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Project Manager

Location:
Richmond, Virginia, 23235, United States
Posted:
August 09, 2018

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Resume:

PROFESSIONAL SUMMARY

Servant Leader interested in applying my expertise to get real business value for clients. Astute people skills and a range of technical abilities experienced in providing technical, analytic, and management expertise in the development and deployment of effective technology solutions to business needs. Varied experience in healthcare systems, Medicare, Medicaid, Pharmacy and (EHR) Electronic Health Records, Claims, Provider and Membership.

PROFESSIONAL CERTIFICATIONS

Certified Scrum Master License 000270825

oCertification Date: Aug 2013 – Nov 2017

oCertification authority: Scrum Alliance

Certified Scrum Product Owner License 000270825

oCertification Date: Nov 2013 – Nov 2017

oCertification authority: Scrum Alliance

SAFe Agilest

oCertification Date: Oct 2015 – Present

oCertification authority: Scaled Agile

PROFESSIONAL EXPERIENCE

VERSCEND/Formerly Verisk Health Sept 2015 - Current

Senior Business Analyst, Certified Scrum Product Owner (CSPO), Certified Scrum Master (CSM)

Safe Agilest(SA)

Member of an AGILE Medicare, Medicaid, MMR, RAPS and EDPS data development team that produced the software product behind the system, performed analysis to validate and develop user story requirements for software developers and quality assurance testing analysts. Validated user story request from product owners against HIPAA 837I, 837P and 837D functional requirements and edit rules as defined by CMS (Centers for Medicare and Medicaid Services) to ensure client encounter submission acceptance rates were 80-90%. Applied Lean, Kanban practices to balance production issues and prioritized user story development and delivery.

Accomplishments:

Provided leadership, decision making and direction to project team to ensure successful completion of the projects

Facilitated and lead grooming sessions and product demos.

Validated HIPAA rules and edits as defined by CMS for 837 institutional, professional and durable medical equipment claims via the CMS Common Edit Enhancement Module(CEM).

Ensured code set regulations (ICD 10, ICD 9, HCPCS, CPT, NUBC, NDC, etc.) were adhered to by providers so that (members) Medicare recipients’ claims were paid without interruption.

Developed and refined user story requirements for developers and testing analyst

Developed B/I reporting specifications for reporting team

Shielded the team from non-substantiated development request by product management

Developed requirements based on product backlog priorities, including story writing, acceptance criteria, estimates and additional artifacts.

Collaborated with other teams to handle dependencies, negotiated, and reprioritized stories as appropriate

Maintained a healthy backlog of ready state development requirements

Identified project risks

Environment: Rally, SharePoint, Microsoft Team Foundation Server, Visual Studio 2008, Microsoft Office Tools (Word, PowerPoint, Excel, Access, Visio), XML, ETL, SQL, Stories.

Richmond Computer Resource/Virginia Department of Motor Vehicles Jan 2014 - May 2015

Team Leader for (TREDS) Traffic Records Electronic Data Systems, Certified Scrum Product Owner (CSPO), Certified Scrum Master (CSM)

Member of an AGILE development team that produced the software product behind the system, lead agile software developers and business system analysts in gathering requirements to produce user stories, planning and executing AGILE sprints while keeping the project on track and the business users happy. Removed impediments and administered the product backlog meetings with the business owner, applied Lean, Kanban practices to balance production issues and prioritized user story development and delivery.

Accomplishments:

Provided leadership, decision making and direction to project team to ensure successful completion of the projects

Facilitated daily Stand-ups, lead grooming sessions and product demos.

Identified and removed potential obstacles and impediments

Maintained product burn down chart, Shielded the team from interruptions during the sprint

Set up retrospectives, sprint reviews or sprint planning sessions

Developed and maintained a product backlog including story writing, acceptance criteria, estimates and business valued priority.

Performed data analysis to validate user stories and business rules

Used the estimates and product backlog to determine delivery date(s)

Managed / Collaboration with other teams to handle dependencies, negotiated, and reprioritized stories as appropriate

Ensured core agile team understood the business drivers and business value of the backlog Items

Maintained the release plan and strategy, announced releases & ensured product rollout

Represented the product to the project stakeholders

Negotiated scope, funding, and schedule, Identified and managed project risks

Environment: SPARX Enterprise Architect, Visual Studio 2012, Microsoft Team Foundation Server, Microsoft Office Tools, Visio, XML, BPM, SQL, UML, Stories, BizTalk, WSDL, SOA

BRANCORE Technologies/ Business Systems Analyst (Capital One) June 2011- Dec 2013

Collaborate with business and IT partners to facilitate and manage the end-to-end development of Business Requirements for complex initiatives impacting Risk Management and Compliance (Privacy and Anti - Money Laundering, PCI DSS) business areas, functions and system platforms. Collaborate with business partners and technical development team to drive requirements planning, gathering, analyzing, organizing, validation and business approval, using Lean, Kanban practices to balance production issues and prioritized user story development and delivery.

Accomplishments:

Served as Certified Scrum Master and Business Analyst

Facilitated the daily standup activities

Developed User Stories, business requirements, data mapping and UI design

Environment: Version One, SharePoint, Microsoft Team Foundation Server, Microsoft Office Tools (Word, PowerPoint, Excel, Access, Visio), XML, SQL, BPM, UML, Stories, WSDL, SOA, ETL

Virginia Dept. of General Services ISS / Project Manager/ Business Analyst June 2009-June 2011

Managed the (EHR) Electronic Health Records project. Developed the initiation and planning document, project charter, partnered with sponsors to secure project approval, developed communication management plan, defined project team roles and responsibilities, developed work plan structure and project schedule, developed deployment plan, lead project meetings, documented and prioritized scope changes and facilitated approval processes, and performed other duties when needed.

Documented user requirements, analyzed and designed application functionality using UML, worked with developers to implement system enhancements. Coordinated acceptance testing, defect resolution, training, new user’s enrollment and the change control process.

Accomplishments: Authored an HL7 Electronic Data Exchange Implementation Guide for Lab Orders and Lab Results to;

Submit OML^O21 laboratory orders.

Receive ORU^R01 laboratory results or notification of receipt of specimen message.

Receive ORL^O22 laboratory acknowledgment accepted or rejected by message.

Send an ACK^R01 acknowledgement of an unsolicited transmission of an Observation Message to acknowledge the receipt of an Unsolicited transmission of an Observation Message. Environment: SharePoint, Microsoft Team Foundation Server, Microsoft Office Tools (Word, PowerPoint, Excel, Access, Visio), XML, SQL, BPM, UML, Stories, Rhapsody, WSDL, SOA, TOAD

(ACS) Affiliated Computer Systems /Functional Business Analyst Nov 2007 - May 2009 Alaska Medicaid DDI Replacement Project - Systems Consulting Senior Analyst

The Alaska (MMIS) Medicaid Replacement project was the transfer and modification of Legacy MMIS technologies, business processes and reporting components to the ACS Enterprise MMIS system. The replacement system had to meet all Federal MMIS certification requirements, be MITA aligned and address Alaska-specific requirements. As a Business Analyst on the Member and Provider team(s) which included analyzing the RFP and developing a (RAD) requirements analysis document that clarified the understanding of customers’ needs. Developed detailed design specifications via Use cases, Web User Interfaces, OLAP reports and batch interfaces as part of an overall functional management solutions team. Analyzed Business processes and performed needs assessments to align technology with business needs. Interpreted business needs and translated them into system requirements. Wrote business specifications that were forwarded to product subject matter experts to ensure proper alignment with enterprise system.

Accomplishments:

Developed use cases based on data analysis for UI design, business rules, system list, valid values and system parameters to configure and customize enterprise functionality.

Participated in Design Peer Review reviews for other functional areas.

Facilitated detailed system design walk-thru with the customer.

Analyzed and designed Member system interfaces.

Worked with system architecture group to develop new and updated database tables.

Extensive design for ANSI X12N 270/271 Health Care Eligibility Benefit Inquiry and Response transactions for HIPAA compliancy.

Analyzed and designed Provider system interfaces insuring NPI and JCAHO accreditation, regulations, requirements and standards.

Environment: SharePoint, Rational Requisite-Pro, Rational Requisite Web, Rational ClearCase, Microsoft Office Tools (Word, PowerPoint, Excel, Access, Visio), SPARX Enterprise Architect, Sametime, Oracle, DB2, SQL, EDI ANSI X12N 270/271(004010X092A1), WebEx, NetMeeting, BPM, UML, XML, ETL.

Virginia Department of Motor Vehicles/ Business Systems Analyst Nov 2006 - Sept 2007 Traffic Records Electronic System (TREDS) Functional Architect

The Traffic Records Electronic Data Systems (TREDS) an agile project was setup to streamline and automate the collection and administration of crash accident processing. It was a multi-agency project; stakeholders included the Virginia State Police, DMV and VDOT. This included a complete re-engineering and design of the current paper Police accident report to an electronic format and a replacement of the mainframe legacy systems and crash reporting processes. Functioned as a Scrum Master, facilitated daily Stand-ups, retrospectives, sprint reviews, sprint planning sessions, identified and removed potential impediments.

Accomplishments:

Lead the Operational Readiness team which included conducting SME interviews and developing the business specifications document.

Assessed the improvement in quality of the scanning process being handled locally in the crash accident recording center.

Created a plan to move the crash report scanning to the centralized accident processing center.

Set-up work area for new scanners to be physically located

Coordinated the scanner selection and procurement process

Developed Operational readiness test plan for new scanning process

Assisted in the design, gap analysis and delivery of the new accident crash report for the Virginia State Police and all the police localities around the state of Virginia.

Assisted in statewide law enforcement focus groups

Attended 33rd International Forum on Traffic Records and Highway Safety Systems.

Developed XML specifications for electronic submittal of accident reports

Performed analysis of as-is and to-be processes.

Challenged conventional thinking and stimulated new ways of thinking within the business environment.

Created value by formulating Business Process Models (BPM) that captured and re-engineered business processes across organizational units.

Developed quality requirements in UML2 (use cases, functional and non-functional requirements, flow of event activity diagrams, sequence diagrams

Assisted in the design and delivery of the new accident crash report for the Virginia State Police and all the police localities around the state of Virginia.

Environment: SPARX Enterprise Architect, SharePoint, Microsoft Team Foundation Server, Microsoft Office Tools (Word, PowerPoint, Excel, Access, Visio), XML, SQL, UML, Stories, BizTalk, WSDL, SOA

TEC Systems/ANTHEM BLUE CROSS BLUE SHIELD Feb 2006 – Oct 2006

Business Systems Analyst

New Federal HIPPA laws demanded that identification of medical providers be conducted on a national level rather than state by state. The project at Anthem Blue Cross was initiated to implement a new electronic National Provider ID Initiative.

Responsibilities:

Translated business needs into business requirements based on the project charter, scope, requirements development need, historical documentation, change requests and defects.

Reviewed current and historical project documentation and engaged the stakeholders, business areas, project teams, analysts (business, technical, testing), affected groups/individuals, project managers, and program managers.

Developed and documented business requirements to satisfy project needs.

Worked on 4 projects in the provider profile area (PEX) Performance Extra, Provider Inquiry, (ANSIR) Anthem Network System Inquiry and Response, and Medicare Part “B”.

Gathered requirements, wrote detailed test plans and test cases for each project.

Executed test runs and listed testing summary reports.

Performed role as Testing Lead and aided developers in trouble shooting, writing and executing application code.

FIRST HEALTH SERVICES Aug 2004 – Dec 2005

Interface Manager /Configuration Manager

Worked on multiple projects and held the role Business Systems Analyst, Configuration Manager, and Interface Manager. One project included the development of a Microsoft Access application to track and report interface metrics between First Health’s MMIS organization and state and federal government benefit programs, pharmacy benefit administrators, operational interfaces, web site designs, and private vendors.

Responsibilities:

Reported to the Project Technical Manager, responsible for the Project Interface issues and managing the interface process, including maintaining the project Interface Database and elevating interface issues to the Project Leadership Team for timely resolution.

Responsibilities included customized data mapping for all interfaces.

Executed data conversions from one software platform to another.

Facilitated and monitored vendor engagements from Statement of Work through design, coding, testing, file transfer, web site planning, deployment and sign off.

Established strong relationships with interfacing agencies and application teams.

Took complete ownership of project delivery and provided technical leadership for large and small projects.

Engaged CMM processes and excelled across technologies.

Developed and implemented Configuration Management processes and procedures that complimented the methodology employed by the project(s).

Created software builds for the project teams including development, integration and test environments.

Established the Change Request Process to ensure that proposed changes to the system are assessed and applied in a consistent and controlled manner.

Worked with the project team to create automated scripts for regression testing of new builds.

Worked with the project team to integrate existing code changes for iterative development with parallel code changes.

Worked with the project team to identify and communicate integration issues with code migration.

Helped to identify issues related to configuration management by identifying and working with appropriate members of the project team to find solutions or to escalate issues for resolution.

FIRST HEALTH SERVICES June 2002 – Aug 2004

Systems Manager

The HIPAA Remediation Project involved the implementation of the Alaska MEDICAID MANAGEMENT SYSTEM (MMIS) business initiative for HIPAA. Responsibilities include project management tasks, facilitating workgroup discussions to develop conceptual\detail project design, developing a project plan, and leading the project team through detailed design, development, testing and support of the implementation process.

Responsibilities:

Met with internal and external workgroups to guide the development of project specifications and design for 9 ANSI X12 HIPAA Transactions. This includes interfacing with policy-making\governing bodies from the inception of the project, assisting with writing the requirements document, and determining project flow, architecture, and overall project design.

Worked on process improvements and overseeing technical documentation for operational readiness design, testing and implementation.

Redesigned prior authorization and claims and appeal subsystem to improve the appeals turnaround process.

Participated in application architecture design, GAP analysis, EDI crosswalk mapping, code development and system implementation.

Selection of project team.

Procurement of training and ongoing allocation of resources.

Provided technical leadership of the team to ensure successful completion of the project.

Monitored project team status as it relates to the project timeline, problem resolution, EDI mapping and testing.

Provided management with feedback on project team member’s performance. Develop project plans, including time and resource estimates.

Oversaw completion and dissemination of all communications related to the project including design, technical specifications, trading partner communication, security and companion guides. Support business analysis functions for other projects.

Worked with other project leaders and management to support departmental planning efforts. This effort was inclusive of all sub-systems in the MMIS application (Claims, Recipient, Payment and Remittance Advice, Prior Authorization).

Environment: Microsoft Project, Project In Vision, COBOL, SQL, DB2 UDB, Microsoft Access, JCL, VSAM, ANSI X12 837, ANSI X12 835, ANSI X12 270, ANSI X12 271, ANSI X12 276, ANSI X12 277, ANSI X12 278, NCPDP 5.1, See Beyond, EDI Mapping, Remedy, CMM Level 2, HL7,UB92, HCFA 1500, HCPCS, CPT codes, ICD9, CLAREDI, PVCS, ENDEVOR, VIASMARTTEST, Microsoft Office Tools, J2EE, BE WebLogic, Unix, Visual Basic, Oracle, SOA

Capital One/ Management Information Systems Analyst IV Dec. 1999-June 2002

Designed and developed systems.

Points and Rewards Information System. The application tracked and accumulated points, rebates, cash back and rewards acquired by credit card purchases. Performed in a dual role as developer and project manager for bringing on new partnerships. Acted as liaison between systems and business customers. Elicited system and user requirements for specialty markets. Developed high level and detailed specifications for developers. Developed, tested and implemented COBOL programs.

Transaction Archive and Retrieval System this application retrieves and formats transactional data (transactions and authorizations) for Marketing and Analysis statisticians and data analyst. The information is used to cross-sell and market new products. Marketing representatives would submit specific criteria of customer buying patterns by age, date, and purchase amount, place purchased from etc. Performed as developer and analyst working with marketing department personnel. Elicited marketing requirements buying patterns the wanted to research. Developed, tested and implemented COBOL and SAS programs to create transaction extracts.

Environment: COBOL, ORACLE, SAS, SQL, JCL, VSAM, JAVASCRIPT, CHANGEMAN, ASSEMBLER, DFSMS, EXPEDITOR

AJILON CONSULTING/FHSC/ Staff Manager/ Lead Developer July 1997 Dec 1999 EPIC Pharmacy Reimbursement Network (PRN).

Signed on as a programmer\analyst to work on a software takeover project, within the second week assumed the role as a team leader\coach, ended up as Project Manager and System Manager for the First Health Staff while upholding Staff Management role for AJILON Services.

Lead the Participant Enrollment, Eligibility and Billing subsystems conversion and implementation.

Lead the team in developing and mentoring team members, managing deliverables, interacting and integrating with other development teams and participating in design sessions.

Consulted and directed the Elderly Pharmaceutical Insurance Coverage (EPIC) strategic planning and development efforts for the Participant (Member) Sub-system.

Played a key role in meetings, staff and system development in both the Albany, New York and Richmond, Virginia.

Acted as project manager for project, including deliverables and schedule. The project was basically a rewrite from an existing batch transaction driven system to real-time on-line CICS, COBOL, VSAM touch of a button processing.

Lead the design and development of an ACCOUNTS RECIEVABLE system and support for PC system ADD-ONS.

Conducted various general management actions including technical interviews, conducted performance and salary reviews, participated as a member of the branch delivery team, and resold the services of consultancy.

Environment: COBOL, VSAM, CICS, SQL, VIA SMARTEST, MICROSOFT PROJECT, VISIO, MICROSOFT WORD and PowerPoint, Staff Management, System Management and Project Management, Design and Analysis, PARADOX, SDLC

EDUCATION & TRAINING

B.S. ECONOMICS PURDUE UNIVERSITY, Certified Scrum Master, Certified Scrum Product Owner, Safe Agilest, HL7 V3 CDA Training (VITA), (CPM) Project Management Training (VITA), Rhapsody Training, Emotional Intelligence: Excelling Under Pressure University of Richmond, Understanding Yourself as a Leader University of Richmond, BRAIN BENCH Certified IMS 6, CMMI Level III,,E*Gate 4.5 (See Beyond) Product Suite for Managers, Amazon Cloud Web Services Foundation Class

SKILLS

Agile, SPARX Enterprise Architect, Microsoft Team Foundation Server, Visual Studio 2008 & 2012, Microsoft Office Tools (Word, PowerPoint, Excel, Access, Visio), SQL, XML, UML, Stories, Plainview, Mercury Test Director, Project In Vision, QMF, SPUFI, Princeton Softech Move Access, ANSI X12 837, ANSI X12 835, ANSI X12 270, ANSI X12 271, ANSI X12 276, ANSI X12 277, ANSI X12 278, NCPDP 5.1, SeeBeyond, EDI Mapping, CMM Level 2, HL7,UB92, HCFA 1500, HCPCS, CPT codes, ICD9, CLAREDI, PVCS, ENDEVOR, ASSEMBLER, COBOL, JCL, IMS DB\DC, SQL, CICS, DB2, ORACLE,VSAM, TSO\SPF, INTERTEST, EXPEDITOR, PARADOX, FILEAID,ENDEAVOR, LIBRARIAN, PANVALET, VIA SMARTEST, BMS, LOTUS NOTES MAIL, OAS, PARADOX,ORACLE, JAVASCRIPT, SAS, PVCS, HTML, MITA,SharePoint, Rational RequisitePro, Rational Requisite Web, Rational ClearCase, Spark, Sametime, WebEx, NetMeeting, Quality Center, Application Life Management(ALM), Bridger XG by Lexus Nexus, ACTIMIZE, Possible Now, PCI DSS, TFS, Version One,Rally,TFS

APPLICATIONS

General Ledger, Police Systems, Policy Management Service (PMS), Cost Planning And Tracking (CPTS), Life Claims, Health Claims, Agency, Pharmacy Systems, (MMIS) Medicaid Management Information Systems, Configuration Management, ACS MMIS Enterprise. Privacy IT Compliance, (AML) Anti-Money Laundering Compliance, Electronic Traffic Records



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