Yoemy Waller Email & Phone Number

Glen Burnie, MD, US

Arlington, Virginia, US

• After selling company- Remained as Consultant on retainer for next owners. Manage of Health IT developers, managers, technical professionals, Database and middleware team to develop healthcare and dental software to.
• Manage all process of new client implementation from setting up requirements for changes and managing development work through SDLC to interoperability for interfacing and integration of systems for bi-directional data.
• Manage software development complete cycle from planning, design data models, development, implementation, redesign, improvement and optimization of software development, in a variety of schemas to include Waterfall.
• Successfully coordinated infrastructure integration, data selection and gathering, security protocols, data exchange, reporting and analytics, development work, change management and versioning.
• Conducted informatics and in-depth analysis of claims. Working with big data of around 50 to 400 million rows, processing clinical data, claims real time and returning customer with results. Integrating systems between.
• Implementations with major payors and TPA’s: medical and dental claims, diagnosis, CDT codes, pharma/medications, DME, providers rosters, NPPE, Clinical data, risk models for population health to create robust models -ML

• Expert knowledge of Agile project management
• Provide significant leadership in the development and maintenance of the Reporting Strategy and Healthcare Analytics and KPI’s. Including: defining initiatives, developing business case, high level estimates and.
• Scrum Master and Agile expert managing multiple mission critical IT projects simultaneously from new claims systems development, system migrations, integration and data analytics, infrastructure deployment and.
• Successfully revamped EDI operations and projects for EDI HIPAA Claims Transactions- Electronic Data Interchange of 5010 X12 EDI transactions including: 834 Patient Eligibility, 270 and 271 Coverage inquiry and.
• Developed new and improved existing process flows, for full automation of data and analytics of Claims payments, rejections, denials and reconciliations, including mapping, crosswalks, and full reconciliations of data.
• Developed and implemented SLA- Process mappings and Improved data and process flows professional and institutional claims. Developed system for keeping State, plans and Trading partners dashboards and KPI’s including.

Healthcare industry subject matter expert, data Scientist leading projects of software development on Computable biomedical informatics. Clinical best practices quality assurance, clinical and dental cross over analytics. Implementing expert systems for detection and prevention of fraud, waste and abuse in healthcare.

• Directed the Implementation of interoperability platforms for Laboratory interface for State reporting and connectivity with 17 different EMR systems. Radiology applications with connection to remote PACS system using.
• Adept at reaching interoperability between stakeholders and gaining buy out from clinicians implementing CDA and CCDA exchanges between hospitals and clinics and HIE. Following the continuum of care for the patients.
• Masterfully performed data ETL: Extracting from heterogeneous sources, Transforming and mapping then loaded for systems migration. Keeping critical data from legacy systems and integrating into new upgraded.
• Conducting statistical analysis and OLAP- Online Analytical Process through ODBC-Open Data Base Connectivity on different systems to integrate data for trends and business intelligence. Mining, managing and retrieving.
• Data Dashboards and Quality Measures both for Hospital side and Physician’s side PQRS and GPRO, KPI’s- Key Performance Indicators abstraction and reporting. Six Sigma and Lean projects data management and analysis..

• Developed and implemented Clinical/ Costs/Quality Metrics Data Warehouse for Tracking Patient utilization, cross reference data from hospital, clinics, labs, medications, high utilization of ER, readmissions, and.
• Expert knowledge of Managed Care: Medicare, Medicaid, and Commercial Insurance (Group and Individual). Familiarity with Standard Medicare, Medical Supplements and Medicare Advantage Plans. Knowledge of HMO, PPO, POS.
• Integrated data to prevent over utilization, improving coordination of care and share of information among specialists, PCP, Inpatient, Outpatient, Health Information Exchange and Claims and Costs data from CMS/.
• Analyzed costs reduction, patient’s clinical risk factors and social determinants of health analytics using multiple data sources. By utilizing data modelling and risk management achieved reduced costs and ACO shared.
• Managing Big Data systems, integration and trend analytics with longitudinal studies and population data. Experience with EMRs, Healthcare Data Warehouse and Healthcare Informatics: Population Health, Patient Access.

Lakeview, US

Director for Information Technology and Data Mining and management for Critical Access Hospital including Electronic Healthcare Records-EHR, Information systems management for HIS and CPSI systems, Information Security Management. ODBC and OS data Mining for Compliance and Quality Controls. Software Management and Audits, Web Development and Updating for.

Panamá, Panamá, PA

Promote Panama Canal around the World, conduct market analysis for Third Set of Locks Canal expansion project.

Bs, Marketing, Management And Advertising

Mba, Business Administration

Ms, Marketing, Logistics And Intl Trade

Bachelor Of Science (Bs), Quantitative Analysis