Providing business system support for The Permanente Medical Group (TPMG) Referral Claim processing systems by:• Investigating, documenting and providing resolutions to system issues.• Supporting non-Kaiser providers in claim submission and processing issues and requests.• Performing software configuration changes, executing user acceptance testing of software and benefit plan/rate changes.• Developing and documenting new processes to streamline existing support processes.• Supporting the reporting needs of department and senior management requests.• Educating team members about business and technology information and tools.• Assimilating new business and systems knowledge that involved claims processing, EDI, technology tools.

My own business that has limited activity when I'm working on a contract job and one that I use to keep skills "alive" when I'm looking for a new position.Providing consulting services to small business and non-profit clients in:• Business practice organization and in documenting and defining current/as-is and future/to-be business and IT system processes.• Problem definition, high-level requirement definition and the proposal of possible solutions• Gathering and assessment of functional requirements, software evaluation/testing (fit/gap analysis), selection and the implementation of software to improve service delivery to their clients/customers and assist the business in their vision for improvement.• Developing solutions to resolve off the shelf (OTS) software or business process gaps.• Updating websites.

Performed various software-based activities to support the Regulatory Informatics Team by:• Developing user interface (UI)/functional unit test cases, system test plan and cases and executed iterative test/reporting cycles to ensure a quality delivery of a custom Enterprise Content Management (ECM) add-on.• Identifying steps required to ensure software licensing compliance for a named user/node product and documented and executed process to limit learning curve for future efforts.• Evaluating/testing of several business software tools based upon manager stated requirements providing documented results based upon features, usability, cost and an overall purchase recommendation by software tool function.• Developing system design documents, user guides and user process guide sheets for various software tools.

Assisted the IT Application Management Team prepare for the release of a new claims pricing application.• Applied the Information Technology Infrastructure Library (ITIL) Service Transition framework in the diagramming of the software change and deployment workflow and including RACI (responsible, accountable, consulted and informed) information to ensure clear communication of software change management (SCM) activities and team/individual responsibilities.• Performed gap analysis and modified existing PMLC, SLC and SDLC documents to ensure that documents included callouts for legacy system support requirements.

Assisted the IT Application Management Team and the Mental Health Benefits business team by:• Working with the business team to extract, document and validate claim processing business rules from a software program to ensure an understanding of current claim processing rules by the entire business team.• Assisting in BSCA’s Application Readiness effort by documenting and/or completing Operational Readiness, Service Level Agreements (SLA), and Help Desk Support documents for their Software as a Service (SaaS) applications.• Performing a technical analysis of MS-Access-based applications developed by the business teams, making redesign recommendations where appropriate.

Supported the Customer Relationship Management (CRM) application which provided consumers with product information and medical device support and enabled business teams the ability to manage medical device complaints for diabetic meters and testing supplies.• Gathered and documented functional requirements for software and system changes.• Developed required FDA compliant documents to support software and system changes.• Developed unit / system integration test documents (IQ/OQ/PQ), the traceability matrix and the validation summary report to support the change.• Responsible for the technical review and approval of the hosting provider’s software and infrastructure change and release documents.• Developed process and RACI-based workflow documents to clearly communicate business and IT responsibilities when addressing configuration, data and software changes.• Trained to business analyst team on the change management process.• Developed and implemented a quarterly process to Extract, Translate, Load (ETL) and report on competitors medical device report data filed with the FDA.