SUMMARY:

Senior Enterprise Program/Product/Project Manager experienced in Agile & all SDLC methodologies

Senior Business, Systems, Data (Forecasting), Financial, Technical and Change Management Analyst with 20+ years of experience achieving optimum levels of competitive advantage and profitability for an organization with high emphasis on quality specifically though efficient Analytics/ETL and creating value from Big Data (Structured, Unstructured, Geographic, Real-time Media, Natural Language Data, Time Series, Event Data, Network Data, and Linked Data (i.e., all data that is rich, denormalized, nested or lacking schema/relational construct)

Specialist in the effective use of Business Process Engineering to leverage information for the business purpose of securely sharing the information inside and outside the organization in a Global Delivery Model

Technical Expert in Software Development Life Cycle (SDLC): Planning, Feasibility/Analysis, Design/Prototyping, Development, Testing Implementation/Integration and Operations/Maintenance for both As-Is to To-Be Processes and for Commercial off-the-shelf (COTS) deployments.

Business Requirement Elicitation & Documentation (BABOK) – User Requirement Specification expert

Suppliers, Inputs, Process, Outputs, Customers (SIPOC) Diagramming

Responsible for leading the strategic design and maintenance of business intelligence applications (SSIS, SSRS & Tableau) by identifying, researching, and resolving complex technical integration and analysis services through Reporting and Visualization platforms with graphs, images, charts, etc.

Ensured that the use of business intelligence applications enhanced business decision making capabilities through both Data Integration/Mapping (Unidirectional & Bidirectional)

Project Management of Business Intelligence technologies including data warehouses, dashboards, ad hoc reporting, data discovery tools and cloud data services. Identity, Lifecycle & Governance (IDLG) process improvements.

Delivery of Data Analytics through observation, interviews, questionnaires, and integration of Project Teams both on the Business and Technical side of the organization as well as working with external Stakeholders/Process Owners

Database Design/Development, T-SQL Query, Stored Procedures, Functions and VBA Scripting

Highly skilled in following the phases of the ETL process: Development: ETL development on a workstation, Testing: running in simulation mode in a real environment (i.e., on the ETL Engine) and Production: importing the production data.

Systems and Quality Processes Review professional (Modification to Organizational Workflow and Process to deliver the results) through adherence to RAID log and RASCI matrix

Wireframes/Use Case Diagraming/User Stories to include End User Go-Live Support

Joint Application Development (JAD) & Root Cause and Impact Analysis with Process Mapping

Data Extraction, Transfer and Load (ETL) – XML, XL7, Flat Files

Data Loading via insertion of data into the final target database such as an operational data store, a data mart, data lake or data warehouse

Demonstrated use of Statistical concepts (Regression, Correlation, Analysis of Variance, etc.)

TECHNICAL SKILLS:

Platforms: MS Win 11 & Office 365/Azure DevOps/AWS (IaaS/PaaS/SaaS/Cloud Storage), Snowflake

Collaboration: MS Teams/Zoom/Skype/WebEx/gChat & Hangouts/Go-to Meetings/Slack/Gmail Meet/Cisco Jabber

Software Dev: Waterfall (SDLC)/Agile w/Scrum (Stand-ups/Sprints)/Kanban/Scrumban/Joint Application Dev (JAD)/ADKAR/Lean Six Sigma/DMAIC/Balsamiq/Supplier, Input, Output, Process, Customer (SIPOC)

MS Office: Word/Excel (VBA)/PowerPoint/Visio/OneNote/Publisher/Outlook/SharePoint/MS OneDrive/Office365

Analytics: MS Access (VBA)/MS SQL Server 2005-2018/Teradata/Salesforce/Fieldglass/MongoDB/NoSQL

BI Tools: SQL 05-18/SAS/Bus. Objects/Cognos 10/Crystal Reports/Power BI/SSIS/SSAS/SSRS/Tableau 9.1/DAX

PM/REQ Tools: JIRA/Confluence/HP Quality Center 9.2/HP ALM/Smartsheets/RAID/RACI/IRAAD Logs/CI/CD Dev.

Pub/Clinical Ed: Adobe Acrobat Pro/HTML/Corel Draw 9.0//Uberflip/CAD/Photoshop 5.5/PageMaker/Illustration

PROFESSIONAL EXPERIENCE:

OptumRx (UnitedHealth Group) – TN (remote) 8/23 – 11/23

Senior Project/Implementation Manager & Data Lead

Analyzed Pharmacy Benefits data for Healthplans transitioning to OptumRx using Salesforce for this MCO

Facilitated internal and client facing cross-functional discussions, decision-making and issue resolution

Owned client facing Master Data Test Strategy development, supported internal and external executive governance reporting throughout implementation and post-go-live support period.

Lead in internal and external cross-functional call forums in support of test readiness activities including requirements, test planning, test execution, and defect management.

US Dept. of Veterans Administration – TN (remote) 1/23 – 7/23

Senior Project Manager & Data Integration Engineer (Software Development) w/Public Trust

Supported the data integration via ETL for the Training Support System (TSS) Enterprise Mission Services

Planned, designed and implemented the integration process for the VA’s software remediation and mitigation project with MS Access and Salesforce

Worked with the Client through analysis and design of the solutions and/or enhancement that were to be integrated. The use of VBA, SQL and Power BI were integral to this position daily.

Centene, Inc. – MO (remote) 8/22 – 12/22

Project Manager & Data, Business and Technical Analyst

Increased the velocity of the Medicare Advantage (HHS) Disenrollment optimization project for the Data Quality Hub initiative to improve team productivity for this MCO

Measured, optimized and keep constant a definition of "done" for all technical/IT aspects of the Medicaid/Medicare business lines

Broke Requirement Stories into small parts such that the whole team could bring tasks to PROD by benchmarking User Stories to a set point of measurement against assigned time and effort value

Anthem, Inc. – GA (remote) 4/22 – 8/22

Project Manager & Data, Business and Technical Analyst

Managed Immunizations and Covid 19 Rosters for Multiple States for HHS w/Jira and analytics via Confluence for this MCO

Optimized costs and time utilization by minimizing waste and deliver projects on time on budget as per the contract and agreed scope with a high-quality result with effective use of Salesforce

Anticipated all possible risk and managed them by applying the suitable risk management strategy (creation of RAID and RACI) for the Special Needs Programs and Medicare (HHS)

Tracked and reported project KPIs and analyzed project health

NYC Health & Hospitals – NYC (remote) 9/20 – 11/21

Program Manager & Data, Business and Technical Analyst

Managed Medicaid Improvement via Epic and HEDIS/STARS measures with Enterprise Dashboard Used analytic tools such as SSIS, SSRS and Tableau for data analysis and visualization for this MCO

Worked with Clinicians across multiple care areas to establish the enterprise data warehouse (EDW)

Prepared, maintained and owned business glossary and data catalog documents for the Special Needs Programs and Medicare (HHS)

Maintain and update the existing suite of reporting and dashboards while worked in cross-functional project teams that included ETL development, Data Quality Assurance, and Data visualization.

Pratt Miller Engineering – TN (remote) 2/20 – 4/20

Business and Technical Analyst & Project Manager

Analyzed requirements for software development while documenting new functionality and defect fixes in process flow diagrams as needed for an Agile Software development

Performed UAT planning & execution with developers and client cost-benefit analysis was completed to measure using RFID tags on tires to integrate with the software to render reporting (time through the process) reporting more robust.

Coordinated the ETL or weekly uploads for current tire specifications

AmerisourceBergen: The Lash Group – Fort Mill, NC 8/19 – 11/19

Technical, Data and Business Analyst & Project Manager

Managed Pharma Distr./Provider & Patient Portals/Drug web Publications w/Salesforce

Launched 2 drugs using Pfizer SDLC within a budget of approximately 1.5M/drug for software development (using JIRA), hardware installations, network upgrades, cloud computing and virtualization rollouts, business analytics and data management projects and implementing IT services

Ensured Provider, Patient and Risk Evaluation and Mitigation Strategy (REMS) portal met CQM

Worked closely with Pfizer to ensure information for Electronic Common Technical Document (eCTD) interface via ETLs had data points/fields for transfer of regulatory information (utilized the Common Technical Document (CTD) format

Assured GxP and Title 21 CFR Part 11 for electronic records held to highest compliance/validation standards

State of California (HHS) – AZ (remote) 12/16 – 6/19

Program/Project Manager & Technical, Data and Business Analyst

Requirements Gathering/Use Cases/Data Visualization & Management/HEDIS and the Special Needs/Medicare/Medicaid (HHS) programs

Analyzed large datasets to Geo map using Tableau

Reported via complex queries in a SQL Server environment

Delivered files in Extensible Markup Language (XML) data file format with custom tags

Built the infrastructure (data warehouse) to hold business metrics

Envolve Pharmacy Solutions (Centene) – Phoenix, AZ 4/15 – 10/16

Senior Analytic Advisor for Medicare Part D Program Manager

Pharmacy Benefits Management (PBM) via SQL/SSIS/SSRS in support of 340B, Medicare Part D

Managed and modeled data outcomes for 12 Health Plans across 7 states via EXCEL (VBA), SQL Scripts and SSRS Provider Payor reporting (ETLs) working with CIO assuring compliance with Federal and State (HHS) contractual requirements for not only the Medicare Part D program but also Parts A, B & C integration/co-alignment for patients

Applied Title 21 CFR Part 11 (records in electronic form that where created, modified, maintained, archived, retrieved or transmitted under any records requirements set forth in FDA Agency regulations)

Dignity Health – Phoenix, AZ 10/14 – 1/15

Business and Data Analyst for ICD-10 Readiness

IDC-10 transition/Provider Training/HEDIS Re-mapping/HL7/FHIR and HHS guidelines

Delivered effective presentations that offered immediate insight and recommended task planning, resource allocation, expenditures, and impact assumptions for the project to include Provider and Vendor education.

Used Excel (VBA)/Gantt/bar/milestone charts for reporting dependencies and/or constraints among activities and network/production schedules that where united to show an overall integrated Master program schedule to include Medicare/Medicaid lines of business.

Maintained and advanced the ICD-10 project to include support of physician training, joint ventures, Pharmacy Benefit Management, and benefit management for HEDIS and STARS as paired with new code set and business vendor readiness programs.

McKesson, Corp. – Scottsdale, AZ 7/14 – 10/14

Senior Systems and Data Analyst

Pharma Distribution/Software Development & Sunset/Oracle PSQL Tested

Utilized Agile approach via JIRA and MS SharePoint to advise Business Stakeholders and current/future benefits management suppliers (Merck, Amgen, Biogen, Genentech, Ispen, Novartis and Takeda) on ways to optimize their Reimbursement processes through root cause analysis.

Planned, facilitated, and coordinated User Acceptance Testing (UAT) using Excel for universal template for Pharmacy Benefits Management such that the Payor constituents were abreast of change request implementation

AMN Healthcare – CA 5/13 – 6/14

Technical, Data and Business Analyst

Policies/Procedures for HR and Finance (C-Suite)

Developed Requirements for management of opportunities for improvements while understanding system functionality to ensure that proper procedures and best practice were maintained for the Payor and Providers

Worked closely with AMN Business Partners (Finance, Quality Services and Housing) to identify and maximize cost control

Provided solid support of ITIL for the IT department to include the CIO, IT directors and managers, architects, project managers and support staff

Previous Work – 1/2000 – 4/2013

Technical, Data and Business Analyst & Project Manager

Client

Primary Deliverable(s)

TRICARE West:

Prepared the Annual Business Planning & HEDIS evaluation for 72 Medical Facilities

Project Managed, across 4 time zones, the authoring of annual TRICARE Business Plan

Developed Strategic Initiatives for States and Regions: Wounded Warrior, Clinical Quality (HEDIS), Prevention (HEDIS), Disease Management (HEDIS), Customer Satisfaction, Decreasing Cost, Pharmacy Benefit Management

Reduced duplicate claims using Lean Six Sigma methodology for claims analysis and audits and/or process improvement for Medicare/Medicaid (HHS)

Prepared clear and well-organized specific documentation to reflect analytic methods used

Wellpoint:

Developed Project Plan for conversion of legacy HEDIS application to Commercial of the Shelf (COT) product utilizing JAD sessions and Use Case modeling between Business and IT Groups

Assured data mapping (ETL) deliverables matched source to target so that the two-way exchange of data was meaningful by using common sourcing and targeting by way of the primary enrollment database and MS Excel (VBA)/SQL data sets

Kaiser Permanente:

Led SCRUM and SPRINT activities for ICD-10 and 5010 conversions to include HEDIS program information execution

Created data models as Visio diagrams, PowerPoint flowcharts Excel (VBA) spreadsheets to visually illustrate the relationships between data and systems

United Health Group:

Analyzed and evaluated Claims Detail, Professional, Institutional, Member, HEDIS, Pharmacy Benefits Management and Prior Authorization data for improvement in reporting while managing delivery of the TRICARE Access to Data (A2D) application release

Developed Hierarchy Conditional Code (HCC) algorithms

Omega Group for the Bureau of Medicine and Surgery (BUMED):

Analyzed clinical data (inpatient, outpatient, ancillary, pharmacy benefit management and HEDIS) using SQL 2005 to evaluate existing and/or potential trends

Gold Coast Healthplan:

Performed Business analysis and developed gap analysis documents for integration with master project plan on the Payor side while ensuring project and technical review milestones were met

Led and cultivated relationships with the health partners and business units to complete analysis of Return on Investment using Power MHS transaction system for claims adjudication as future state deliverable

Molina Healthcare:

Developed policies and procedures to facilitate enhancements and workflow for claims adjudication and reimbursement optimization and monitored existing system functionality and made benefits set-up recommendations, where appropriate, to maintain acceptable levels of automation in claims adjudication, Pharmacy Benefit Management and accurate provider reimbursement and tracking for Quality measures

United States Navy

Active Duty

Date

Mar 1994 - Mar 1999

Title

Senior Medical Support Specialist & Analyst (Hospital Corpsman - HM3)

Location

New Bern, NC

Type

Contract – 5-year Enlistment completion with Honorable Discharge

Supervised twelve Hospital Corpsmen while providing administrative, medical and nursing education in the Labor & Delivery Unit: Navy Achievement Medal for reduction in cost of supplies through business process alignment and Blue Jacket of the Quarter for outstanding managerial and healthcare delivery to expectant mothers

Medical Assistant charged with admissions, dispositions, deliveries, post-partum recovery and care of neonates and mothers: Blue Jacket of the Year for 3 years of leadership and service on the Labor and Delivery/Mother Baby units and Navy Achievement Medal for 5 years of exceptional service in many departments

Conducted programmed classes in prevention, awareness and Health Promotions (HEDIS) to Nursing staff via selected subjects to include healthy eating and smoking cessation through Pharmacy Benefits Management of Nicotine Transdermal Patch management. Coordinated broad range of public affairs, budget management, professional correspondence, database, internet and graphic design activities: Meritorious Commendation from the Marine Corps for professional and effective smoking cessation program for the Navy and Marine Corps constituent

EDUCATION:

University of Phoenix - AZ

Master of Business Administration (MBA) (2005)

Specialization in Healthcare Administration

Mount Olive College - NC

Bachelor of Science (BS) Degree in Business Administration (2003)

Specialization in Management and Organizational Development

Undergraduate thesis: Database Development (Personnel Management System for the US Navy)

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