Project Manager

EMPLOYMENT OBJECTIVE: Obtain a challenging full time as Business Analyst or

Project Coordinator Analyst roles in your organization where I can use

project management skills to support high quality software development

projects, work with stake holders, customers to develop technical,

business and functional specifications.

SUMMARY OF QUALIFICATIONS:

- Almost 2 years of good IT Business System Analyst in Healthcare EDI

experience in all phases of the SDLC/ ITIL/Agile including requirements

gathering (BRD/FSD), analysis, design, implementation, and testing along

with using Business Process Modeling and completed SharePoint Business

Analysis and MS Project for Management using SDLC/ Water Fall /Agile& Scrum

Project Management.

- A good knowledge in creating Use Case diagrams, Activity diagrams, State

diagrams based on UML Methodology and Business Process Flow Diagrams using

MS Visio. Good understanding basic of SQL, PL/SQL, Toad Data Analyst for

updating, deleting, editing, querying and requesting information stored in

a certain database management system in Healthcare Industries..

- A strong knowledge with HIPAA code set resolution, EMR, EHR, HIE and CDP

medical record from Healthcare Industries.

- 4+ years of extensive experience as an Assistant Researcher Data Analyst

worked with database and data analysis using SQL, Pl/SQL, SPSS and MS Excel

programs at Institute of College of Population Studies and Kasetsart

University in Thailand.

SKILLS: SQL, PL/SQL, MySQL, Toad for Data Analyst, SAS, SPSS, Project

Management, MS offices, SharePoint, Access, Excel, Visio, SDLC, ITIL, UML,

Water Fall, Agile & Scrum, Business Process Modeling, QA testing and

experience in HIPAA 4010 and 5010 EDI healthcare transactions like 837, 835

and 834

COURSE WORK: Healthcare Management, Legal Aspect in Healthcare

Administration, Information Technology in Health Care, Designing

Qualitative Research, Essentials of Health Policy and Law and Managing

Public Organizations

EDUCATION:

( M.S. Healthcare Administration (Mar 2011- Sept, 2012): CSU Eastbay,

Hayward, USA; GPA: 3.93/4.0 (Honors in MS-HCA).

( Advanced Program Certification at Advanced English Academy, San

Francisco, CA (Jan 2009 - Jan 2011) - ESL and TOEFL IBT.

( De Anza Community College, Cupertino, CA (Apr 2007 - Dec 2008): Student

Exchange Program/ ESL along with AA level courses.

( B.A. in Sociology and Anthropology (Jun 2002 - Oct, 2006): Kasetsart

University, Bangkok Thailand. GPA: 3.36/4.0.

( B.S. in Social Forestry (Environment Science) (Jun 2002 - Oct, 2006):

Kasetsart University, Bangkok Thailand. GPA: 3.14/4.0.

CERTIFICATIONS:

( ITIL Certified from EXIN in May 18, 2014

( Presently preparing for Oracle Certified, MySQL 5

( CHC Certified in Healthcare Compliance HIPAA Compliance for Health Plans

Compliance Certification Board (December 2012)

( Healthcare Compliance Strategies (HCCS HIPAA Compliance)

American Health Information Management Association (AHIMA) (December 2012 )

( CICARE, Stanford Hospital & Clinics (Dec 3, 2011)

WORKSHOPS / TRAINING:

( The Change Management Specialist (CMS) Training: Management and Strategy

Institute: July 2014 - Present

( The Six Sigma Lean Professional (SSLP) Training: Management and Strategy

Institute July 2014 - Present

(Business Analyst Training @ ZaranTech Inc (September, 2012) ( Next Gen,

Patient-Centricity at Asian Health Services (Feb, 2012)

( CDP data entry for Cancer Detection Programs: Every Woman Counts

California Department of Public Health at Frank Kiang

Medical Center: Asian Health Services, Oakland (Dec, 22 2011- Mar, 28

2012)

( Health Module Training Stanford Hospital & Clinics (Oct, 2011) ( CICARE

Training Stanford Hospital & Clinics (Dec 3, 2011)

WORK EXPERIENCE:

( WellCare HealthPlan, Inc. Tampa, FL- Business System Analyst in

Healthcare EDI (November 12 - April 14)

Role: Business System Analyst in Healthcare EDI

Environments: SQL, PL\SQL, Visual Basic, MS Visio, QC 10&11, MS Project,

Agile, SDLC, Toad for Data Analyst

WellCare provides managed care services targeted to government-sponsored

health care programs, focusing on Medicaid and Medicare. WellCare offers a

variety of health plans for families, children, blind and disabled as well

as prescription drug plans.

Projects:

( FL Reform Amended Contracts Exhaustion of Benefit Letters: This project

involved developing new software module to generate benefit letters and

mail them to members of WellCare when they met 100% of any health plan

benefit limit; that is set less than the standard Florida Medicaid fee for

service limit.

( Agency for Health Care Administration (AHCA) From: This project involved

working with Agency for Health Care Administration (AHCA) - Florida. AHCA

has given WellCare the ability to register providers for a Medicaid IDs who

do not wish to register with AHCA themselves. By allowing WellCare to mass

register them, the providers will have the ability to provide and bill for

Medicaid services through WellCare or another Managed Care Organization

(MCO).

( Involuntary PCP Transfer Letter, Medicaid Plan in the State of Missouri:

This project involved launching a Medicaid plan in the State of Missouri

for members effective in April 1, 2013 through the acquisition of Missouri

Care, Inc., a subsidiary of Aetna, Inc. under the MOD line of business.

( Certificate of Health Plan Letter, Medicaid Plan in the State of South

Carolina: This project involved implementing a Medicaid plan in the State

of South Carolina for members effective in April 15, 2013 through the

gaining of South Carolina Member under the SMD line of business.

. Conducted interviews and collaborated meetings with Business Team,

Project Management Team, Technical Development Team and QA Team to

gather, analyze, review, identify and create business requirement and

functional requirement document and analysis in order to support

information technology solutions with non technical/ technical

initiatives.

. Conducted JAD session with vendors, stakeholders and team to create "As-

is" and "To-be" process flows and collaborate with business users in

identifying, defining, documenting process improvement options and

alternatives design, develop and maintain key components of Business/

Functional Requirements Analysis and developed solutions for all phase of

the SDLC application across Current and Future solutions, as directed by

Business and Architecture needs in order to resolve all the issues, come

to an agreement quickly and recommendations for solution in compliance

with SDLC protocols via SharePoint Sites.

. Identified and coordinated of fundamental concepts, practices and

procedures of provider networks and health care management with CMS

representative team for gather the requirements and comply with Centers

for Medicare and Medicaid Services (CMS) which mandated HIPPA regulation

and legal aspect for ability to compose letters in-house via the VDP

application.

. Performed Gap Analysis to check the compatibility of the existing system

infrastructure with the new business requirements.

. Defined the scopes, objectives, risks, assumptions and requirements

based on business needs. Analyze, evaluate and document existing current

process and future process or proposed systems and Business/ Functional

Requirements design.

. Assisted development and reporting groups in optimizing SQL, PL/SQL

statements in applications, batch jobs, reports, design and using

databases, applications and processes for maximum performance, security,

reliability, and availability.

. Responded for the development and implementation of HIPAA EDI Map sets

834, 835, 837 and 5010.

. Identified gaps between current policies and procedures and new HIPAA

5010 compliance and developed an action for the migration process.

. Developed requirements traceability matrix to be used in software

development and QA testing.

. Assisted onsite and offshore QA for Quality Assurance Process in HP-QC11

and Testing Process in order to interface with program management, defect

identification, tracking and analysis, troubleshooting and execution

regarding quality assurance goals.

. Involved in quality assurance using Quality Center(HP-QC11) and performed

manual black box and white box testing on the project deliverables.

. Provided support to Project Manager/Development/QA/UAT Teams to employ

SDLC methodologies for IT application systems and Deployment Process

through post implementation support, and transition to production

environments by using SharePoint Site tracking communication.

( Intelligent Mail Bar Code (IMB) with CTS ID Bar Code process via Pitney

Bowes & VDP Application: This project involved implementing the Intelligent

Mail Bar Code (IMB) with CTS ID Bar Code process. IMB requirements and

comply with CMS mandated regulations subsequently configured based on the

documented business requirements; thus providing WellCare with the ability

to compose letters in-house via the VDP application. Pitney Bowes mailing

software solution will provide WellCare the ability to comply with USPS

requirements for IMB.

. Worked and coordinated with CMS representative and IMB team for gather

the requirements and comply with Centers for Medicare and Medicaid

Services (CMS) which mandated HIPPA regulation and legal aspect for

ability to compose letters in-house via the VDP application.

. Created Use Case and Activity diagrams using MS Visio to give web

developers a better idea of the application design.

. Conducted meeting with vendors, stakeholders and team to create Current

and Future process flows and collaborate with business team in

identifying, defining, documenting process, alternatives design, develop

and maintain key components of Business/ Functional Requirements Analysis

and developed solutions for all phase of the SDLC application across

Current and Future solutions via SharePoint Sites.

. Assisted onsite and offshore QA for Quality Assurance Process in HP-QC11

and Testing Process in order to interface with program management using

defect identification, tracking and analysis, troubleshooting and

execution regarding quality assurance goals.

. Involved in quality assurance and performed manual black box and white

box testing on the project deliverables.

. Provided support to Project Manager/Development/QA/UAT Teams to employ

SDLC methodologies for IT application systems and Deployment Process

through post implementation support, and transition to production

environments by using SharePoint Site tracking communication.

( Florida Managed Medical Assistance (FL MMA): Currently, FL Medicaid

business is 22.1% of all Medicaid revenue and 13% of the WellCare Company's

entire revenue. This project leads opportunity for Wellcare to add $1B in

revenue. The huge responsibility for this project is to assist in

implementing major changes and preparing for a successful launch with

allocation of resources to focus and prioritize on MMA implementation by

using the Inovalon-HEDIS report base requirement to map the source systems,

the database and applicable data marts for new vendor like Alere.

. Participated in conceptual Modeling ETL Analysis/ Reporting Tools/ Design

Database with tool like Toad Data Analyst, PL/SQL in DIAMCRMS, QRS, EDW

Environment and map the requirements to the source systems, database and

applicable data marts.

. Analyze impacted programs to identify, understand and document business

rules in order to develop the source to target mapping documents and

transformation logic to HEDIS Report Requirement.

. Map the requirements to the source systems, the database and applicable

data marts base on Inovalon-HEDIS report requirement.

. Assisted Product Owner in the definition of high-level business

requirements and the prioritization of the product backlog.

. Created and managed a backlog of clearly defined and prioritized user

stories Agile & Scrum.

. Used Agile methodology in defining the problem, gathering requirements,

development iterations, business modeling and communicating with the

technical team for development of the system.

. Completed SharePoint Business Analysis and Project Management using Agile

/ Scrum Project Management

. Assisted and overseen onsite and offshore QA for Quality Assurance

Process in HP-QC11 and Testing Process in order to develop, prepare, and

execution of test plans, test scenarios and scripts using QA standard

testing methodologies and procedures in compliance of SDLC standards to

meet project management teams regarding quality assurance goals.

( Stanford Hospital and Clinics (November 2011 - September 2012)

Stanford Hospital & Clinics are committed to healing humanity - one patient

at a time. The clinics provide an absolute best in health care, along with

the personalized concern and compassion for patient and their family. The

clinics also seek to make the patient stay as comfortable as possible

through an array of amenities and personal services. Guest Services offers

many programs to serve the needs of patients and the local community and

can assist guests with any needs, concerns or requests. Stanford Hospital

and Clinics is a 477-bed teaching hospital that is accredited by the Joint

Commission. Stanford Hospital and Clinics is a not for profit organization

and has 1649 registered nurses to serve the patient need.

Role: Healthcare Professional Volunteer

Environments: SQL, SPSS, MS Project, MS Office and MS Excel

Projects: Analyzed and generated statistical data using SPSS, SQL and MS

Excel programs base on patient and family members visiting the hospital and

patient's used transportation to cancer center.

. Helped the information desk administrator and supervisor for the office

work responsibilities. Analyzed and generated statistical data using

SPSS, SQL and MS Excel programs base on the information of patient and

family members visiting the hospital. Coordinated between various

departments. Used health care information systems to manage patient's

data.

( Frank Kiang Medical Center: Asian Health Services, Oakland (December 2011

- March 2012)

Asian Health Services (AHS) is a nonprofit organization that has a

comprehensive, federally qualified community health center, which offers

medical care, behavioral health services, dental care, health education,

insurance counseling, and client advocacy to the underserved Asian and

Pacific Islander population in Alameda County. Frank Kiang Medical Center

is part of the new centers of Asian Health Service. Asian Health Services

is a community health center that offers primary health care services with

36 exam rooms and a dental clinic with 7 chairs. The clinics serve over

23,000 patients and over 111,000 patient visits annually. The staff is

fluent in English and ten Asian languages: Cantonese, Vietnamese, Mandarin,

Korean, Khmer (Cambodian), Mien, Mongolian, Tagalog, Lao and Burmese.

Role: Assistant RN Clinic Manager and Site Manager

Environments: SQL, PL/SQL, SPSS or PASW Data Collections, MS Excel, MS

Office, Next Gen centricity, CDP data entry, HIPPAA, EMR

Projects: Analyzed and generated statistical data using PL/SQL, SPSS and MS

Excel programs base on patient and family members visiting the clinics, CDP

data entry for Cancer Detection Programs: Every Woman Counts California

Department of Public Health and helped develop "the Clinic Cycle Time Sheet

Initiative" and analyzed by using PL/SQL, SPSS and MS Excel programs.

Responsibilities:

. Shadowed to Manager and coordinated recruiting activities for the

clinic. Screened applicants and interview candidates for part time, full

time and on call job at the clinics. Developed Health Fair toolkit and

templates for planning and organizing.

. Analyzed clinic data using PL/SQL, SPSS and MS Excel programs to

determine staffing needs. Analyzed, report and chart or graph data of

patient primary languages that visit the organization.

. Develop outreach plans by seeking and targeting new refugees and

immigrants to assist them in their healthcare issues.

. CDP data entry for Cancer Detection Programs: Every Woman Counts

California Department of Public Health.

. Reviewed and checked the patient's medical record in order to find out

the regular or irregular Pap-smear lab result issues.

. Helped develop the clinic cycle time sheet initiative in order to help

the clinic improve the better quality care service and save time for the

patients when they visited the center by using SharePoint Sites

communicate, analysis and MS Project for Project Management Methodology.

. Next Gen training, got train in order to use Patient-Centricity and find

out database in order to support data analysis.

( Institute of College of Population Studies; Chulalongkorn University

(November 2006 - February 2007)

The College of Population Studies was established in early 1966 as an

autonomous research and training unit of Chulalongkorn University. In order

to serve the rapid changes in socio-economic and demographic trends in both

research and training aspects, the organization also serve the users who

come to the center and distribute the interesting information on population

to the government agencies, non-government agencies, private agencies,

international agencies, universities, schools, etc. The organization has a

mailing list database for information dissemination, and there are about

3,000 records in this database.

Client: government agencies, non-government agencies, private agencies,

international agencies, universities, schools and students.

Project Name: "Setting Up Monitoring System and Assessment of the Second

National Plan for Aging Population".

Role: Research Assistant Data Analyst:

Environments: SQL, PL/SQL, SPSS, MS Excel and MS Office

. Created questionnaires to survey the available facilities for older

people in the cities across Thailand.

. Collected the survey data and used those data to analyze and derive

results from the SPSS, PL/SQL and MS Excel programs via the quantitative

and qualitative research methodology and created the proposal.

. Coordinated the seminar between Chulalongkorn Hospital and the College

of Population Studies to create the long-term population plan.

. Helped and drafted the long term plan to develop the next national

policy in Thailand.

( Kasetsart University (January 2003 - October 2006)

Role: Research Assistant Data Analyst, under Assistant Professor Dr.

Rachanee Parthian:

Environments: SQL, PL/SQL, SPSS, MS Excel and MS Office

Projects: Analyzed and Created questionnaires to survey how to manage Agro-

Forestry for communities across Nontaburi Province, Thailand in order to

maintain the local community with sustainable Agro-forestry harvest.

. Under Assistant Professor Dr. Rachanee Pothitan, I worked as a research

assistant data analyst related to Agro-Forestry and Social Forestry

studies which conducted a cooperative society research group in

Nontaburi Province, Thailand.

. Created questionnaires to survey how to manage Agro-Forestry for

communities across Nontaburi Province, Thailand.

. Used the survey data to analyze and derive results from the SQL, PL/SQL,

SPSS and MS Excel programs.

. Implemented and evaluated survey results to assist the community with

sustainable Agro-forestry plan via the quantitative and qualitative

research methodology and created the proposal.

REFERENCES: Available Upon

Requests

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