SUMMARY:

• SME and key contributor on major projects involving the creation of new and expanded Medicaid programs and services, portal applications and HIPAA compliance
• Entrusted to create and present quality software application product deliverables to stakeholder on large and small projects
• Worked extensively as a Medicaid business analyst and key contributor on projects involving updating, automating and enhancing claims edits and audits
• Consulted as a MMIS SME to assist employees with projects that involve enhancements to claims edits and audits

TECHNICAL SKILLS:

Information Technology: Microsoft Suite IDX KINTANA/PPM EDI Visio Meditech AMISYS HL7 Inteledata Orchard/Harvest LIS MMIS SQL Quality Center/Test Director Business Objects Compass 21 Edifecs UltraEdit Rational Clearquest OutsideView OnBase PL/SQL Developer TOAD SOAPUI MS Project PLEXIS SharePoint Software Development: Software Development Life Cycle (SDLC) Facilitate JAD/ JAR sessions Software Quality Assurance Testing Project Management Healthcare: Health Care Administration Medicaid Management Information Systems (MMIS) Laboratory Information Systems Medical Billing s:

PROFESSIONAL EXPERIENCE:

Senior Systems Analyst

Confidential

Responsibilities:

• Write detailed requirements for DSHS systems applications development, upgrades, modifications and maintenance. Develop use cases and user stories to detail applications processes and procedures to stakeholders. Create test plan, test approach, test cases, user acceptance testing and lead applications testing efforts. Review and approve requirements and test case documentation for Junior Business analyst.
• Mentor and guide Junior Business Analyst in writing requirements, test cases and testing. Facilitate meetings with stakeholders, management and program staff. Participate and facilitate JAD sessions. Develop artifacts using, Visio, Excel, Word and PowerPoint documentation for project deliverables presentation. Communicate with stakeholders and management to keep them up to date on project statuses. Work closely with Developers to communicate and translate business requirements.

Business Analyst Consultant / Quality Analyst

Confidential - Austin, TX

Responsibilities:

• Assist in facilitating RFP JAR sessions with Texas Confidential Program SMEs to develop and track requirements for the Texas Medicaid Vendor Drug Program PBM procurement. Developed requirements for the new Pharmacy Benefits Management system (PBM) from the Vendor Drug as-is contracts documentation. Performed data analysis on pharmacy data extracts to create flow diagrams, trend analysis of Pharmacy Claims and Encounters and informational charts and tables for the procurement library to assist RFP respondents in making an informed bid on the Pharmacy RFP. Facilitated Best Value Criteria and Financial
• Approach meetings to set a baseline for proposal evaluations. Perform administrative record keeping for non-disclosure agreement (NDA) form signatures, Action Items and meeting minutes. Document meeting notes and Action Items and perform follow-up on completion of Action Items. Assisted in developing response evaluation criteria setup and participated in the Vendor Conference and responded to questions derived from the Vendor Conference.

Business Analyst Consultant / Quality Analyst

Confidential - Austin, TX

Responsibilities:

• Perform Initial project analysis and estimate project hours to completion. Work closely with developers and business analyst to develop quality software and software enhancements. Interact with Texas Health and Confidential ( Confidential ) stakeholder to gather business and system requirements for Texas Medicaid software development and enhancements. Communicate business requirements to stakeholders verbally and written.
• Perform software quality assurance testing. Create use cases, test approach, test plan and test scripts. Follow projects through to implementation and warranty period. Performed process improvement analysis and process design for new and existing MMIS systems.

Business Analyst Consultant / Quality Analyst

Confidential - Austin, TX

Responsibilities:

• Perform stakeholder interviews, researched policy and procedure documentation and technical systems specifications to determine where and how ICD-9 codes are currently used within the Confidential Enterprise, the MMIS and other applications.
• Elicited information from key staff to determine where and how ICD-9 conversion will need to be performed for written documentation, processes, procedures and IT systems. I wrote an assessment of each department’s needs as part of the project deliverables. Created high level MS Visio process flow diagrams to clearly display where ICD-9 conversion would take place.

Business Analyst Consultant / Quality Analyst

Confidential - Austin, TX

Responsibilities:

• Perform Initial project analysis and estimate project hours to completion. Work closely with developers and business analyst to develop quality software and software enhancements. Interact with Texas Health and Confidential ( Confidential ) stakeholder to gather business and system requirements for Texas Medicaid software development and enhancements. Communicate business requirements to stakeholders verbally and written. Perform software quality assurance testing. Create use cases, test approach, test plan and test scripts. Follow projects through to implementation and warranty period.

Office Automation Assistant

Confidential - Austin, TX

Responsibilities:

• Perform data entry for the Confidential database and general office duties. Correspond with external customers through telephone, email and written correspondence to ensure accuracy of information provided. Input and retrieve information in databases and spreadsheets. Create correspondence and facilitate internal audit inquiry.
• Maintain manual records of Confidential surveillance submissions. Perform SQL queries in the database to maintain accurate information and counts of entries. Ensure the validity of samples entered into the Confidential database in compliance with USDA-APHIS policy.