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Quality Project

Natick, Massachusetts, United States
January 31, 2018

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Valery A Taboh: MHA

U.S. Citizen, in Baltimore, MD, willing to Travel and relocate within a 1-2 Weeks’ Notice



●15+ years of experience in the Healthcare Industry

●5+ years’ in Agile Scrum Master roles, SharePoint Identity Management, Salesforces

●4+ years of experience as a Project Manager result driven professional.

●3+ year’s’ as junior Oracle 11g Database administrator

●Knowledge of various Agile frameworks: Scrum, XP, Kanban Principles

●Knowledge of Salesforce, Jira, MS Project, Sharepoint, Business Analysis

●Oracle database 11g Certified Associate, Sql, Salesforce,

●Use of Business Analysis tools, Excel, Tableau, Informatica, MS Project Plan, Jira

●Experienced in Agile techniques: User Stories, TDD, Continuous Integration


●MS Project Server, SharePoint, Salesforce, Jira as a tool for project management.

●Experienced in Agile Scrum and Lean methodologies with exposure to Waterfall.

●Knowledge of HIPAA, Fraud Waste and Abuse, ACA, Medicare and Medicaid government compliance guidelines, SAFe

●Analysis data using Excel and tableau

●Managed ICD-9 to 10 transition testing for Austin Recovery and a New Leaf.

●Provide technical support for EMR, EHR, Sharepoint. Salesforce

●Developed Project Change Control, Issue, Risk and Budget tracking processes.

●Managed multiple Med D Client Implementation and enrollment engagements.

●Used Agile, Scrum, Kanban and Lean methodologies during annual enrollment.

●Strong understanding of customer/stakeholder relationships, prioritization, estimation, capacity management as a business analysis.

●Experience using Jira to track and make visible sprint backlog workflow preferred

●Prior experience performing gap analysis and assessments involving HIPAA related issues.

●Full SDLC Implementation experience from Initiation to Execution on Claims and Care Management.

●Basic HTML/CSS/JavaScript, python,sql coding skills

●Manage and Lead a team of staff, coaching, writing performance reviews, hiring and firing of staff


●Agile Certified Practitioner (PMI_ACP) (completion date expected – 2018)

●Scrum Master (CSM) – Scrum Alliance

●Lean Six Sigma Green Belt - Arizona State University

●Lean Healthcare - Villanova University

●Oracle 11g database Administration - Oracle


●HealthCare Administration (MS) Kaplan University 2010 – 2012

●Organizational Communication (BA) Northern Arizona University 2006 - 2008


Anthem Blue Cross Blue Shield/Short Term Contract PinPoint Oct 2017-Present

Sr Scrum Master

Responsible for multiple teams, leading and coaching on the Anthem global encounter payment strategy system process, agile planning and communicating with Sr Leaders. Working with Scrum Teams, knowledge of Kanban and if possible, SAFe. Some of my responsibility as Sr Scrum Master include but not limited to;

●Leading, negotiate, and coordinate with technology, and business stakeholders on prioritization of tactical and strategic technology initiatives, as well as monitor the entire project process

●Work with other team members to identify and justify investment opportunities for the encounters

●Work directly with business owners to define requirements (epics and user stories)

●Implement processes, practices, and tools allow for multiple paths of delivery. I.e., create simplified, consistent, reusable, efficient and flexible methodologies

●Recommend improvements and drive alignment across the MarketPlace solutions organization

●Serve as a Coach and Mentor within the organization to facilitate adoption and maturity for scrum team

●Coach and mentor product engineering team(s) on scrum / lean/ agile principles and practices

●Evangelize, coach and mentor business and management stakeholders on value proposition of Lean, Agile & Scrum. Serve as a Scrum Master / Agile Coach for multiple teams, Assist in release planning and sprint planning, Run standup/scrum meetings for engineering team

●Lead and influence others including those more senior on best practices

●Facilitate the daily standup, sprint planning, retrospective, backlog refinement ceremonies and coach the teams

●Inspire others to adopt the new processes and improvements based on program retrospectives

●Evaluation and provide consultative services that enhance business performance, minimize risk and optimize care management programs/services/interventions.

●Collaborate with business leaders, agile Learning and Development, and Culture and Engagement teams in identification and implementation of best cost of care management practices. Develop methodologies and tools to monitor performance and prepare Executive Summaries

●Responsible for the administrative, coaching and leadership roles that make Scrum development/delivery possible

CVS Health Pharmacy Benefit Management Dallas, TX March 2017 -Oct 2017

Sr. Consultant Project Lead

●Provide oversight to a portfolio of projects ensuring on-time delivery of all tasks across multiple departments. Establish continuous deployment process, plan releases and obtain project life cycle approvals. Discuss enterprise system enhancement project requirements and stories with analysis & advisor

●Perform business analysis and develop innovative solutions to address med D client implementation and assist the team with research, report creation and quality control of all deliverables. Maintained Scrum Team Dashboard, assist Product Owners with backlog creation and grooming of stories

●Perform user access by reviewing individual users to ascertain their need for access and permissions to active directory and other systems like Facet,Fazal, RxClaim, AS400, Valencia, MARx UI, Peoplesafe, Sharepoint etc. Ensure system design solutions meet business needs and align with enterprise and CMS Med D standards.

●Sharepoint administrator managing permissions, analyzing/reporting, monitor trend and page/site creation and modifications

●Department Salesforce SME, managing and tracking all client implementations and providing report to Sr managers, directors and VP

●Managing Libraries, as needed, work on special projects as assigned. Provide day to day compliance support to the sharepoint site, design processes to meet business and operational needs

●Design Med D project dashboard using data tools like Tableau, SharePoint, Excel pivot tables, charts, graphs, and custom reports. Recommend agile methodologies for improvements and automation, lead initiatives and follow-through

●Department Sharepoint Administrator, Maintain the integrity and reliability of access to information including backup and recovery practices

●Establish and maintain end-user access policy and permissions and delegating permissions authority where necessary

●Work with developers to create customized solutions including integrating third-party tools and/or custom code into SharePoint

CVS Health Pharmacy Benefit Management Dallas, TX Feb 2015 - March 2017

Business Process Supervisor

Develop an effective SCRUM-based agile methodology for Med D enrollment that meets the diverse needs of CVS customers and internal stakeholders. Coordinate organizational change management aspects of agile introduction and play a prominent role in influencing the acceptance and practice of scrum/agile process

●Coach and mentor product engineering team(s) on scrum / lean/ agile principles and practices

●Evangelize, coach and mentor business and management stakeholders on value proposition of Lean, Agile & Scrum. Serve as a Scrum Master / Agile Coach for multiple teams, Assist in release planning and sprint planning, Run standup/scrum meetings for engineering team

●Maintain and refine Salesforce workflows to support scrum/agile development process

●Develop, produce and monitor team performance reports (velocity, estimates vs actual)

●Issue/task tracking, enforcement of Salesforce processes (time recording, task breakdowns)

●Assisting in prioritizing work

●Progress tracking for active releases (done vs remaining, projected completion dates)

●Work with PMO/Directors/VP to incorporate Salesforce processes into enrollment teams

●Utilize SAP Fieldglass to manage workforce

●Train new comers on our methodology Maintain Med D best practices materials (SharePoint, Tableau,presentations, FAQ)

●Performing all job functions consistent with CMS Med D policies and procedures, including those which govern handling PHI and PII

●Participate in and/or lead internal and external meetings on product innovation and development

●Lead a team of sr and enrollment consultant analysis to exceed performance standards, quality expectations in the med d enrollment division, by coaching and providing guidance

●Perform monthly/annual client reviews, facilitating special projects and daily work flow management

●Ensure the successful delivery of compliance/audit results and timely handling of all rebuttals and responses.

●Drive automated solutions and eliminate facilitated processes to drive compliance and quality

●Handle interviewing/hiring, evaluating and reviewing performance, coaching & counseling, disciplinary action and daily supervision of analyst and enrollment consultants to ensure that all department and company policies and procedures are followed

Austin Recovery Drug & Alcohol Addiction Treatment Service Nov 2013-Feb 2015

Director of Client Operation Lean Healthcare Coach

Project Scope: Migration from a manual clinical and claims data management model to an implementation of a 3rd party automated claims data management system

●Oversee the coordination of quality improvement activities in keeping with the strategic vision of Austin Recovery Centers and direct the operations of the Department of Quality Improvement

●Oversees the coordination of activities for the QI program for all divisions of the organization

●Coordinates and directs activities in the Department of Quality Improvement to ensure provision of an effective Quality Improvement program. Develops goals and objectives for the department that assure alignment with the strategic initiatives of the organization as well as compliance with Federal, State, Carf and Joint Commission standards

●Designs, develops, implements and evaluates quality improvement policies, procedures, documentation tools and monitors a capital and operating budget for the department

●Interviews, hires, trains, assigns and monitors productivity of staff, develops performance plans and evaluates the performance of all staff

●Maintains effective communication and working relationships with staff at all levels of the institution regarding quality improvement. Carf /Regulatory liaison back-up to the regulatory

●Maintains current knowledge of Quality Improvement information, Patient Safety, and Regulations to serve as an advisor to all personnel including the Medical Staff and Senior Management

●Oversee and direct the flow of information through the quality structure. Facilitate and oversee follow-up for performance measurement for all quality initiatives

●Oversee and coordinates projects related to benchmarking opportunities (both internal and external). Oversees the completion of the Core Measures Project and reports to senior leadership as appropriate

●Coordinates the Performance Improvement activities related to Carf, Joint Commission surveys and accreditation. Coordination of follow-up for quality of care denials

●Train and educate staff on all levels regarding principles of QI, and quality improvement process including teaching workshops (i.e. QI, Data Management) and orientations (New Employee/Managers/Housestaff)

A New Leaf/Crisis Psychiatric Service (contract) July 2013 - Nov 2013

Manager of Quality Improvement Project: Implementation an EMR system (NextGen) that collapses all care management programs into a single primary nurse & clinician model using custom outreach patterns, triggers, trumping orders and customer reporting. Implement key Multi-Channel Communication features and connectivity. Assists in strategizing and facilitating various committee structures and functions to best address the QI process and oversees Quality Committees

●Responsible for assuring compliance with mandated clinical interventions inclusive of core measures within the organization and state. Direct interfaces with VP, Directors, Administrators, Nursing, Medical and Quality Leadership, and Clinical Staff, overseeing administrative and daily operations of the core measures and clinical intervention compliance program

●In conjunction with Nursing, Medical and Quality Leadership, coordinates core measures and clinical intervention compliance activities. Assists in development and design of action plans to support compliance with measures indicators and provides support and educational resources to departments and services relative to core measures quality assessment and improvement processes

●Assists in establishing and implementing short and long term goals, objectives, policies and operating procedures for core measures programs

●Provides coordination and leadership in the execution of day to day program activities, as appropriate to program objectives and areas of expertise

●Oversees the collection, compilation, and analysis of clinical program activity data

●Provides technical assistance, resource services, consultation and education to clinical departments relative to core measures activities, resolving and/or escalating impediments to help your team ship code

ConnectionsAZ INC/ConnectionsAZ Inc Emergency/Crisis Psychiatric Service Dec 2010 - Nov 2013

Team Manager

●Develops and leads the quality assurance/performance improvement program

●Collaborates with leadership team in identifying opportunities for improvement. Oversees production of metrics and reports for internal balanced scorecards, RBHA, County and State reporting deliverables

●Facilitate daily scrums, Sprint review, Retrospective and sprint planning

●Oversees patient safety tracking, critical incident reviews, root cause analyses and risk mitigation strategies.

●Collaborate with multiple stakeholders across Behavioral Health clients and internal business teams to uncover and develop emerging ideas and proposals into innovative solutions

●Works with leadership to determine appropriate success metrics with which pilots will be evaluated

●Develops strong quantitative and qualitative value proof for product innovations including but not limited to expected operational metrics, expected benefit expense metrics and financial business cases for MAP and potential clients. Other activities as directed by the management team

●Lead cross-functional meetings, own the product backlog. Facilitate the Agile development process as a key product owner, participating and leading the development sprint efforts and daily task activities necessary in Agile development

●Strong experience in analyzing requirements for Salesforce, configuration and customization on Workflow Rules and Approval Processes

●Researched markets for advancements and advocated the use of new database technologies

●Provided constant online or on-call assistance to end users for handling their queries

●Maintained a backup or recovery options to retrieve the lost data

●Assisted in building strategies for installing and improving the database

●Inspected the operations of the database as per the standards set by the organization

●Focusing teams to deliver value quickly, fostering a motivating culture of openness, collaboration, and continuous improvement, coordinating across other Agile teams for complex projects

●Leveraging data to measuring & monitoring progress against commitments

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