SUMMARY:

• Management Professional who possesses over 10+ years of leadership experience in Mobile Product Ownership/Management, Agile, Revenue Cycle, Finance, Business Operations, & IT Enterprise Architecture, within the Healthcare Industry.
• Strong Scrum Agile & Waterfall background; Certified Scrum Product Owner & ScrumMaster® through Scrum Alliance; in addition to Lean Six Sigma background, Black & Green Belt Certified through MSI - Management & Strategy Institute.
• Very experienced and proficient with Stakeholder Management, Project Management, Requirements Elicitation, Budgeting, Planning, & Strategy for all levels of organizations.

Professional Experience:

Confidential, Pleasanton, CA

Lead Product Owner

• Lead Product Owner of Mobile Application: Benefits Advanced Search Environment - User Interface (BASE-UI) & web-based portal for Polaris Enterprise Segment of Confidential .
• Lead multiple Value Streams which intersect with BASE-UI & Consumer Experience Strategy for Polaris Navigators group of U.H.C.
• Agile Development of BASE UI (Benefits Search Advanced Search Environment - User Interface) Mobile application for the Consumer Digital Experience (CEXP) Business Segment of UHC s Polaris R2R Value Stream.
• Define Portal Performance Capacity Volume Estimates, Vital Business Functions, Executive Presentations, Business Cases, & Strategy for all consuming applications & portals across Polaris R2R Value Stream; in addition to developing new initiatives from Human Centered Design perspective through stakeholder engagement
• Own User Stories, Use Cases, & Business Cases. Pull Feature & User Story Performance Reports from CA Agile and Sprint Metrics to lead team in continuous improvement per Agile Iteration per Program Increment.
• Leverage Financial SME knowledge to drive P&L management in addition to strategic budgeting & planning analysis of Business Cases for BASE UI delivery across Polaris Value Stream.
• Drive Data Request & Response (R&R) Service sessions with Interface Layer teams as key Business delegate for BASE-UI, perform comprehensive analysis to identify key elements & attributes to include in AngularJS logic from Host Oracle RDB source systems aligned with MVP Business Requirements, in accordance with Use Cases & wireframes cross-app data mapping for BASE-UI UX design.
• Design standardization of R&R service across all Constituents & Consuming applications to ensure minimal gaps in the communication channels.
• Lead Agile Best Practice framework in adherence to OSAM, focus on Voice of Customer communication in addition to Product Features, User Stories, & Backlog grooming, regrooming, sizing, & refinement with Product Director, stakeholders, & Scrum team
• Act as SME for Business Quality Analysis & Stakeholder Engagement, deliver innovative solutions and process re-engineering improvements in alignment with LEAN & Scrum methodologies
• Lead Program Increment (PI) Planning sessions & map out all Sprints with risks, dependencies, for all Features & Stories under iteration
• Map datasets from XML input files for all Benefit Language display, prior to BASE UI consumption to ensure data integrity & quality.
• Monitor & maintain CA Agile Central (Rally) Business Value Features & US, & overall Sprint performance per Program Increment delivery. lder engagement & Agile & LEAN SME experience.
• Tata Consultancy Services

Confidential, Pleasanton, CA

Lead Solutions Architect

• Designed Medical Mobile Bill Pay Application for iOS & Android development, & deployed in all seven client regions, producing $500m in revenue generation & 60% reduction of cash conversion cycle time, through elimination of manual revenue collection streams; in addition to designing end - to-end Mobile Bill Pay testing process automation, augmenting 50% of backend operational efficiencies speeds for client, Kaiser Permanente, at conclusion of FYE 2016.
• Lead Daily Scrum sessions for multiple end-to-end architecture solution delivery initiatives, including the Web-Based User Portal for both Customer & Workforce utilization, which reconciled ~$1B in revenue; coordinated with UX, DEV, & QA teams for requirements elicitation, user stories development, & backlog review, pertaining to design of applications, definition of APIs, process integration, & regression testing automation prior to the next sprint.
• Requirements & Solutions Analysis for systems & process integration & enhancement utilizing multiple data streams and workflows incorporating internal & external stakeholders for our client Kaiser Permanente. Member of KP IT Revenue Cycle team (RCIA)
• Collaborate directly with Principal Architect, Solutions Consultants, Business Analysts, Development, & Leadership to ensure all deliverables are executed in accordance with KP IT guidelines; prepare presentations based on analysis and deliver to leadership & customers during releases and phases
• Create and append Application Logical Solution Design Documents with test cases which are sent to testing for approval, before being finalized & sent to Production Support & Business Application + Data Owners for final sign-off prior to production.
• Gathering requirements from business & development and ensuring requirements on par with SDLC guidelines; facilitate JAD sessions among stakeholders; utilize Excel to track & document progress
• Configure Application Logic through documenting transformations which occur & create test cases, obtain sign-off from testing before sending to prod.
• ANSI X12 EDI Standards to analyze 835, 277CA, 277P, 999, & Lockbox file structures, naming patterns, and assess electronic remittance streams + transformations, in addition to integration points and present solutions to Business.
• Integrating all systems from RCIA back-end systems to EPIC front-end systems (KPHC patient record) through synchronizing workflow streams to enable strong communication channels between systems & reduce account days in A/R.
• Document Servers & Integration Points for Migration. Also matched up data points for payment files + trading partners corresponding to the Source Systems per respective regions.
• Ensure Enterprise-Scale Initiatives are followed through utilizing SDLC methodology (Waterfall) to ensure timeliness in accordance with respective deliverable dates for each phase.
• Collaborate with technology and business departments to define deliverables and develop solutions that are reusable across the organization
• Lead the overall delivery of projects including the direct management of project team members
• Perform project management duties including the creation of status reports, work plans and presentations to client leadership
• Provide well-informed opinions and architectures for technical solutions including application presentation, data access, and integration
• Participate in development and configuration projects for a broad set of solutions including transactional applications, EDI, business intelligence and self-service portals
• Develop technical design documents to describe and support justification of the chosen architecture and proposed implementation
• Review and approve developer detail design documents, data structure diagrams and code assets
• Ensure quality assurance by directing unit test activities including the development of test cases and publication of unit test results
• Conduct research studies that may include collecting, analyzing, trending and presenting data and recommendations to management
• Assess and recommend vendor products to client leadership
• Develop financial models and tools, including cost-benefit analysis, resource utilization models and performance reports
• Create written and oral communication materials that effectively summarize findings, support fact-based recommendations and provides appropriate detail to substantiate conclusions
• Maintain work papers, project deliverables and other artifacts that can be recreated and leveraged as intellectual capital
• UnitedHealth Group/OptumInsight

Confidential, Rancho Cordova, CA

Sr. Business Systems Analyst

• Designed Reporting & Reconciliation Mobile Application which rectified over $36m & $41m from total production A/R, through execution of VBA macros on weekly basis, reducing system revenue cash conversion cycle from twelve to six months, at conclusion of FYE 2014 & 2015.
• Optimized over $10m in EDI cash flow via business process re-engineering, by mapping out all inbound electronic remittance payment file channels, & designing the solution of integration with outbound channels for submission of payment with state & federal payers, improving traceability of file movement for Business Reporting.
• Integral Member of many enterprise-wide projects, ranging from small-large scale complexity, which incorporates teams of many cross functional staff/stakeholders of Enterprise, such as Clinical, IT, Business, Leadership, and Executive Sponsorship from both UHG and Dignity Health
• Business Operations Analytics and Financial Reporting for the State of Utah Medicaid program. Utilizing tools such as Crystal, UltraEdit, Access, SQL, and Excel for querying and reporting of data in addition to preparing presentations for upper management for forecasting.
• Claims Analytics at a granular level utilizing all aforementioned tools; ensuring that all claims are adjudicated appropriately per authorization, claim status, eligibility, and expected reimbursement.
• Owned & execute multiple processes; deploy automation through Macros in MS-DOS emulator in Host IBM AS400 system utilizing VBA commands & mail merge of data from MS Excel spreadsheets into MS Word. Import/Export electronic files into Host Server using FTP transfer programs
• Utilize LEAN Six Sigma knowledge for investigating Gaps Analysis: identifying process gaps. & process improvement through investigation via Root-Cause Analysis. Introduce QA process improvement metrics for solutions when appropriate.
• Provide Data Analytics Guidance of process/system performance to many other departments within organization, which involve cross-departmental and cross functional teams
• Serve as Database Administrator of MS Access Change Control Systems Database; triage Issues to appropriate Analysts which are concerned with Systems Issues, Fixes, Process Gaps, perform file maintenance, and identify other critical System issues/errors, utilize Excel Issues Tracking Log workbook to track status/progress of all incoming & existing issues
• Query Relational Databases through filtering/sorting data fields & defining parameters
• Execute many Tests to ensure QA Testing is optimal for all EMR/EHR upgrades and roll-outs
• Collaborate with fellow team members on Statewide Projects to establish clear defined measurables/deliverables and assess project completion, identify potential process & system risks, and defects. Troubleshoot and fix and all existing risks & defects
• Perform UAT Validation, in Test, Pre-Production, and Post-Production environments which incorporate all Systems of enterprise for End User satisfaction.
• Effectively utilize SDLC, Agile, & Scrum knowledge for System Go-Lives and Upgrades. Provide Training and Insight when appropriate to meeting deliverables/initiatives.
• MS Suite tools for reporting of Systems and Process performance.
• Gather requirements from the Business prior to report documentation
• Interact with internal and external customers to define reporting needs and specifications, implemented change control processes to cater towards those specifications.

Confidential, Hayward, CA

Financial Analyst/EPIC Trainer (contract)

• Implemented Salesforce Mobile Platform to assist call center with stakeholder queries pertaining to all accounts, totaling to $1.5m
• Ran reports and work flows of all daily system processes via SQL master data base in EPIC Resolute PB/HB modules
• Assisted stakeholders with risk portfolio & assets management regarding personal accounts
• Researched accounts & patient disputes in regard to account balances, claims, insurance payments, refunds, & accounts receivable inquiries via EPIC Resolute Provider Billing/Hyperspace Modules
• Submitted patient and insurance coding disputes in regard to claims directly with coding department, in concurrence with coding, verified that all codes were in fact accurately coded & billed out on claims
• Ensured all claims would be adjudicated to active insurances if billed to incorrect insurance, in addition to providing administrative adjustments on accounts if patients were billed in error
• Verified accuracy of all charges, coding, and payment posting to correct accounts of patients & stakeholders via EPIC
• Educated Clinical Staff on the use, functionality and Meaningful Use of EPIC to meet MU objectives
• Worked directly with major insurance carriers/third party insurance payer systems: Blue Shield, Anthem Blue Cross, United, Aetna, Medicare, Medi-Cal, HMOs, and PPOs.

Confidential, Walnut Creek, CA

Business Consultant

• Integral designer of Mobile Application which eliminated $2.5m in expenses through automating processes & developing BI tool, Crystal, at conclusion of FYE 2013.

Confidential, Fremont, CA

Sr. Product Manager/Business Analysis Consultant

• Lead Mobile Application Design & gained senior leadership buy-in for (Practice Fusion), over EPIC.
• Drove organizational Agile transformation & software deployments.
• Utilized LEAN to improve business processes & automate testing, which reduced delivery cycle time by 55% & rectified $5.5m in budget
• Implemented and configured EMR/EHR software platforms through teaching & training clinical staff. Medical software platforms taught included EPIC, PracticeFusion, Cerner, NextGen, Gentricity and Meditech in conjunction with the Lead Implementation Analyst following SDLC guidelines utilizing Agile/Scrum methodologies
• Utilized and performed daily system maintenance on Host ADT/AR System for integration with interface management with other systems in the organization.
• Wrote reports and presented data in formats such as abstracts, graphs or summaries in MS Excel PowerPoint; utilized v-lookups, pivot tables, and process roadmaps/slideshows for validation &presentation.
• Developed new methods for optimizing product performance, revenue, and adoption.
• Developed technical specs and developed and executed work plans that involved more than one analyst on multiple projects.
• Prepared documents, correspondence and other communication materials to convey information to appropriate internal and external audiences to enhance stakeholder engagement within Scope.
• Made oral presentations about reports and reporting systems to key stakeholders, customers, and users to promote stakeholder engagement.
• Participated on internal and external task forces and committees to provide analytical insights and support for implementation of new programs, products and services and enhancement of existing systems
• Participated in the design of reports that integrate data from multiple sources, including design of reporting systems and standardization of metrics and formats across departments and functional areas.
• Critically reviewed and revised existing systems and applications for update and enhancement.
• Facilitated data reporting and analysis projects involving team members from multiple departments.
• Interacted with internal and external customers to define reporting needs and specifications, implemented change control processes to cater towards those specifications.
• Provided report documentation and consultation for optimal processes using Agile/Scrum and LEAN Six Sigma principles.
• Assisted team members through training and mentoring for all phases of the SDLC/Project Life Cycle.
• Sought and provided advice to analysts in other departments and business units regarding standardization of business rules and algorithms for analysis and reporting.
• Identified business risks relating to report design and production, implemented risk management measures to forecast for those risks.
• Provided training to designated team members to mitigate risk and provide back up for report production; acted as a risk management coach for all teams involved within the Project.
• Ad hoc analysis as requested for Projects and Software roll-outs.