Senior Application Development Specialist Resume

SUMMARY

Top performing Application Development Specialist wif over twenty years experience in the Healthcare Industry focusing on COBRA Administration, Membership systems, and large conversions.
Broad experience collaborating wif external vendors. Strong tenure wif HCSC, PW and EDS. Ranked consistent Lead and Subject Matter Expert on many key projects.

SUMMARY

TECHNICAL
COBOL
MVS JCL
TSO
CICS
VSAM
IDCAMS
UNIXEXPERIENCESY
NCSORT
FILEAID
FILEMASTER
EXPEDITOR
INTERTESTMIC
ROFOCUS - COBOL
UNIX Kornshell scripting
AIX DB2

PROFESSIONAL EXPERIENCE

Confidential

Senior Application Development Specialist

Responsibilities:

Represented my application team to internal Change Management, Release Management and Incident Management forums. Contributed to user groups to develop new and refine existing standards related to these areas.
Served as Disaster Recovery Analyst for assigned applications. Also participated in all DR exercises and forums related to this subject.
Managed small projects wif 4-5 member teams including all phases of the System Development Life Cycle. . Implemented automation improvements to a UNIX-based application, including Kornshell batch scripting and ‘cron’ scheduling to support a COBRA Billing and Notification application for over 10 years.
Developed and maintained customized billing applications which generated billing in excess of $2 million each month. Delivered enhancements to an existing payment process which was limited to traditional pay-by-check methods, to also include ACH and EFT payments.
Implemented solutions to automate the generation and delivery methods of client-driven monthly financial reports on a large volume scale. This resulted in an 80% reduction of manual processes required to generate these reports.
Completed and implemented all systems modifications to convert the Prescription Drug Membership interface to a new Pharmacy Benefits Manager (PBM). Responsible for all aspects of the conversion, including documentation of existing processes, design, coding, and testing on a mainframe platform.
Developed project plans and estimates. Provided research and subsystem noledge to team members. Completed small project assignments, and provided mentoring assistance to developing new and less experienced staff. Recognized as a production support expert for the Membership batch mainframe subsystem. Assisted wif training and managing the transition of support functions of 2 large applications to strategic external vendors
Analyzed, debugged and implemented code modifications to a managed care capitation and reporting subsystem which is responsible for the administration and payment of over $30 million each month.
Participated in projects to define, develop functional requirements, design and deliver new HMO insurance products which uniquely positioned the business to succeed in the market.

Confidential

Senior Consultant

Responsibilities:

Served on a team consisting of over 20 consultants to manage and maintain a legacy mainframe Membership System for client - Confidential (HCSC).
Architected and managed the development through implementation of an automated solution to receive eligibility data from external customers and develop customer interface to allow them to drive the process.
Coordinated and completed all modifications to the Prescription Drug eligibility system for the Corporate Membership System. Developed excellent working relationship wif external vendors. Worked exclusively wif the Pharmacy Benefit Manager management to resolve eligibility related issues.
Designed and implemented all modifications to provide an eligibility interface for a new electronic major medical drug claim submission service for members.
Managed the technical transition between vendors, and coordinated the continuation of eligibility information throughout the process.
Assisted in development of a new HMO product, including all phases of design, development, testing and implementation. Supervised small project teams (2-4 people) to deliver systems solutions to several customer areas.

Confidential

Systems Engineer

Responsibilities:

Designed, developed and maintained application software for the Connecticut Medicaid Management Information System (MMIS).
Led a development team to complete requirements, functional/technical design and project planning. Responsibilities included full system life-cycle development projects involving UB-92 claim processing and HCFA backend reporting systems.
Conducted on-call production support to troubleshoot production errors, code fixes, monitor production cycles, review reports, and provide management status reporting.
Provided Business Analyst Services to the New Jersey Insurance Underwriters Association (NJIUA), which provided auto insurance services to the states High Risk Pool. Duties included monitoring the daily production and delivery of batch print reports to customers throughout the organization, and developing new Help Desk Operations for the entire account.

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