JANNA N. GRIGGER

Lower Gwynedd, PA ***** 215-***-****

acxb5q@r.postjobfree.com

SUMMARY

Individual with long track record of Electronic Data Interchange (EDI) management seeking an employment opportunity in a rewarding and challenging business environment. Possess extensive experience in EDI Project Coordination including all facets of the project lifecycle development from initial design through project clos- out. Extensive experience in EDI coordination used to present complex, technical information solutions to a cross-functional range of decision makers and stakeholders. Coordinated logistics management and training for related business applications within the Health Care industry, including proprietary warehouse management, inventory, transportation and replenishment.

TECHNICAL SKILLS

Programming & Databases: SQL, C, PLTRIM, Visual Basic, Oracle, EDISIM, Cache (M), Java.

Web Publishing: HTML, XHTML, XML, CGI Script, Perl Script, JAVA Script, JAVA.

Network & Communications: EDI (ANSI X12 & EDIFACT), Sybase ECMap and ECGateway, PaperFree, FTP.

Computer Platforms: UNIX OS, DOS, Windows, Windows NT.

PROFESSIONAL EXPERIENCE

Change Healthcare – Altegra Health, Mt. Laurel, NJ (2014 – current)

Senior Business Analyst / Product Coordinator

As business analyst & product coordinator in Risk Reporting & Analytics solutions group provided software, analytics, and reports to identify risk adjustment factor (RAF), score gaps, and prioritized resources to more effectively care for healthcare organization members. Using flexible risk adjustment platform analyzed risk scores based on the specific risk adjusted model Hierarchical Condition Categories (HCCs) defined by the Centers for Medicare and Medicaid Services (CMS) for Medicare and ACA-Commercial models, and state-based Medicaid programs.

Frequently interacted with internal (Altegra Health) and external clients (Major Health Plans). Demonstrated strong problem solving skills by being able to diagnose issues and coordinate the tracking of their completion. Designed and conducted Risk View(internal application) functional testing. Working well independently to meet aggressive client delivery dates as well as the ability to quickly master new applications and processes.

McKesson Health Solution, King of Prussia, PA (2012 – 2014)

Senior Technical Rules Analyst / Developer – Claims Healthcare IT

As technical rules developer-analyst played a leading role in establishing standards, polices strategy and best practice while on Prometheus Bundled Episode Payment Healthcare project, the strategy of bundling reimbursements for healthcare services into a single lump sum payment.

Critically evaluated business information gathered from multiple sources, formulated and defined scope and objectives based on user needs, decomposed high-level information into details and distinguished user requests from requirements into functional strategy and technical design specification to satisfy user requirements. Collaborated with developers and established the technical strategy to achieve expected usability and performance needs. Worked with stakeholders on process improvement projects designed to improve results. Tested application using test cases and reviewed clinical reports to ensure meet technical functionality and usability from the user’s prospective. Accountable for completion of all documentation including reporting on all issues identified during implementation. Lead business problems re-engineering efforts on Applied Pathways projects. Managed and lead projects with all levels, as established by the PMO.

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KELLY IT Resources, Fort Washington, PA (2011 – 2012) assigned to:

Quest Diagnostics, Norristown, PA (2011 – 2012)

Senior EDI Support Coordinator / Business Analyst

Acted as an EDI production support coordinator for daily receipt, load and maintenance of inbound and outbound EDI transactions and EDI related reports. Responsibilities also included research, troubleshooting and resolving EDI issues reported by trading partners, internal users or customers. Acted as liaison between trading partner and business unit/customer for new EDI setups related to conversion into new X12 5010 standard. Coordinated maintenance, schedules, QA and UAT testing activities. Also responsible for testing connectivity between EDI and trading partner using secure FTP,

Dial-up, website and email.

TEKSYSTEMS consulting, Plymouth Meeting, PA (2010 – 2011) assigned to:

Exelon / PECO Corporation, Philadelphia, PA (2010 – 2011)

Senior EDI Support / Business Analyst

Acted as an EDI resource manager for Electronic Supplier Exchange and associated EDI transactions

Due to recent changes to promote customer choice within the electric supply industry, led a project that

performed transaction and configuration management, associated technical test execution, and support

test coordination to ensure meeting all functional criteria and business requirements.

Primary responsibility included harmonization of supplier data through a certification process in the EDI system during exchange of data communication and verification, configuration, to make sure that Supplier’s data complies with EDEWG Guidelines and Exelon/PECO standards. Interacting with business partners, suppliers and EDI vendors. Acting as lead business resource while certifying X12 EDI 248, 568, 810, 814, 820, 824, 867HU, 867MU and 867HI transactions.

CAI COMPUTER AID INC. consulting, Allentown, PA (2009 – 2010) assigned to:

PPL Corporation, Allentown, PA (2009 – 2010)

Senior Sybase EDI developer /Sybase Production Support / Business Analyst

Primary responsibility included developing processes and reports through Sybase (PaperFree) and GISB communication server, testing, debugging, creating and maintaining associated technical

documentation. Standardized reporting software and processes utilized in the implementations of PPL EDI solutions. Performed solution analysis and evaluation to determine project feasibility implementing critical enhancements to the Paperfree/ECGateway system in X12 EDI 248, 568, 810, 814, 820, 867 areas. Acted as lead technical resource for multiple projects and management in the interpretation of 248, 568, 810, 814, 820, 867 messages. Used EDISIM to validate EDI messages. Worked in a team oriented environment, actively engaged in driving the goals of the team. Provided on-call production support.

MEDECISION INC, Wayne, PA (2004 – 2009)

Senior Programmer / Business Analyst

Primary responsibility included programming in Cache(Mumps), testing, debugging, creating and maintaining technical documentation of software and processes utilized in the implementation of Healthcare software used by MEDecision clients. This includes enhancements to existing software, Client Letter, analysis of pre-production issues and development of solutions to resolve them, working directly with Systems Analyst, Client Quality Assurance (QA) and Technical Services (TS) to solve specific customer software implementation issues. Acted as Project Coordinator, developed and organized project requirements, facilitated multiple meetings with stakeholders, provided off-hours on-call support on as necessary. Working in a team structure actively engaged in driving the goals of the team. Participated in Six Sigma incident management process improvement project, resulting in reduced project issues and increased focus on client satisfaction during project User Acceptance Testing.

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INDEPENDENCE BLUE CROSS, Philadelphia, PA (2002 – 2004)

Senior EDI Systems Analyst /EDI Coordinator

Primarily responsibility included leading Blue Exchange 276 project within the EDI Department.

Implemented critical enhancements to the Paperfree/ECGateway system in EDI 837, 276, 277 areas. Act as lead technical resource for multiple projects and management in the interpretation of 837, 276, 277 financial and encounter data, FTP transmission and served as a resource to end-users by providing on-going support and gap analysis. Used Claredi as claims certification tool for Hipaa compliance. Developed ECGateway scripts and 276XML to 276X12, 277X12 to 277XML maps, 997 Functional Acknowledgement Report map, 277ENV map, UB92 to 837I and NSF to 837P maps. Created EDI test data using EDISIM, submited Regression, Unit, System and User Acceptance testing involving Local and Out of area claims. Worked with UB 04 and 1500 Claim Forms. Was involved in NASCO claim processing.

PALARCO INC. consulting, Wayne, PA (1996 – 2002) assigned to:

AETNA US HEALTHCARE, Blue Bell, PA (2002 – 2002)

Senior EDI Business Analyst /Sybase EDI Consultant

Reviewed QA specifications, documentation and provided problem identification and resolution.

Verified the completion and accuracy of information of EDI transmissions. Performed investigation and error recovery. Evaluated test data sent to Gateway Translator as ANSI X12 and HIPAA compliance by using EDISIM. Performed Regression, Unit, System and User Testing for EDI 835, 837, 276, 277, 278, 997 Claim Transactions. Rational ClearQuest was used to enter testing defects. Developed ECGateway scripts and ECMaps using Sybase mapping tool.

INDUSTRY-MATHEMATIC INTERNATIONAL, Mount Laurel, NJ (1998 – 2002)

Senior EDI Programmer/ Business Analyst /Consultant

Designed and developed EDI (Electronic Data Interchange) routines used in IMI product Vivaldi-SAP like

(order fulfillment engine) stand-alone and in conjunction with Oracle CPG (Consumer Product Group) software suite. Programmed using PLTRIM and Oracle SQL. Provided on-site technical support.

QA life cycle tester for EDI(X12) Projects using WinRunner and LoadRunner.

Analyzed data and determined discrepancies, test reusability, data set-up, documented system test plans/scripts inspections. Assigned to IMI/Oracle CPG (Consumer Package Goods) customer support projects. Performed analysis by investigating current functionality within Vivaldi SAP like (System Chain Monitoring). Assigned to AT&T, Starbucks, Federal Express, Smuckers, Kelloggs projects. Customized the core code to meet the client requirements. Provided customer EDI technical support and Supply Chain functional support(EDI 835, 837, 276, 277, 278, 997 Claim Transactions). Responsible for developing test plans, test plan preparation, test cases and testing client-server applications of a full project life cycle.

AMERISOURCE HEALTH CORPORATION, Devon, PA (2001 – 2001)

EDI Coordinator/ Business Analyst Consultant

Coordinated EDI (ANSI X12) Projects to agree project plans, resource estimates and timelines. Effectively communicate to company personal and clients/vendors. Managed and coordinated projects aimed to meet clients/vendors expectations. Managed timelines and resources.

MATSUSHITA ELECTRIC–PANASONIC, Secaucus, NJ (1999 – 2000)

Staff Consultant

Technical Representative (on-call service). Troubleshoot software and hardware problems on UNIX and Mainframe systems. Provided on site customer technical support. Programmed using C, PLTRIM (DB enabled derivative of C) and Oracle SQL. Worked with UNIX and Mainframe to establish corporate network. Provided on-call service, Supply Chain support (Order Management, Price and Promotion Management, Stock Replenishment).

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Team member of an Y2K project that customized and debugged System ESS-SAP like (Supply Chain). Used PLTRIM and Oracle CPG software suite. QA and Integration tested all aspects of System ESS including Enterprise Resource Planning (ERP) for Y2K compliance.

VWR CORP, West Chester, PA (1996 – 1999)

Programmer / Analyst

Coded online and EDI programs using C, PLTRIM and Oracle SQL. Created and built reports for General Ledger, Demo Sales, Discrepancies, Vendor Returns, and Customer Returns which were used by executives and managers to analyze their sales. Troubleshoot and debugged existing programs.

Created functional and technical specifications. Provided on site customer technical support.

EDUCATION

Penn State Abington, Abington, PA. E-Commerce, Webmaster Certificates, Java.

DPT Business School, Philadelphia, PA. Client Server Programming and Applications.

Belarusian State Economic University, Minsk, Belarus. B.S. Finance and Accounting.

Specialized Training: PLTRIM Technical Training, System ESS EDI Engine, ESS EDI Customization, ESS Logistics Functional Training, AMTRIX EDI Mapping, Six Sigma.

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