Summary

With over ** years in the managed care industry, I aspire to secure a director role. As a forward-thinking project management specialist, I excel in leading teams, managing schedules, and coordinating resources. Proficient in data analytics, project management, and report preparation, I bring a wealth of experience to enhance team success. Adept at programming and problem-solving, I ensure projects stay on track through decisive supervision. Specializing in SQL development, my meticulous approach to data processing is complemented by a deep understanding of database structures. My strong communication and negotiation skills, honed with internal teams and stakeholders, contribute to project success. Eager to leverage my strategic mindset and organizational skills, I seek to drive business intelligence and analytics initiatives in a director role. Skills

Project Management

Gathering Requirements

Organization Skills

Database Development

Business Intelligence

Data Modeling

Performance Improvements

Hardware Upgrades

SQL Reporting

Quality Assurance Testing

JS Frameworks: React, Angular, Vue

Software Application Testing

Programming Languages: Java, C#, .Net, Python

Database Management Software

Code Writing

Unit, Integration, and System Testing

XML Web Services

Linux Environments

Experience

PROJECT LEAD, BUSINESS SYSTEMS ANALYST 06/2015 - 01/2024 Centene/WellCare

Ensured compliance with established policies, procedures and standards within the project scope. Lead team in bi-weekly meetings and manage teams projects Set forth contingency plans and monitored progress and risks of various projects. Establish and oversee the development of a data warehouse for reporting purposes, catering to both team and business superusers. Provide comprehensive support for end-to-end implementation of pharmacy Part D initiatives. Developed and implemented project plans, schedules and budgets. Discovered critical loopholes in enterprise-wide initiatives, contributing to the West Region market consistently maintaining a four-star rating for consecutive years.

OWNER 06/1990 - 01/2024

Aloha Charter Inc - Huntington Park, CA

Participated in meetings with investors regarding financing options for the company. Establishes and nurtures relationships with business banking institutions to secure working capital for the company. Owns and operates a service driving consumers to appointments, schools, etc.

Researched potential partners in order to expand services offered. Created and implemented marketing and advertising strategies to support revenue goals and promote strategic growth. Prepared staff work schedules and assigned team members to specific duties. BUSINESS INTELLIGENCE ENGINEER 08/2014 - 06/2015 Modern Health Inc.

Analyzed design or requirement information for equipment or systems. Collaborate with business partners to outline analysis requirements, lead them through the Business Intelligence (BI) delivery process, and articulate the roadmap for business and application architecture. Finished projects on time and within budget.

Oversee high-impact reports and ensure the implementation of an efficient solution for prompt and on-demand reporting turnaround. Designed test protocols to ensure quality control of manufactured parts. GREGORY DALE

CABOT

7036 Stanton Ave Buena Park, CA, 90621 CA 310-***-**** ad3ywr@r.postjobfree.com Take the lead as a developer overseeing outsourcing efforts, establishing standards for efficient and high-quality programming. Define guidelines that enable any developer to step in and manage tasks seamlessly. SQL DEVELOPER AND DATABASE ADMINISTRATOR /BUSINESS ANALYST 08/2013 - 08/2014 WellCare

Designed code to help company develop necessary applications and websites. Implemented an automated process for sending files via email, utilizing SSIS packages that iterate through multiple lists of filenames and email addresses, ensuring efficient and automated transmission.

Developed database dictionaries and schemas.

Developed Datawarehouse for all departmental reporting aspects Implemented SSIS automation for the management of outbound and inbound vendor files. Implemented debugging programs to determine vulnerabilities and issues in software. Configured SSRS for automation and file archive for end users access to reports. APPLICATIONS ENGINEER / SQL DEVELOPER AND DATABASE 04/2010 - 08/2013 Humana Health Plan

Remodeled applications to optimize performance.

Played a role in the design and assistance of various aspects of the QNXT check-run process, encompassing the SQL design and operation of the check register.

Improved and corrected existing software and system applications. Created new processes to streamline the import and normalization of data, including the development of data files for counterparties. Developed requirements for system modifications and new system installations. Executed a database refresh using a full export at the table level and conducted a comprehensive database defragmentation, leading to enhanced performance and efficient space management.

Created and presented application prototypes.

REPORTS ANALYST 09/2008 - 04/2010

Northrop Grumman Information Systems On assignment for Toyota Motor Sales Headquarters - Torrance, CA. Utilized pivot tables to automate AR aging report updates. Designed and sustained enterprise reporting through SSRS (SQL Server Reporting Services) based on specified requirements and business needs. Also, made modifications to existing reports as required. Scheduled meetings to address exception reporting issues and solutions. Created new OLAP cubes or modified existing ones along with MDX coding to extract historical data. Additionally, conducted peer reviews on existing stored procedures/functions and optimized them for better performance. Researched and acquired data to assess economic indicators, analyze KPIs and monitor trends. Held daily face-to-face operational meetings with customer management executives, delivering comprehensive analyses on service area performance and ticket quality.

DATABASE ADMINISTRATOR 06/2007 - 02/2008

Torrance Hospital Independent Physicians Associations - Torrance, CA Analyzed and developed technical and functional specifications for databases. Managed and supported databases and systems by executing tasks such as table maintenance, backups, data cleaning/audits, and delivering training and troubleshooting support for users.

Performed daily backups of the databases using RMAN utility. Consulted with internal departments to identify customer needs to include in project objectives. Performed quality assurance processes to support data warehouse improvements. Worked with software vendors to analyze and resolve software installation and ongoing support issues. QUALITY ASSURANCE ANALYST 04/2007 - 05/2007

Leverage Point - Los Angeles, CA

Maintained up-to-date knowledge of industry standards related to software testing best practices. Possess expertise in a range of testing methodologies, including Functionality testing, Black Box testing, System testing, System Integration testing, Regression testing, Database-driven testing, Browser testing, and User Acceptance testing (UAT). Performed functional, system integration, regression, user acceptance testing. Streamlined processes, increasing efficiency and consistency to support quality initiatives. Developed, documented, and executed manual tests for web-based applications. CLAIMS EXAMINER 01/2002 - 04/2007

MV Medical Management - Los Angeles, CA

Managed workloads efficiently by prioritizing tasks based on urgency or importance. Conducted hardware and software installations, delivering high-level customer care, training, and technical support. Proficiently assembled and installed diverse computer systems, workstations, and peripheral hardware. Obtained necessary information to complete proper evaluation of injury claims. Provide services such as price quotes, billing, insurance verification, and customer support. Collaborate with other departments for efficient record validation. As Lead Examiner, train new staff and assist in auditing. Also, support computer operations in various departments. Conducted audits of claim files to ensure adherence to departmental standards. CLAIMS EXAMINER 01/2002 - 04/2007

Health Care Partners - Los Angeles, CA

Advised customers on their rights under their health plan policies when necessary. Oversee the processing of diverse medical claims for hospitals, insurance firms, and patients. Consolidate and cross-check billing and collection records. Manage inquiries and follow-ups to expedite collections. Evaluated evidence with ultimate goal of creating positive outcomes for client's claims. Investigated potentially fraudulent claims with focus on thoroughness, quality and cost control. Education and Training

California State University - Dominguez Hills Bachelor of Science Business Administration, 06/2007

Cerritos College - A.A. Degree

Business Administration, 06/1998

CERTIFICATES

Lean Six Sigma Green Belt, SSRS, SSIS, SSAS, ITIL v3

Contact this candidate