Vicky Brown Email and Phone Number

Sr. Business Analyst working on ICD-9 to ICD-10 transition analysis.

Texas ICD-10 Documentation Services Project Senior Business Analyst on project analyzing the business and technical impact of the conversion of the ICD-9 codes to the ICD-10 codes for the HHS (Health and Human Services) agencies for the State of Texas Identifying business processes, stakeholders and system impacts for non-Medicaid health programs within the DARS; Preparing appropriate documentation to communicate and validate ICD-9 conversion impact information, utilizing SharePoint and Casewise V-Modeler tool (interface to Visio)Conducting Stakeholder interviewsAssisted in creating Business Document Review Report template and Impacted Business Processes templateCreated training materials and coordinated UAT Training for State's testing team

Business analysis of Third Party Liability for North Carolina relacement MMIS.

Business Analyst on the Third Party Liability team for the North Carolina MMIS (Medicaid Management Information System) replacement Assisted the TPL team in creating the BSD (Business System Design) documentAssisted the technical team in writing, reviewing, and editing the TDD (Technical Design Document)Met with the client and facilitated discussions regarding TPL Letters/ReportsPrepared TPL letters to send to the Non-Electronic Submission Build for productionUtilized the Document Builder Tool used for storing documentation that ultimately created the TDD (Technical Design Document) Utilized Lotus Notes, Visio, Borland Caliber, and SharePoint to complete assigned tasks

Business Analyst/Team Lead for Prior Authorization on a contract to build a new MMIS using Service Oriented Architecture (SOA) technology for NebraskaGathered and analyzed business objectives, requirements and functional specifications for Claims and Prior Authorization areas through Stakeholder interviews, Joint Application Development (JAD) sessions, and Whiteboard discussionsEvaluated "as is" and "to-be" business processes to perform Organizational Change analysis and propose solutions for business process improvements Performed Gap Analysis on Claims, Reference, and Prior Authorization areas to determine if additional requirements or modifications to existing requirements were needed based on Medicaid Information Technology Architecture (MITA) and federal regulations for CMS certificationAssisted in creating business processes and diagrams for new MMIS using Business Process Modeling Notation (BPMN) standards and Visio for the Prior Authorization areaPerformed policy decomposition using the State Medicaid Manual and State Rules and Regulations (Natural Language translation)Produced written deliverables meeting specified deadlines and standardsMet with functional owners and facilitated discussions to derive pain points in current system regarding Prior Authorization

Extensive testing for MMIS (Medicaid Management Information System) Claims' application (Edits/Audits and Pricing) for Implementation Projects in KY, AL, FL, and OH. Worked remotely from home as part of a virtual team for the aforementioned implementations Used Test Director and Web Portal for testing documentation Wrote Training section for new business (Oregon RFP)Created test cases, test plans, and tested system defects and enhancements for client server system and .Net web based system (interChange) Gathered business requirements, analyzed, defined and designed various projectsLiaison between customers (internal and external) and technical team (System Engineers)Facilitated internal and external customer project walkthroughsBusiness Lead for the Control Series (system reporting) initiative and OnBase reporting systemPerformed HIPAA testing for Control Series initiative Cycle monitor, On-Call for model office and production cycles

Supervised 10 Business Service Analysts and 2 Systems LibrariansConducted performance reviews and administered pay increases and bonus requestsParticipated in selection and training of new staff (Business Service Analysts)Managed projects and oversaw maintenance for the Legacy system during new implementation

Business lead on various project implementations including Indian Health ServicesCreated test plans and tested defects and enhancements for the Legacy systemActed as Systems point of contact for new claims application Formworks/Viking

Reviewed and edited the Texas Procedures Medicaid Manual, Texas Medicaid bulletins and the Program Policy Interpretation ManualActed as liaison between Policy department, Technical department, TDH (Texas Department of Health)Acted as customer contact for all policy changesImproved process for distribution of Federal and Texas Registers to the account saving EDS approximately 75% of procedural costs

Acted as Business Lead for the Eligibility, Managed Care and Data Sharing applicationsFacilitated internal and external customer meetingsServed as liaison between Systems Engineers and customersDesigned and coordinated the production of the plastic Recipient Identification Card for the Commonwealth of VirginiaInteracted extensively with vendorsCreated operational procedures for the ID card and assisted with testing procedures

Educated and assisted Medicaid population in adapting to Managed CareDeveloped, wrote and created marketing materials for clientsEdited materials developed by medical providers for clientsPlanned initial enrollment events and ongoing events in neighborhoodsConducted information presentations to groups and individual eligible clientsUsed TOPPS (Triple Option Product Processing System) to enroll recipients in managed care plansAnswered client "hotline" and resolved health care issues

Served as liaison between Texas Department of Human Services and Medicaid ProvidersInvestigated client billing and service issues relative to Federal and State policiesAnalyzed claims processing procedures to ensure accurate paymentPrepared written responses and reports to State agencies regarding irregularities, errors, fraud or failure to comply to providersStreamlined the process of provider and DHS correspondence resulting in 30% less time to perform the taskActed as back-up trainer for new hires in the Provider Relations Department