Business Analyst
Resume:
Gardenia Johnson-Twiggs
Multi-faceted and innovative Business Analyst with experience in variety of environments including federal government, healthcare, insurance, and software companies.
Specializes with implementations in healthcare regarding electronic medical records, patient management systems, pharmacy orders, and claims data.
Collaborate to develop or enhance existing client products including documenting business requirements, ensuring technology meets business requirements, conduct validation processes, perform testing in conjunction with the QA Team, and creating end user documentation and training.
Experienced in creating user stories and documenting/implementing the functional requirements, technical specifications and templates.
Serves as a technology translator for clients and leadership teams to ensure quality and effective products are delivered and meet all business requirements.
Utilized UAT and VCR testing software to manipulate data point with Explores SAS tool and collaborated with data scientist, ensuring accuracy of data ingested and reviewing mapping documents from clients to uncover gaps in data.
Skilled in Rally
Prior experience working for UnitedHealth Group in a consultant role.
SKILLS
•Platforms: Windows, Cloud, NT, AS400, UNIX OS
•Tools: JIRA, MySQL, IBM (Rational), Jenkins, Bitbucket, GIT Hub, SnagIt, CrashPlan, Slack, File Zella, IBM Notes, BOX, DB Beaver, Cisco Any Connect, Keeper, ILC, QMF, Explory’s Population Management Suite, Super Mart, Confluence, Your Learning, Tableau, Citrix, SharePoint, Planview, MAPD, QNXT, QSHR, Analytics, CSP Facets, OHBS LINX, Multiple EMR Systems, Dragon, Remedy, Microsoft Office (Word, Excel, PowerPoint, Project, Access), WebEx, Zoom, Teams, Smart Sheets, Outlook
PROFESSIONAL EXPERIENCE
Genenis10, New York, NY 02/2024- Pres.
Manager BA Consulting, Care Delivery Shared Services
Remediation liaison internally
Maintaining IRAAD documentation for multiple states
Participate in daily Data Quality Standup meetings
Completed standardization of OptumCare_OptumHealth_CombinedPivotViews
Attended QPS Measure Gap Analysis/Solution Design – Optum Health Solutions meetings
Analyze large volumes of data
Provide outreach to source leads to obtain data sets
Outreach to source data teams to verify mapping requirements
Provide regular feedback in meetings and update all Rally tickets
Ensure steps in place to avoid data issues in future across other markets
Create tickets in Service Now
ECG Quick Connect for transferring PHI information
Genenis10, New York, NY 07/2023- 01/2024
HUB E2E Testing Lead, Optum Health Solutions
Test in the INT, Stage and QA Environments
Successfully implemented Hub App deployment completed on 15 programs
Included BYOV (Bring Your Own Vendor)
Web view MyUHC.com completed successful deployment 15 programs
Tested OCM 2.0, Compass, ICUE, ACET, VEP and vendor referral.
Member enrollment
Reporting verification products sold, renew, term, not review
Billing validation included in new product
Validate program content
Confirm recommended program eligibility
Verify dispositions categories referrals accept, decline, not applicable ect.
Created playbook on how to test within APP/Web
Trained new employees on how to test within APP/Web
Created test ID’s username and passwords within APP/Web INT environment
Created Test Strategy Plan
Document defects on issues log
Meet with all functional teams to review test scenarios and obtain status weekly
Provided testing directly with external clients and vendors
Genenis10, New York, NY 07/2022- 06/2023
Non Claims UAT Lead, BI Initiatives
Successfully implemented 4 projects last year on time.
Reviewed requirements that support the Behavioral Health Initiatives.
Liaison between all functional teams.
Perform data analysis within CSP Facets test and OHBS Linx staged environments.
Create training documentation to support new processes.
Trained new consultants as well as FTE’s.
Developed strong working relationships with all functional teams.
Managed the authorization submission for clinical claims processing in test environment.
Performed testing on the member portal site Living and Work Well.
Verified claims were split correctly between medical and behavioral health.
Created test plans and validated test labs within ALM.
Created test strategy plan.
Reported weekly on scorecard for percentage of testing completed.
Documented bugs and verified issue resolved.
Selected to be a member on Quality Program Pilot to review team member’s work.
Received BRAVO from team member 12/28/22.
Nominated for Employee of the Quarter
EchoHealth Inc., Westlake, OH 07/2021 – 06/2022
Business Analyst II
Gather requirements to support client implementations along with processing of claims for explanation of benefits 835 and processing of physician payments.
Data analysis and data translation between proprietary and standard file formats.
Documenting and implementing the functional requirements, technical specifications and template documentation
Reviewing complex data files, creating mapping documents, interpreting client requirements and providing guidance
Utilize SQL databases to analyze inputs/outputs to identify coding issues and/or changes needed.
Liaison between teams, responsible for system enhancement and defect submissions and correction confirmation with the QA Team. Perform validations for all system development.
Developed strong working relationships with new and existing clients.
Collaborate to develop or enhance existing client products including documenting business requirements, ensuring technology meets business requirements, conduct validation processes, perform testing in conjunction with the QA Team, and creating end user documentation and training.
Identify and implement opportunities for improvements and escalate issues for resolution as needed.
Managed the implementation of new payment delivery technology projects including developing implementation project plans appropriate for each client.
Participate in internal daily stand-up meetings
Document feature
Creating user stories
Creating acceptance criteria
Creating bugs within user stories
Agile Methodology
IBM Cloud and Cognitive Software, Cleveland, OH 11/2016 – 07/2021
Delivery Specialist/Business Analyst
Supported client services by performing discoveries at client sites prior to onboarding new implementation source systems.
Gathered and documented information as well as created screen shots to create internal workflow processes to ascertain if there were any data gaps. If additional systems are identified during this review, then additional data sources were ingested into the platform to support the quality assurance measures and claims.
Processed, tracked, and sent signoff acceptance document for completion of project to client to confirm deliver and satisfaction with product.
Successfully implemented 55+ EMR systems into Cloud Platform, compiling data on millions of lives in lake and allowing de-identification of data.
Utilized UAT and VCR testing software to manipulate data point with Explores SAS tool and collaborated with data scientist, ensuring accuracy of data ingested and reviewing mapping documents from clients to uncover gaps in data.
Ran and reviewed mapped and unmapped standardization, ensuring accuracy of data entered into platform.
Streamlined and trained internal teams on new process for validating 4 registries at once instead of individually, significantly decreasing time to perform.
Conducted weekly status calls with client, reviewing all issues identified during and post implementation phase and resolving in timely manner. Educated and trained clients remotely or onsite, driving smooth implementations.
Revived key project in jeopardy of not meeting deadline, conducted independent analysis to determine data gaps locations, and collaborated with data scientist and engineer architect to obtain additional data elements from data lake, successfully meeting deadline.
Developed and streamlined Internal Testing and User Acceptance Testing as well as reorganized 5 priority sources, meeting all milestones, increasing productivity, keeping project within budget, and delivering complete project on time; recognized for superior performance by senior management and received cash award for work.
IBM Watson Health 11/2016 - 1/2018
Consultant Program Specialist
Worked as consultant within client services department. Assisted all senior level delivery specialist that required additional resources to complete projects on time for clients. Worked with data expedited internal testing and documented all bugs found within application.
Trained clients on-site and remotely, ensuring smooth operations and increasing client satisfaction.
Authored and created new test plans for internal and external use.
Performed internal testing, utilizing new tools that provided better insights into data for analyzing procedures, diagnosis, labs, outpatient visits, observation etc.
Created new processes for validation of patients’ CCD’s (Continuity of Care Documents) along with screen shots of data, assisting team in overall process, providing clients with information to improve outcomes, and ensuring project was completed on time.
Recognized for superior work, receiving and accepting full-time offer with IBM.
Blue Cross and Blue Shield of Alabama, Birmingham, AL 09/2016 – 11/2016
Senior Business Functional SME/Business Analyst Consultant
Managed documentation and gathered requirements from 3 business groups used to map out joint venture center of excellence project.
Assisted with build of Enterprise Data Warehouse, streamlining internal communications across enrollment, finance, and patient engagement business units and creating reports via tableau based on combined data.
Coached junior level BA’s on how to elicit stakeholders, document business requirements, and conduct analysis. Created use cases and trained to create tickets within Jira.
United Health Group, Eden Prairie, Minneapolis 10/2015 - 4/2016
Applications Development Consultant II (Hedis Database Exchange)
Participated in JAD sessions
Mapped elements
Drive solutions that help Payers and Providers measurably improve the quality of care
Based on regulatory requirements, client input, market assessment, and operational needs, NCQA, CMS, AHCA
Documented business requirements for new product functionality
Meet product release commitments and contribute to the future product roadmap
Collaborated with strategy, technology and operations to meet business goals and exceed client expectations
Served as a subject matter expert on HEDIS, Stars and other quality management programs
Grooming sessions
Trained vendors on Optum Hedis Manager application
Tested in Staged, Test environment environments
Environments: Optum Hedis Manager, Staged, Test environments, Outlook, Rally, Plainview, Field Manager, Field glass, SharePoint, Outlook, WebEx, MS Office Suite, Coznos, Tarzan, MyID Smart Card, Cisco Jabber, Cisco Any Connect Mobility Client, Webex Productivity Tool, Citrix Receiver, Ca Agile Central, Task Tracker Perfect Management, UHG App Store, eLearn
MedHOK, Inc., Tampa, FL 11/2014 – 06/2015
Consultant HEDIS Lead (Healthcare Effectiveness Data Information Sets)
Documented and gathered requirements for Interactive Data Submission System (IDSS), Data Layout, CHAP/QHP/HOS/AHCA submission. Trained clients on population health management software as a service tool, which allowed providers or clinically integrated systems (CIN) to work in tandem to close patients care gaps.
Conducted business analysis; develop business requirements and functional design documents.
Recommended best practices for configuration/implementation of core system according to client’s line of business.
Assisted with developing test plans and conducting functional testing from within Electronic Medical Records.
Successfully completed 2 implementations on time and on budget.
Community Health Systems, Carlisle, PA
Consultant GO-Live Support Training
Molina Healthcare Insurance, Columbus, OH
Contractor Business Associate HEDIS QI
EDUCATION / CERTIFICATION
University of Phoenix – Phoenix, AZ
Master of Arts (MA), Organizational Management
David N. Myers University – Cleveland, OH
Bachelor of Science (BS), Business Administration
Certification:
Certified Medical Secretary, Cleveland, OH
TRAININGS
Completed Company Sponsored Training in NICE Performance Manager Staff, Employee, and Team Evaluation Tool, HEDIS/PID, MS Project, Secure Email, and ICD-10 Awareness
HIPAA Training, Security 102 Payer Version, Privacy 201 Member Services, and HITECH
Completed Training Courses at New Horizons Computer Learning Center in Project Management, ITIL, and Coaching
AREAS OF EXPERTISE
Requirements Gathering
Change Management
Software Development Life Cycle (SDLC)
Project Management
SQL Management
Issue Resolution
Trainer
Organizational Management
Documentation
Consulting
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