all desktop computers and NT processes; migrated from Novell to Windows NT and moved email system from Groupwise to Exchange
- Assisted department heads, CEO, CFO, and CMO in preparing and implementing company business/operations plans; established working relationships between systems and other areas.
- Received multiple employee of teh month s.
- Worked with IT Leaders from hospitals and sister PHO companies to build system wide IT strategies.
- Assisted systems’ IT leaders with vendor management and developed an EDI strategy between business owner
Confidential, Dallas, Texas
- Led and mentored five Business Analysts and directed project teams in teh successful implementation of major and minor projects throughout teh project life cycle.
- Supervised a team of up to 50 members migrating legacy systems to AS/400 and HP3000 platforms.
- Reduced thousands of dollars in costs by implementing ability for employees to work remotely.
- Configured AMISYS adjudication system and taught configuration classes to employees and clients.
SOFTWARE: Microsoft Word, Project, Excel, Access, PowerPoint, Outlook, Visio, DB2, Business Objects, AMISYS, Extol, Crystal Reports, Novell Groupwise, Sungard Recovery Services, X12N, HL7, BluePrint Requirements Center, Serena Team Track, XEngine, Specbuilder, ICD-10, Revenue Cycle Management, Informatica, ETL tools, JIRA, COGNOS, Agile
OPERATING SYSTEMS: Windows NT/ /XP, Linux, OS400, MPE/iX, Oracle, .NET.
HARDWARE: IBM AS400, Dell Servers and Desktops, HP3000, HP desktops, laptops and servers, SQL Server.
PROGRAMMING LANGUAGES: ASNA, RPG, COBOL, SQL, PIC, ALC, JCL, CICS, Pascal, Basic, PL/SQL, Java, HTML
NETWORKING: LAN, WAN, SMTP, TCP/IP, Ethernet, Meridian Telecommunications, Norstar PBX, PIX firewall, EFS, DMZ, KIX32, VPN, secure FTP SSL, ServersAlive.