OBJECTIVE:

• A proven leader passionate about process improvement, data, agile, lean and problem solving with outside - the-box solutions.
• 15 years in healthcare, with 10 in clinical and 5 in PBM. With more than 6 year practicing lean and agile and 3 with Oracle Database 11g.

AREAS OF EXPERTISE:

• Agile frameworks: Scrum, Kanban , Six Sigma, Lean Healthcare, JCAHO, Carf, HIPAA,
• Oracle database 11g Certified Associate, Oracle Sql, Salesforce, Tableau, Microsoft Office, MS Suite
• Experience in working as a Project , Excel, Informatica, MS Project Plan, Jira, Confluence

WORK EXPERIENCE:

Confidential, Dallas, TX

Sr. Consultant Project Lead/Scrum Master

• Provide oversight to a portfolio of projects ensuring on - time delivery of all tasks across multiple departments. Advocates the adoption of Scrum methodology and agile best practices. Supports daily Scrum activities, protect the team from external distractors and ensure the team is fully functional and productive . Discuss enterprise system enhancement project requirements and stories with analysis & advisor.
• Act as the scrum master with a focus on guiding the team towards process improvements. Liaison between IT and business regarding system scope, design, impact to the Med D enrollment and perform UAT testing.
• Perform business analysis and develop innovative solutions to address med D client implementation and assist the team with research, report creation and quality control of all deliverables. Maintained Scrum Team Dashboard, assist Product Owners with backlog creation and grooming of stories. Manage Password Security and Resources, Users, Privileges and Roles.
• Perform user access by reviewing individual users to ascertain their need for access and permissions to active directory and other systems like Facet, Fazal, RxClaim, AS400, Valencia, Marx UI, PeopleSoft, and SharePoint etc. Ensure system design solutions meet business needs and align with enterprise and CMS Med D standards.
• Support SharePoint Administration efforts, which includes managing permissions, analyzing/reporting, monitor trend and page/site creation and modifications. Managing Libraries, as needed, work on special projects as assigned. Provide day to day compliance support to the SharePoint site, design processes to meet business and operational needs.
• Design Med D project dashboard using data tools like Tableau, SharePoint, Excel pivot tables, charts, graphs, and custom reports. Recommend agile methodologies for improvements and automation, lead initiatives and follow-through.

Business Process Enrollment Supervisor/Scrum Master

• Manage a team of Sr. analysis, participated in database platforms design for Med D enrollment data such as Oracle, SQL Server. I used ETL tools like Informatica for validation and transforming data. I used Salesforce, Tableau, SharePoint and other to create dashboards and visualizations.
• I introduce scrum and lean to my team when working on projects, coach and manage the team towards improving a lean and agile environment. Engage with Account Management, DBAs, System Administrator, Developer and other internal/external partner as needed to determine best solution to assist Product development and delivery.
• Served as the Scrum Master to the department and a servant leader to motivate and ensure the Scrum framework is used as intended by educating the team on agile practices, facilitating agile ceremonies (Stand-up, Backlog Grooming, Team Based Estimation, Retrospective, Product Review)
• Participate in big data testing during client implementation, backup and restoring database in a test environment. Collaborate with DBAs and developer on EDI file in identifying and transferring data into new database.

Quality Analyst/Scrum Master

• Responsible for running daily Scrum meetings with the software development team. Provide guidance to enrollment consultant, EDI file developers and DBAs regarding the implementation of system upgrade. Addressed enrollment problems through risk management and contingency planning.
• Facilitates communication and collaboration with Product Owners, cross functional development teams, and Project Managers to support development and product delivery Identifies and resolved impediments that interferes with the delivery of the product and team.
• Tracked and managed product backlog, burn-down metrics, velocity, and task break-down. Have a working knowledge of HIPAA standards, data conversions, data mapping, data translation and healthcare CMS standard on data file formats such as 834, etc.
• I apply agile and Lean Six Sigma concepts and techniques to improvement department workload on prioritizing the project backlog. Conducted sprint meeting to discuss new projects. Pull enrollment data from various source like Oracle, sql server etc. Participate in the validation of data to make sure client are implemented into the correct med D plan, plan coordinate and supervise activities related to the integration enrollment data across various systems. Expose to Oracle database, AS400, Facet etc.

Director of Client Operation/Lean Coach

• Responsible for reviewing the final determination of quality of care grievances from members, providers, internal departments and regulatory bodies. Identify quality issues and evaluate clinical or business processes for opportunity. Facilitate, design, implement and maintain quality initiatives. Establishes and coordinates committees and sub-committees where appropriate to achieve health plan goals.
• Responsible for quality assurance processes related to client intake, service tracking, billing, and clinical documentation in collaboration with the Director of Treatment Services. Fulfilling the role of an agile coach and be the leader of the Agile/Scrum process for Software development using Test Driven Development for the EHR software development.
• Design an HP service incident management (HPSM) ticketing system for the IT team. An agile evangelist breaking through impediments between the team and delivering value to the organization while supporting the Agile ecosystem
• Document agency EHR architecture process flow and solutions, generate reports to track trends (e.g. credits, billed services, delivered services, client phi data, and admission record), create dashboard reports, charts, power point presentation for the COO, President, CEO and Board.
• Provide oversight to financial consultants for the successful delivery of projects. Lead new solution offerings development by identifying/defining use cases, writing process blueprints and walkthroughs & collaborate with technology partners/support architects development.
• Develops and / or maintains policies and procedures that support the corporate initiatives that meet State, Federal, and legal requirements and standards. Collaborates with physicians to execute the implementation of the clinical quality data initiatives
• Maintains current knowledge of regulatory requirements associated with the QI program.
• Maintains QI program documents, reports, and committee minutes and follows all internal privacy and confidentiality policies and procedures
• Manages and monitors clinical quality studies to include receipt and analysis of trended data, assessment of national benchmarks as available, development of improvement recommendations (to include ROI and best practice interventions as appropriate), presentation to senior leadership, implementation of plan, and evaluation for desired result.

Quality Management Specialist

• As a consultant I reviewed quality of care grievance and compliance on the NextGen EHR software, build a user friendly application. Use agile methodologies to bring teams to an even higher level of performance. Facilitated scrum ceremonies as a scrum master for the development of an electronic medical record software, use sprint or iteration planning, backlog grooming, daily stand ups, sprint retrospectives and release planning
• Protect the NextGen EHR development team from outside distractions, impediments or team conflicts and maintain focus on product backlog and project timeline.
• Develops performance metrics to establish process success. Recommend and minimize impacts, track and report tickets daily using HP Service Manage. Identify trends/area of opportunities, perform root cause analysis in conjunction with clinical and medical director to develop solutions on improving clinical care to clients. Managed Client EHR Implementation Process .
• Facilitates root cause and barrier analysis discussions regarding PIPs, Provides oversight to vendors who are delegated to perform quality activities

Interim Youth Program Manager

• Lead and conduct primary and secondary research. Analyze client data and lead client interviews to gather facts and insights into a client’s issues, concerns and grievances.
• Design deliverable content to precisely reflect the client service contract, needs and strive to improve deliverable quality through verification and validation of results by working in closed relation with the social workers and nurses.
• Determine the program priority in conjunction with program director. Planned surveys and coordinate with the Joint Commission, Government, State, Auditors and funding organizations.
• Review patient's/client referrals and coordinate admissions and assessments; supervise a team as well as the treatment oversight. Maintain and manage quality assurance, HIPAA, Agency P&P, Joint Commission and state agency updates. On-call for crisis intervention, behavior management and program compliance with DHS, CPS, JCAHO.
• Analyzes key plan metrics, such as top diagnoses, clinical procedures, and operational performance, to enable the development of sound and valid recommendations regarding and prioritization of clinical and service improvement initiatives

Team Manager/Quality

Responsibilities:

• Oversees patient safety tracking, reporting, critical incident reviews, root cause analyses, data modeling and risk mitigation strategies. Address the tickets and provide resolution in timely manner based on SLA.
• Database support and programming of all mobile devices for the company, assist in phone system maintenance. Help to maintain and create documentation for IT policies and procedures and anticipate, research, plan and track future projects and potential problems.
• Maintain IT database of all assets and continue the asset tagging program and coordinate the activation, maintenance, and inactivation of user accounts for all staff.