Project Development
Resume:
SUMMARY
During my career, I have held a number of positions from Business Analyst
to Program Manager. In these positions I gained team management skills by
building and managing teams with diverse groups of personnel. These
positions also allowed me to demonstrate my skills in policy and procedure
writing, report preparation, project methodology and documentation, as well
as, my abilities to organize, analyze, and review statistical data. I also
developed a working knowledge of most Microsoft products, a strong
understanding of software development, software lifecycle methodology,
information systems development, and several programming languages. I have
also developed several relational databases for use in disease management
programs.
PROFESSIONAL EXPERIENCE
Genoa Healthcare, LLC 2010 - Present
18300 Cascade Ave S. Ste.251, Tukwila, Washington 98188
Sr. Healthcare Data Analyst
. Perform detailed analysis of large clinical data sets, to identify
trends, problems and opportunities for business improvement.
. Evaluate and recommend process improvements to enhance current
analysis and monitoring systems.
. Manage key analytic portions of a project from start to finish.
. Responsible for designing and implementing reports across multiple
departments to meet business requirements.
. Serve in key technical role for reporting.
. Analyze reporting requirements to identify system constraints, develop
design specifications, and build reports to meet business
requirements.
. Convert existing legacy reports into new BI reporting using a
combination of data sets, data marts, data cubes and databases, SQL
programming, SSRS, and other BI Solutions.
. Implement, configure and maintain the Orchard Harvest LIS
. Act as subject matter expert for the Orchard Harvest LIS and the BI
suite of reports.
Molina Healthcare of Washington 2002 - 2010
21540 - 30th Dr. SE, Suite 400, Bothell, Washington 98021
Healthcare Data Analyst II
. Participated in the selection of additional personnel for the
Healthcare Analysis department, as those individuals were needed.
. Developed and implemented processes and standards for the Healthcare
Analysis department.
. Trained and mentored staff and other personnel in the use of technical
tools that are developed by the Healthcare Analysts or implemented
through other means.
. Designed, developed, and implemented standardizations for programming
of analytical processes.
. Participated in the system conversion from QMACS to QNXT.
. Converted existing Crystal report analysis from the QMACS system to T-
SQL reports utilizing the QNXT system to reduce the technical overhead
associated with those analyses. Some of these analyses were reduced
from two or three days to less than a day.
. Development, implementation, and maintenance of programming and
analysis for the collection and reporting of data to satisfy the
contractual requirements of various state agencies.
. Designed, developed, implemented, and maintained Asthma and Diabetic
Registries, using MS Access and Crystal Reports, to track membership,
and claims data for the participants in these Molina QI Programs.
. Designed, developed, implemented, and maintained standardized
reporting for Molina's NCQA accreditation effort. The plan received a
full three year accreditation.
. Designed, developed, and implemented analysis and reporting for the
acquisition / transition of Aetna's 13,000 Basic Health and Healthy
Options members to Molina Healthcare.
. Designed, developed, implemented, and maintained analysis and
reporting for Molina's Upper Respiratory Infection, Emergency Room,
and Inpatient Follow-up QI and UM programs.
. Standardized and coordinated more than 20 monthly analysis and
reporting projects for the monitoring of QI and UM programs.
Point of Careware 2000 - 2001
14405 SE 36th Street, Suite 300, Bellevue, Washington 98006
Program Manager
. Developed and staffed a Quality Assurance Unit, including the
standards and processes for that unit.
. Mentored and trained QA staff in the development and documentation of
various test cases to insure the applications certification.
. Managed the activities of the development staff and processes for a
web based application, from the requirement stage through to release.
. Performed the process of collecting, defining, and documenting the
User Requirements, Business Requirements, Project Scope, Functional
Specifications, Detailed Designs, and User Guides for the development
and certification of web-based applications and enhancements, by
consulting with end users, managers, and development staff.
. Tracked and prioritized the correction of bugs found by the QA unit.
. Controlled and tracked the Change Management process for enhancements
and modifications requested by the Beta sites.
. Identified and resolved technical issues, insuring the project
deliverable is on schedule.
. Successfully delivered a suite of products, for a web-based
application (ASP) developed for the Assisted Living Industry, which
utilizes a hand-held device (PDA) for data collection.
. Completed all project documentation, including Functional
Specifications, Project Scope, Detail Design, and User Guides.
Regence Blue Shield 1998 - 2000
1800 Ninth Avenue, Seattle, Washington 98111
Underwriting Systems Development Coordinator
. Designed, developed, implemented, and maintained a Y2K compliant
database for tracking the retention, administrative fees, rates, and
other associated underwriting/actuarial data, for new and renewing
groups and associations utilizing Microsoft programming tools (MS
Access and SQL).
. Converted underwriting/actuarial legacy data to Y2K compliant data and
validated the accuracy of that converted data.
. Developed and maintained financial and risk management reporting of
Underwriting, Actuarial, and Group data for various departments,
including Provider Contracting, Finance, Underwriting, and Marketing,
using Microsoft programming tools.
. Participated in the development and documentation of specifications
and the design of various systems functionality.
. Analyzed and contributed to the timely resolution of system-related
issues affecting department activities by acting as a troubleshooter
and intermediary for the Underwriting and Actuarial departments.
. Acted as liaison between the Marketing, Underwriting, Actuarial and
Information Technology departments.
Providence Health Plans 1997 - 1998
4800 37th Ave. S.W. Seattle, WASHINGTON 98126-2793
Risk & Reimbursement Analyst
. Managed an ERISCO to Amisys conversion data validation project, for
the organization's claims adjudication system, that included
development of a consolidated log for problem tracking and resolution.
. Teamed with management and users to document and define test cases and
perform data validation.
. Developed an automated financial analysis reporting database that
allowed on demand access to reports and data, utilized by Underwriting
and Provider Contracting to develop rates and measure risk, that
previously took up to three (3) weeks per report to produce.
. Developed standardized reports that aided the health plan to acquire a
full 3-year NCQA accreditation.
. Developed standardized reports allowing for the collection of monies
through a reinsurance agreement.
. Developed an automated claims lag reporting system for IBNR revenue
development.
. Supported Provider risk model project by working with Provider
Contracting personnel to define and document report specifications, as
well as developing ad hoc reports.
. Developed and maintained programming for PC based risk structure
model.
. Developed and maintained programming for PC based fund settlements.
. Completed financial analysis for new products, product lines, and new
services areas.
Premera Blue Cross 1982 - 1996
7001 - 220th SW, Mountlake Terrace, WASHINGTON 98043
Project Coordinator 1992-1996
. Directed and facilitated the activities of multi-divisional project
team members to accomplish the design, development, and implementation
of major corporate projects to meet intended project objectives.
. Managed the development, design and implementation of electronic
communications software covering two (2) states, 350 clinics, and over
2000 providers for the purpose of enhancing communications between the
provider community and third party payers.
. Managed the development, design and implementation of a corporate
project to introduce new triple option dental products offered in two
(2) states through an alliance with Premera Blue Cross and Health
Management Services.
. Managed the development, design, and implementation of a corporate
project to automate customer enrollment which reduced group enrollment
processing from 30 days to 14 days.
. Designed, programmed, and generated management reports, utilizing the
FOCUS programming language, for corporate customer enrollment
statistics. This allowed for the reduction of two (2) FTEs and
provided the Underwriting department with "to the minute" statistics
for rating purposes.
. Prepared necessary cost analysis and project scope documentation for
various system enhancements and modifications.
. Managed relationships with outside venders to accomplish intended
project objectives.
Systems Coordinator 1990-1992
. Documented, scheduled, created, and executed test cases for production
system revisions, enhancements, and modifications requested by the
Underwriting, Marketing, and Actuarial departments.
. Analyzed and contributed to the timely resolution of system-related
issues affecting department activities by acting as a troubleshooter
and intermediary with Underwriting, Marketing, Actuarial, and
Information Services.
. Due to system enhancements recommended by this position, staffing was
reduced from twelve FTEs to eight.
EDUCATION
Graduated from Woodway High School GPA 3.5
Attended Edmonds Community College GPA 3.75
Courses completed: Introduction to Computer Programming, Beginning Basic
Programming, Beginning COBOL Programming
TRAINING
Microsoft Access Microsoft Excel Microsoft Word
Microsoft Office T-SQL Report Builder 8.0
SharePoint Services
Orchard Copia LIS Orchard Copia LIS Health Level Seven
Administrator Integration I (HL7)
Beginning Focus Language Intermediate Focus Advanced Focus
Language Language
Crystal Reports 7.0 and Microsoft Project Microsoft Power
8.0 Point
Experienced with the use of: Medical Terminology, ICD-9, DRG, and CPT-4
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