Experienced IT Consultant/Business Analyst with over 15 years of experience driving business processes Experience in process modeling using VISIOKnowledge and experience with IBM Curam HCR social services platformKnowledge and experience with agile methodologiesManagement Information System (MMSI) EXPERIENCE.Strong understanding of relational databases and database structures15+ years developing data mapping for conversion purposes15+ years using SQL15 + and FTP/TCP/IP transmission standardExperience in working with payor systemsExperience with ETL programming and customer support, database data matching, cleaning and load operations, and/ or database analysis and reporting.Proficient delivering quality services in both private and public industries. Skilled at working as a liaison between business owners and IT personnel to develop a joint vision.Proficient in SDLC procedures from basic design procedures to intricate testing in UAT, System, QA and implementation phases. Ability to effectively communicate across multiple levels (executive sponsors to team members); Ability to communicate technical issues to non-technical individualsExperience in Agile Testing Environment.5 years working with Health Level Seven (HL7) Ver 2.3, 2.4Middleware testing (HL7) and script writingExperience in working with Iguana and Cloverleaf interface enginesLead projects to completion.Experienced in delivering business solutions to support the strategic directions of organizations by participating in major installations, upgrades, conversions and GAP analysis. Experienced in designing detailed interface systems for use of front-end or back-end systems.Experience using Test Director, Windows, Oracle Financials, IDX, SharePoint, Microsoft Office suite, Knowledge of health care operations and structure and use of information system applications in the practicing health care environment Patient Management system and conversion experience.HP ALM for QA experience

• Involved in a State of Missouri project as a business system analyst in the area of Medicaid service• Responsible for identifying, understanding, documenting and conveying systems architecture in a SOA Architecture environment.• Analyzing and documenting systems to determine how functionality supports State requirements for business transactions and processes and ensuring compliance; possess an in-depth knowledge of State operations and its corresponding system support those operations.• Worked with software developers and other end-users to ensure technical compatibility and support of the system requirements and technical specifications.• Work with testing teams to ensure a complete understanding of the system requirements and to validate system testing.• Developed use case , user stories and test scripts for Curam health care application and interface processing.• Translate client requirements into concise, highly technical specifications and serve as a technical resource to explain the requirements in technical and non-technical settings.• Agile development tool (JIRA).• Used SharePoint as a repository of documents.

• Primary responsibilities include working in the business analysis phase of the system development cycle and consulting with users to define business processes and the information systems that support those processes in the client implementation phase. Extensive client analysis to prepare detailed specifications used in the Systems Analysis function.• Assisted in the creation of UAT plans.• Supporting a Software as a Service (SAAS )model environment.• Communicate task status both formally and informally as required.• Used SQL*Server to conduct gap analysis on HL7 messages that were sent outbound through a Cloverleaf Secure Courier or Iguana interface engine. Validate results against client specification interface• Work with clients to identify different HL7 feeds that are sent inbound and outbound to Epic, McKesson, and Cerner ancillary systems.• Work closely with hospital clients to deploy software to client site.• Interact with team members such as Project Manager, Technical Assessment Team Engineering Team and customers.• Work with clients to ensure compliance with regulatory requirements such as, HIPPA, etc., as well as internal policies and processes.• Use Team Foundation Server (TFS) as a repository for scrum documentation• Derived current and future state dataflow diagrams.• Conduct and facilitates JAD sessions to develop and coordinate the requirements specification, design and testing efforts.

•Work closely with Technical SME's to help facilitate requirements gathering sessions, review input from SMEs and write detailed requirements for all aspects, including data mapping, application dependencies, and procedural changes required of those using the test environments•Involved in the installation of Camouflage application used for masking the sensitive data in healthcare based on the HIPPA Privacy rules and HIPPA Security Act. •Responsible for the development of business requirements for an eBusiness project which include Ecommerce project using Agile/Scrum methodology•Use Team Foundation Server (TFS) as a repository for scrum documentation build and HP Test Director for developing test cases and test scripts.•Assisted in the design of wire-frames for Ecommerce initiative.• Responsible for the strategy, product roadmap and prioritization of projects and enhancements• Work with other departments to help prioritize projects and assist in developing accurate user stories in support of the development cycle and employ scrum teams to implementation of the user stories• Responsible for reviewing data structure for Siebel (CRM) system, FACETS (health care billing system), Provider Information Management System (PIMS) in order to identify he personal healthcare information (PHI). •Used SQL*Server Management Studio to conduct data analysis for existing sensitive data with all environments•Developed analysis reports for MedVantage using SQL*Server Management Studio•Utilized Visio to develop a descriptive architecture and functional document of company’s process in order to understand and communicate new processes with the client.•Used Share Point as a repository of documents •Developed statistical analysis reports for MedVantage doctor search using SQL*Server Management Studio•Utilized SQL*Server Management Studio for creating tables and importing data from a flat file into the tables.

Contractor• Review SAP ISU and CRM IC Operations and Functionality• Performs account corrections including re-bills, adjustments, clearing of transaction and billing failures• Responsible for resolving and negotiation of escalated customer of issues /complaints forwarded from the call center or other groups within customer.• Performed all company, legal and regulatory guidelines in response to customer issues

•Liaison between the IT Operation team and the Corporate Billing Operation group and Clinical Laboratories in order to gather appropriate requirements and specifications for improving the functionality of the GE Flowcast Billing System (GE IDX BILLING)•Responsible for maintaining updates to SharePoint•Ensures issues are identified, tracked, reported on, and resolved in a timely manner •Prepared Business Requirement Documents and Technical Design Documents based on the requirements identified by the IT Operations , Corporate Billing and Clinical Laboratories •Created test cases and scripts based upon documented business requirements and test plans•Knowledge with HIPAA electronic transaction files (837, 834 files)•Assisting in the documentation of the workflow process for EDI process using VISIO•Developed business and technical documentation for software enhancements of EDI process •Claims experience with Medicaid and/or Medicare•Responsible for conducting BRD and TDD design review sessions.. Documented existing billing workflow using Visio and assess existing gaps between billing needs and Billing Information System (BIS) software functionality.•Developed heath care reports using SQL under a Unix platform using Oracle tools.•Management of incidental tickets resulting from errors using Mercury Test Director Quality Center

•Work with project teams to understand the scope of implementation activities and project interdependencies.•Responsible for analyzing contractual specs and terms and conditions base on Verizon Servicing guidelines.•Responsible for the creation and development of detailed Assessments, Audit Plans and Test events documentation which outlines audit approach, scope, entrance/exit criteria, assumptions, audit cases and schedule.•Responsible for tracking the progress of the project to completion and ensuring the requirements meets the stated strategic goals for the product and/or implementation. •Create manual test cases and scripts within the Mercury Test Director based upon the test plan•Partnered with developers and managers to ensure test plans covered business requirements.•Report any business risks to management that became a show stopper during the audit.•Assist in identifying errors in with the Verizon Billing System that would prevent the future products from being processed correctly. •Executed functional, and regression testing for E-commerce application•Generated weekly status reports outlining audit progress and conduct weekly audit status calls..•Work closely with Customer Premise Support group (CPS) PD and IT organizations on Computer Premise Equipment (CPE) schedules, priorities, issue resolution, audit planning, and audit status reporting. •Participate analyzing, and providing solutions for data integrity for Order Entry application using an Oracle Data Base.•Coordinated with PM, BA's, Developers and functional teams and coordinated meetings