Ms. Vita Nelson

** ******* ******

Trenton, NJ. *8618

Ph#-215-***-****

acs997@r.postjobfree.com

Objective: obtain a stable, challenging position that utilizes my analytical and leadership skills.

Skills:

17 years of experience working in the QA and BA aspects of the healthcare,

insurance, IT and financial industries; expertise in benefit-mapping, HIPAA

compliance, 3rd party/commercial card processing and data analysis

14 years of business (systems) analysis-experience: writing business

requirements, SOPs, desk procedures, creating business rules, process flows,

user stories, change requests, security-testing and data-mapping;

implementation-analysis, risk assessments, gap analysis

12 years of QA and testing experience re: UAT, SIT, Cloud, Penetration, Performance, BI-Business Intelligence...Smoke, Cloud, Black Box and Regression testing...Defect Triage and Resolution via Business Objects, Teradata and Data Warehouse (tools)

11 years of technical writing experience; including traceability matrices, project plans, Defect Management Plans, SOPs, training manuals.

5 years of Manager and Project Management experience: coordinating

team efforts, setting objectives and deadlines for a project SDLC; HEDIS & EDI configuration and coding: facilitating status calls and generating reports for

stakeholders

Proficient at analytical and testing duties from initial-stages through implementation throughout SDLC; delegating tasks, leading resources/staff, meeting with--and providing status reports for clients and stakeholders:

Expertise at determining project goals, web and android test planning and

monitoring; defining in and out of scope objectives, project deadlines, test

stages, facilitating progress/status meetings with stakeholders and determining report frequency.

Extensive and proficient knowledge of how to analyze, configure and test data of various types using MS Office, SQL, XML, ClearQuest, Quality

Center/Test Director, RQM, QTP, Rational, Linux, SOA, Oracle, PBM, SharePoint, Agile, Waterfall and SMART methodologies.

Employment History:

February 2014-present: Molina Healthcare. Title: Senior Business-Test Analyst

Duties: Lead and coordinate test efforts for every project amongst onsite and offshore staff:

write test plans, test requirements (criteria) and functional test cases for each software project using an Agile methodology. Perform EDI, RHIS and HEDIS configuration and testing for different states. Document project outcomes, identify risks and downstream effects…log change requests and defects via MS Project, Oracle, Quality Center and SharePoint. Note project milestones and QA outcomes via PBM, Rational, SOA, Test Director, and HP. Train junior analysts, manage some projects: determining the scope, maintaining the SharePoint site and other repositories. Assigning tasks to resources to ensure full test coverage of all aspects of the project by established deadlines. Generate progress reports and give the status of defects to stakeholders onsite as well as remote, via conference call and WebEx.

June, 2013-Mar 2014: Tetrasoft/IBM. Title: Test Architect

Duties: Wrote business rules, business requirements, test plans, test cases and defect-handlingprocesses for all healthcare and IT projects in Waterfall and Agile environments. Wrote training procedures and requirements manually (via MS Office) and automated tools. Coordinated UAT and Cloud Test efforts across onsite, remote & offshore teams via webex and using industry tools (HP, SQL, PBM, Test Director, Oracle, and Rational). Ran queries and analyzed data trends to identify risks via Data Warehouse.

August, 2011-May 2013: TATA Consultancy Services/TCS. Title: QA Manager

Duties: Managed test planning onsite and offshore for various financial and insurance clients.

Wrote test plans, business rules and test requirements for all projects...participated in test

execution efforts-manually & automated for UAT, functional, regression and performance testing Agile projects related to medical and benefit-handling-HEDIS and AMA coding specifically;

financial clients' merchant card and 3rd party-billing software upgrades. Android and application analysis (using Rational, HP, PeopleSoft, PBM and Quality Center). Other duties as assigned.

March 2009-August, 2011: Emblem Health. Title: Senior Business Analyst

Duties: Gathered data and wrote documentation related to software and configuration updates per project. Wrote test cases, test plans, business requirements and project goals for projects- including UAT, SIT, Smoke/Cloud and Performance testing-objectives. Identified and tracked

defects, implemented change- requests...tested applications, websites and software upgrades manually as well as through Quality Center, Oracle, and SOA; employed RHIA & HEDIS coding

skills while creating medical claims for test purposes and for conducting internal audits.

Configured updates to software, trained staff post-implementation and wrote desk procedures

per HIPAA compliance.

June, 2006-Jan, 2009: Arcus and Howard Systems. Title: Senior Business & Test Analyst

Duties: wrote test and business-requirements for various software projects; made configuration

updates to databases, analyzed data trends for commercial card and IVR-related projects.

Wrote and executed test scenarios, tracked defects: delegated testing duties to team of analysts...assisted with (UAT, Smoke, Cloud & Penetration) test-execution, bug-tracking & resolution via RQM, Business Rules, PeopleSoft, Trizetto, CISCO and Oracle.

February 2004 to June 2006: Jacobson Solutions. Title: (Travel) Claims-QA Lead

Duties: recovered medical claim overpayments, calculated benefit limit/overage-fees, configured benefit codes and error messages; tracked anesthesia, private-duty-nursing and dialysis-claim payments... created training-documents and QA checklists, other duties as assigned.

March 2002-January, 2003: Dawn Training Center. Title: Billing and Coding Instructor

Duties: taught medical claims’ and services billing procedures to students. Taught courses related to assigning appropriate HCPCS, CPT, ADA and Revenue code s to medical claims for payment. Created practice exercises and exams for students; explained day-to-day tasks related to billing providers for medical services.

August 1997 to Sept 2003: Independence Blue Cross and Blue Cross Blue Shield of Delaware.

Titles: (Claims) Technical Advisor, Data Analyst, Appeals Specialist, Claims Processor and

Coder

Duties: assigned medical, dental, vision & pharmaceutical codes to medical claims; monitored

benefit usage/limits for members, provided technical and training support to claims' handling,

appeals/grievance and billing departments...documented and investigated member inquiries.

Education:

Drexel University (online)

Dates Attended: January 2013-present

Area(s) of Study: Masters level-Communications program

Degree or Diploma: none (yet); anticipated completion date: December, 2016

Kaplan University (online)

Dates Attended: January 2008-July, 2012

Area(s) of Study: Communications

Degree or Diploma: Bachelors of Science

Overbrook High School (Philadelphia, PA)

Dates Attended: September, 1987-June, 1991

Area(s) of Study: Degree or Diploma: Diploma

Professional References: Available upon request.

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