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Project Manager

Location:
Santa Clarita, CA
Posted:
December 22, 2018

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Resume:

SHIRLEY A. KIVI

661-***-**** Los Angeles, CA

ac7064@r.postjobfree.com

SUMMARY

Detail-oriented Senior Information Technology Professional specializing in DB2 Cobol mainframe systems online and batch processing with SQL via DB2 access/Spufi querying. Key strengths include project management for projects, and problem resolution of projects assigned from testing to implementation.

TECHNICAL SKILLS

JIRA, Agile, ReqPro, SDLC, Lean Certification, COBOL, JCL, CICS, FTP, VSAM, TSO, WGS/IMS, SQL, DB2, DB2 Connect, SPUFI, Microsoft Access, Excel, Word, Visio, Power Point, Business Use Cases, User Stories, Crystal Reports

PROFESSIONAL EXPERIENCE

BUSINESS ANALYST II, ANTHEM contract work for ICONMA April 2017 - Present

•Act as Project Requirements manager for the Real Time Membership Eligibility for Health. New, near real-time web service to provide the most current membership and eligibility to the upgraded CM/DM application designed to be extensible for both commercial and GBD business. Services shall supply data from all applicable Anthem member enrollment source systems/ claims systems. (ie: ACES E & B, CS90 membership, CR FACETS, GBD FACETS, FACETS MD, GBD Member & Claim Data Exchanges, FEP, Simply Health Florida, GHC, HealthLink EDI, NASCO, ISG/STAR membership and billing, WGS Membership & Billing, member enrollment source of reference, WGS 2.0, CSD & GBD, National IT, Facets GMB, Caremore, CHIPS E & B, Medisys, Ehub)

•Act as Requirements Manager for the prepay review of all inpatient facility claims where billed charges are greater than $40,000. Providers will be required to submit an Itemized Bill (IB) along with the inpatient claims. This would be for all POC facilities/providers. All commercial including Blue Card HOST & HOME are in scope. For non-ITS small enhancements to CSBD claims systems. Expecting to touch all CSBD claims systems including WGS, CR Facets, CS90, NASCO, CHIPS.

Portfolio Execution, Cost of Care, Behavior Health Commercial Business, Behavior Health Directory Provider Enhancement Project. Current role a Lead BA with the responsibility to work across systems to complete requirements for signoff, identify dependencies and help resolve any cross system issues blocking requirements completion/signoff. West (CA, CO, NV), CPMF (VA), CPF, CS90 (NY), Central FACETS, NE ACES, EPDSv2 (GA) provider maintenance and new provider forms transformation to SPS new source of truth project

Radiology Level of Care NASCO National IT/CSS GUI

AIM Genetics Testing provider file

AIM MSK – EBA, ACES, CHIPS, CS90, FACETS, (WGS, ISG, SPIDER - UM RULES) including Indiana

Opioid Initiative

Availity Overpayment and Recovery automation, Claims WGS, NASCO, CENTRAL FACETS

WGS documentation

SYSTEMS ANALYST II, ANTHEM, NEWBURY PARK, CA November 2009 – May 2015

Work primarily on the Mainframe online and batch Broker Commissions processing system ISGB, Enrollment and Billing system ISG monthly processing and WGS Sr. business to pay broker commissions based on policyholders and coverage information

Experience eliciting requirements, facilitate/attend requirements gathering meetings, documenting technical requirements or technical solutions

Review requirements for system impacts, create technical responses

Extensive knowledge of SDLC and RUP standards and procedures

Attend SCRUM meetings for status updates and resolve issues that arise from testing defects.

Trouble shoot test and production defects using Clear Quest and determine if they are system issues or user error issues and researched if the business requirements were met.

Conduct meetings with the business for monthly commission process, tracking code changes going into monthly releases. Run trending report and notify business that they can proceed with their monthly processes. Ran SQL queries for reporting purposes.

Create use cases for testing and system documentation.

Act as a liaison between business and IT

Work with offshore/onshore personnel to review code issues

Disaster Recovery testing

BUSINESS SYSTEM ANALYST, FARMERS INSURANCE, Simi Valley, CA

August 2008 – June 2009

Work closely with Subject Matter Experts, Business Analysts and Contractors writing use case documents and process flows based on requirements written by SME’s and BA’s for web based intranet Commercial Business Insurance system including renewals, new business and endorsements.

Conducted requirements walk through review meetings via webinar, remotely and on site with business, developers, SME’s, BA’s, Project lead and management.

Performed as liaison between SME’s and programmers when clarification needed to be made regarding business use case requirements.

Created PowerPoint presentation documents with screen prints of the system’s process flow for New Business quote, Umbrella and Endorsements.

BUSINESS SYSTEM ANALYST EXPLORER INSURANCE COMPANY, Santa Clarita, CA

November 2006 – July 2008

Worked with IT managers, Accounting, Underwriting, and Claims as Team Lead on Mainframe Replacement Z9 project to prepare and implement use cases and test plans.

Coordinated meetings and created documents to instruct business on procedures to follow.

BI (Business Intelligence), BO (Business Objects), Quick Mart, documented objects and descriptions and identified issues when developing reports for Marketing while creating advanced reporting functions for marketing,

Worked with Marketing and IT using business test cases on Quick Mart user acceptance testing project while working on the testing team for QuickMart BI (Business Intelligence), Performed analysis on issues that occurred with Web based Intranet and mainframe PMS to determine whether they were break fixes or enhancements and notified IT to get them resolved.

Worked with Claims and IT documenting business requirements when adding Consumer Bill of Rights letter to policy notices project was on time and implemented in a timely manner.

Worked with IT to update 50 forms with logo on notices by creating business requirements and reviewed printed test notices for accuracy.

Created and updated business BI (Business Intelligence) test cases excel documents with test results.

Used production parallel use cases to verify accuracy of code changes.

Documented business requirements for Agent Weekly Status to be discontinued from mailing and added report as online web link.

Submitted several requests to IT and followed up on implementation of zip code/territory GTAM updates. Maintained/updated many complex Excel reports daily, weekly, monthly and distributed to management.

SENIOR PROGRAMMER ANALYST 21st CENTURY INSURANCE COMPANY, Woodland Hills, CA

February 2003 – November 2005

Maintained programs for online and batch processing and resolved production issues. Tested and migrated projects in development while partnering with international programmers.

Managed implementation of all annual Corporate Accounting processing by working closely with management to process accurate 1099-MISC in-house vendor reporting.

Designed, documented, implemented and supported new vendor system batch processing to combine with Legacy vendor reporting to extract data from DB2 tables, create reports and transmit to vendor for report archival on CD and in-house printing/mailing of the 1099-MISC forms. Recognized by Management of Corporate Accounting for superior performance.

PROGRAMMER ANALYST 21st CENTURY INSURANCE COMPANY, Woodland Hills, CA

(February 1995 – February 2003)

Saved the company $20,000 annually by partnering with Premium Accounting users to implement daily data extract process using FTP to server for encryption, sending bulk transmission data to Bank of America’s processing facility eliminating need for manual data input. Followed production parallel business test use cases to verify accuracy of data sent to and retuned from B of A. Recognized by Management of Information Services and received Senior Programmer Analyst promotion.

Documented the Legacy Vendor System with screen prints and flow charts starting from the Commission and Claims daily extract jobs. Documentation was used to help design the new vendor system.

Report developer using PeopleSoft and BO (Business Objects) Crystal Info. Monitored daily, weekly and monthly reports. Coordinated and implemented procedures to correct production problems and maintained documentation for future reference. Upgraded testing project set up for all of the report objects in the test and production regions to be scheduled and tested. Gathered user requirements and modified existing Crystal Reports/SQL based on user requirements. Ran updated reports and did thorough parallel of production testing. Produced test results for user approval and implemented/monitored reports after moving to production. Followed up with users to make sure reports were accurate based on user requirements.

Tested and implemented Y2K modifications to Vendor and Vehicle Maintenance batch and online programs.

PROFESSIONAL DEVELOPMENT AND TRAINING

Mastering the Requirements Process by Systemation

Requirements Certified Lean Master Practitioner

Business Process Analysis in house training at Explorer Insurance

Logic, COBOL and Advanced COBOL, L.A. Pierce College

Custom U4271 – SQL Workshop by IBM

Advanced Crystal Reports 7.0

Introduction to Oracle for SQL users PL/SQL



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