Rick Mcconnell, Pmp Email & Phone Number

Florida, United States

• Creates Features and User Stories that represent the business need.• Engages in Requirements Gathering, Solutioning, Design, User Acceptance Testing and Implementation.• Serves as a Subject Matter Expert for the 278A and 278N X12 formats.• Creates UAT test plans, Test Strategies and Test Scripts.• Gather, document and presents business requirements.• Conducts grooming sessions with IT to document User Stories in CA Agile.• Serves as a liaison between the business and IT.• Performs in-depth analysis of benefits for the Benefit Clarity initiative.• Works with IT to identify, prioritize, resolve and test system defects.• Serves as a SME resource for other Business Analysts on team.• Reviews EDI errors and works with EDI Operations and/or IT to resolve the errors.

Tampa/St. Petersburg, Florida Area

Achievements:• Increased processing speed of change files from 3 days to 1 day by implementing an eligibility file preprocessor• Developed and implemented automation tools that systematically update records, eliminating the need for unnecessary resource utilization• Generated nearly $4 million in revenue through the successful implementation of 13 new clients, within time and budgetary constraints• Manage all IT activities related to the transition of benefit platforms for employees of newly acquired companies• Employ Agile and Waterfall methodologies to execute implementation of new clients and internal IT applications• Direct implementations, such as preprocessors and rules engines, effecting over 100,000 end users• Review and analyze project proposals to determine timeframe, scope, risk factors, staffing and resource requirements and strategic planning• Responsible for tracking and reporting key milestones, including ID Card set up, eligibility receipt and subsequent file load, ID card generation and mailing, banking account set up, all inbound and outbound file feeds and payment disbursements• Create and run SQL queries to analyze data and identify anomalies• Determine business rule eligibility, such as retroactivity rules and plan rules, across all systems by integrating with current rules engine• Identify, document, and implement areas of improvement for internal processes• Provide subject expertise for on-going operational issues in the Javalina payer platform• Create and maintain Electronic Data Interchange (EDI) files, including 834, 837, XML, CMS 111Medicare, COBA and various flat file formats• Promote efficiencies through the development of automation tools• Set up scenarios in the payer platform that includes eligibility, claims, Medicare processing and EDI configuration• Identify staffing needs/vacancies, select applicants, interview, and hire candidates• Identify and determine impacts to all applications based on new project requests

Achievements:• Achieved efficiencies with a startup company with no formal SOPs• Implemented over 600 EDI files across 15 different TPAs within a 3-month timeframe• Configured, implemented and maintained a payer system to accept and process nearly 600 weekly EDI feeds from 15 different Trading Partners, and ensured data integrity feeds remained on schedule• Managed the client relationship with a multimillion-dollar client with nearly half a million end users• Accepted EDI test files and process files through various different scenarios, including new enrollments, changes and terminations• Completed EDI file testing and provide SFTP connectivity to corresponding Trading Partners• Organized and managed data validation across all vendors, and provided error reports for corrective action purposes• Gathered, documented and presented requirements to IT in regards to inbound and outbound EDI file feeds• Utilized EDI files to address troubleshooting issues and answering client questions• Performed file audits regularly to ensure data on inbound and outbound files are coordinated between the downstream and upstream systems

Unitedhealth Care

• Engaged in Requirements Gathering, Solutioning, Design, User Acceptance Testing and Implementation• Oversaw the implementation of a new consumer eligibility application• Created UAT test plans, Test Strategies and Test Scripts• Created test files for UAT and Regression testing• Gathered, documented and presented business requirements• Served as a liaison between the business and IT• Performed prototype demonstrations to solicit additional business requirements for CDB front end• Worked with IT to identify, prioritize, resolve and test system defects• Assisted with the creation of Standard Operating Procedures for new processes and applications• Served as a SME resource for other Business Analysts on the team• Managed an issue resolution mailbox to ensure quick and appropriate resolutions to issues• Reviewed PROMPT to identify key project stakeholders and receive a high-level summary of the project’s objective

• Responsible for complex issue identification and timely resolution, and managed all UAT activities• Processed and provided IT with business requirements for design requests• Operated as a CAMS Subject Matter Expert, effectively managing issue resolution and general question mailbox• Troubleshot all identified defects and worked closely with IT to resolve all system issues and coordinate all retesting and verification• Wrote UAT Test Plans, Test Strategies, and Test Scripts• Executed UAT on new enhancements and defect fixes• Performed regression testing on all system updates• Managed multiple projects simultaneously

• Managed over 25 complex EDI clients and 10 Trading Partners.• Implemented and maintained clients through electronic data integration for all inbound files• Worked with clients and vendors in the system migration from legacy processing platform to EEMSplatform• Worked with sales team to discuss any issues or items regarding the eligibility file processing for their clients• Assisted with the development of a new processing tool that allows members to submit their eligibility via a convertible spreadsheet• Served as Team Lead and Subject Matter Expert on the automation team• Created macros for more efficient data processing• Mapped data using a translation tool on eligibility files that required data manipulation• Created a database for tracking of EDI files and spreadsheets that were processed

Master Of Project Management (Mpm), Project Management

Master Of Business Administration (Mba), Finance, General

Bachelor Of Arts (Ba), Sports Management

Activities and Societies: Basketball Team Student Athletic Advisory Committee