SUMMARY:

• Dynamic IT professional with over 15 years combined experience in Healthcare/Managed Care, Finance, Utilities and Entertainment, is looking for a great opportunity within the public or private sectors.

SKILLS

• - SDLC, System Analysis, Design Workflows - Test Lead /QA Management /Test Plans /Strategies
• - Healthcare Implementations Consulting - ETL E2E Testing System / Integration / User
• - Managed Care Medicare/Medicaid - Medical Coding ICD 9 10/HCPCS/CPT
• - MS Office, SharePoint, Visio - ALM/ Quality Center/ RUP/Cache/Rational
• - Project Management/ MS Project/Clarity - Java/ XML/.NET / UNIX/ SQL/SQL Server/ Oracle
• - Alineo/ Care Advance 4.6-5.1/HIMs - On-shore / Off-Shore Resource Management
• - Agile/Waterfall Testing - DB VISULALIZER/ Soap-UI /QTP/ Clear Quest

EXPERIENCE:

Quality Assurance Business Analysis

Confidential

• Design test strategies to ensure data captured in CCA mirrors the client's legacy systems within the QA and UAT Environments using SQL and the user interface. Testing includes Medicare and Medicaid Member, Provider and Pharmaceutical data. Reporting was also validated.
• Review requirements specifications and provide feedback based on usability, feasibility, and complexity for clients regarding TRIZETTO's CCA Product.
• Provides QA team with technical/product guidance for UM, DM and CM deliverables as well as QA best practices when managing daily test activities.
• Assist a team of 6 QA analysts and perform hands data loads/ETL testing of patient electronic record from XCELYS to Clinical CAREADVANCE CCA . This implementation includes Medicare / Medicaid customizations and integration for case management and reporting quality of care metrics to various governing bodies Internal Audits, CMS, NCQA, etc. .
• Estimate project level of effort LOE determine project scope and negotiate with the development teams in meeting objectives and delivery dates.
• Manages defects using ALM 11 Quality Center . Tracks, plans, and resolves defects in a timely manner. Review and approve product change requests PCRS with the business while tracking any these change control board items requiring executive review and steering committee review.
• Communicates test results, project status, and complex issues effectively to team members and stakeholders while working closely with the business, development mangers and third party vendors to remediate defects quickly.

Project QA Lead

• Configured and tested CCA across various plans, lines of businesses, and platforms to deliver high quality implementations to leading health plans and payer organizations.
• Worked collaboratively with project team and other departments to define acceptance criteria, resolve issues, implemented test strategies.
• Managed daily test activities while providing technical, product and process guidance to the client.
• Tracked, planned, and coordinated the resolution of defects to ensure defect assignments in a timely fashion. Communicated test results, project status, and complex issues effectively to project team and stakeholders.
• Performed CCA configuration via the TriZetto Content Edit tool for various client environments.
• Controls and manages daily test activities while providing technical, product and process guidance to other QA team members.

Test Lead/ Senior QA Analyst

Confidential

• Completed over 6 Alineo Implementations, 16 Web Enhancements and deliveries Java based , 5 maintenance releases, and tested 7 Milliman upgrades, and 8 InterQual / CERME upgrades. All deliverables were in compliance with department procedures and reflect the level of detail and accuracy expected of a Test Lead. These technologies run on Oracle, Cache databases, and accessed via SQL within a .NET environment.
• Successfully managed the QA effort for company's top clinical information systems ALINEO Nexalign - iEXCHANGE for parent company HCSC Behavioral Health Division.

Consultant - QA Lead

Confidential

• Partnered with internal and external organizations to assist with testing needs, potential impacts, test data, and technical issues. This ensured communication to reduce potential project impacts to teams and ensure cross-platform compatibility.
• Mentored a team of 10 and designed, improved object - level testing using QA best practices to improve departmental efficiencies.
• Performed system - level regression test procedures using automated test suites and test reports using Mercury's Quality Center MS Excel.
• Built and managed test data using QA, development, and production data sources via MS Access and SQL.
• Managed test case development, defect management, change control in a cross-functional team while maintaining standard QA philosophies and methodologies.
• Scripted test cases, managed test suites, developed test plans, reviewed test cases, and performed bug triages using Mercury's Test Director MS Excel.

Consultant- QA Manager

• Established a QA department of 12 QA analysts within Exelon's power generation sector using SQA standards and existing QA processes within Exelon's development and business workflows.
• Provided process improvement recommendations and insights into various quality process methodologies such as Agile, Waterfall Iterative, and Test Driven Development for 8 cross functional teams.
• Administered Quality Center at Exelon for the ERCOT Nodal Project. This includes setting standards, establishing the defect management tool, administering groups/permissions, and training.