Supported Operations & Marketing Teams with Company's 2016 Goals. - Implemented Spanish Messaging into current phone system working with multiple vendors. - Implemented Participant Appointment Scheduling into legacy Compass System.

Supporting the Massachusetts Health Connector Data Exchange Project as part of the Affordable Care Act 2012.Responsibilities:• Under the Project Management Office, supporting multiple cross-functional and enterprise-wide teams with detailed requirements, gap analysis, test plans, communications, and risk assessments.• Project coordination with IT, Enrollment & Billing, Plan Management, Finance, Governmental Affairs, Marketing, Operations, and Customer Service.• Support daily project status meetings with the Massachusetts Health Connector Project Team.

Supported the Massachusetts Healthcare Reform Chapter 224 of the Acts of 2012, Provider of Choice (POC) Attribution Project using SDLC Methodology.Responsibilities:• Coordinated the entry & validity of user requirements & acceptance criteria from ADM (IKMD) Data Warehouse, RTMS, and Blue Serve Connect (BSC) into HP Quality Center.• Performed & Completed User Requirements/Gap Analysis Traceability Matrix for cross-functional systems (ADM, RTMS, BSC). • Wrote & Executed SIT/UAT Test Cases for Blue Serve Connect (BSC)• Reviewed & evaluated all project deliverables including Testing Strategy & Approach documentation for adhering to “IT Best Practices”.• Coordinated the maintenance of project deliverables on BCBS Worksite MP Document repository.• Maintained & Resolved Chapter 24 PCP Attribution Project Issues Log.

Supported the MA-21 MassHealth Eligibility System for the Commonwealth of Massachusetts using Unified Process Methodology.Duties included:• Defined user requirements/test/implement ClearQuest Defect and Enhancement Requests for the MassHealth Eligibility Operations and Premium Assistance/Premium Billing User Community.• Functioned as Liaison between the Business Community, Quality Assurance, and the Technical Development Teams.• Functioned as a Mentor for new Business Analysts within MA-21 Systems Team.

Support the development and implementation of ICD-9 to ICD-10 Mapper HighPoint (Vendor) project. Duties included:• Producing Project Deliverables as required. Working with HighPoint in a support role to ensure compliancy with BCBS MA user requirements. Working with the client to ensure ICD-10 functionality mapping is comprehensive.

Support the development and implementation of several business and systems strategic initiative projects including:• Using Agile Methodology partnered with Edifecs (vendor) on the replacement of the EDI platform and implementation of Service Oriented Architecture. • Health Care Reform 1099 HC Project.• Replacement of BuzzWeb Assessment.• eMember Authentication Assessment.• Access & Identity Management HRMS Project.• Claims Accumulator Management System.All projects require meeting with Business Stakeholders and Technical Programming Leads to coordinate the integration of technical and business systems to conform to business requirements.

Supported the MA-21 MassHealth Eligibility System for the Commonwealth of Massachusetts using Unified ProcessMethodology. Duties included:• Defined user requirements/test/implement ClearQuest Defect and Enhancement Requests for the MassHealth Eligibility Operations and Premium Assistance/Premium Billing User Community.• Functioned as Team Leader for the MA-21 Member Transfer Re-design Project.• Functioned as a Mentor for Junior Business Analysts within MA-21 Systems Team.

Supported the development and implementation of Harvard Pilgrim HealthCare’s joint venture with United HealthcareGroup (UHG) and the launch of Harvard Pilgrim’s National PPO Products (Choice Plus and Options). This project included two phases, phase 1 deployed new data transport architecture for data files and EDI transactions using TIBCO application Software technologies. Phase 2 implemented the National Provider Identifier (NPI) for Benefit EligibilityRequest/Response (270/271), Claims Status Inquiry/Response (276/277), and Claim Payment Remittance Advice (835) EDI Transactions running on the new platform.Duties included:• Identification and maintenance of the NPI user requirements using CaliberRM Requirements Management Tool for the EDI transactions.• Developed UAT Test Scenarios for the NPI Project.• Defined user requirements/test/implement EDI Operational Reports.• Developed and maintain HPHC Project Task Order Documentation including RAID (Risks, Assumptions, Issues, and Decisions) documents, Lessons Learned, etc. all adhering to HPHC standards.• QA of Project Detailed Design Documents including BPMN Charts.• Developed and presented Project Task Order Close Documentation to client for sign-off.

Supported the NewMMIS (Massachusetts Medicaid Information System) Project. Duties included developing Business Process Flows and preparing Test Cases for the following subsystems: Claims Payment, Claims Adjudication & Pricing, Claims Suspension, Claims Receipt, Eligibility Verification System (EVS), Provider Application Process, Early Periodic Screening, Diagnosis and Treatment (EPSDT) and Reference. Accomplishments include:• Functioned as the Subject Matter Expert (SME) for the roll-out of the EDS Evolve Work Force Management Project. Ensured all EDS Massachusetts State & Local employees and projects were compliant with corporate guidelines. In addition, continue to support this project on an on-going basis.• Coordinated the development of the preliminary version of the NewMMIS Project Disaster Recovery and Business Continuity Plan.

Functioned as a Quality Assurance Systems Analyst supporting the Commonwealth of Massachusetts Office of the Comptroller NewMMARS (Massachusetts Monthly Accounting Reporting System) Project. Reviewed all key project plans and deliverables, performed software assessments which evaluated consistency between General Systems Designs, Detail Systems Designs, and delivered software. Reviewed test scripts, performed requirements tracing, validated conversion data. In addition, monitored the development of the NewMMARS interfaces for federal certification, and monitored all aspects of software testing; including System, Release, and User Acceptance.

Functioned as a Systems Analyst supporting the development and implementation of the EDI interfaces for EMC’s Catalyst Project. EDI interfaces included: Supplier Payments via Electronic Funds Transfer (EFT) using Citibank Corporation, Purchase Orders and Schedule Forecasting transactions using GXS, a subsidiary of GE Corporation. Duties included: business and programming specifications development, Test Plans & Strategies development, verification of test data files for compliancy with EDIFACT and ANSII X12 standards.

Responsible for the development and implementation of the interface between the Department of Revenue’s Child Support System and DTA assuring compliancy with Federal Regulations. Duties included: scope of work definition, programming specification development, test plan development and execution, user documentation review, and user sign-off coordination. In addition, functioned as the post-implementation support person.• Functioned as a team member supporting all DTA’s interfaces with multiple agencies (some via COMMBridge) and organizations throughout US.• Performed Systems Analyst duties for DTA’s proposed interface with Department of Social Services (DSS) Family Net system using COMMBridge.

Responsible for the development of the Commonwealth’s Child Support Enforcement System. This system was transferred from LA County and modified according to Department of Revenue requirements.• Functioned as Team Leader for several business areas including: Intake, Litigation, Locate, Enforcement, Case Management, Customer Service, and all Interfaces of the system.• Managed the implementation of Phase I of the DOR Voice Response System that handled 30,000 calls per week.• Responsible for the development of Phase II of the Voice Response System.• Duties included: supervised team members, maintained project schedules, scope of work definition, developed General System Design/Detailed System Design Documents, programming specifications development, produced test plan documents, reviewed systems documentation, supported database file development, and coordinated data conversions.