Kimberly McLeod… Servant Leader
Upper Marlboro, Maryland
Clearance: Fully vetted Secret on 8/8/2019 03 27 DOD CAF
PMP 5 Process Groups: Initiate, Plan, Execute, Monitor, Control, Social Responsibility
Certified SCRUM Master: ID 000767626 Scrum Alliance
Certified: Product Owner (In Process)
Certified Agile Professional: ID 123-7488-e1c17346-1dbb-491b-a75b-1063a195194c
Experienced Scrum Master, Change Management & Communications Specialist with over 15 years of expertise in OCM, Disaster Recovery Implementation, Configuration Management, Network Management Plan & Communications and experience in all aspects of Software Development Life Cycle (SDLC).
Facilitate Change Control Board Meetings and manage timelines
Collaborate with OCM team members Articulate and Develop change management plans
Experience working with Database: ETL, Mass Data Management, Data Warehouse
Develop communications and change management deliverables
Principle Consultant of TIFF, LLC helping small Non-profits align to Agile SCRUM workflows
Performed as a contractor through TIFF, LLC (Staffing Agency)
Used Data warehouse to extract, transform, and load NDC numbers and Prior Authorizations used for drugs to be adjudicated at Specialty Pharmacies
Used user stories to help develop data warehouse parameters for SQL purposes.
Post-modem presentation conducted to close all activities include conducting an end of sprint meeting where sprint products are demonstrated to stakeholders and conducting the end of sprint retrospective with the scrum team and Management
-Trained on how to adjudicate claims for pharmacy benefits Management Companies like Express Scripts and CVS
Team Lead for Smithkine
Provide SCRUM leadership for software development
Train for Prior Authorizations for Membership
Document workflows and business processes
QA, Developers, UAT, Claims, Reimbursement, MDM, Enrollment & Billing
Remedy/ Identity Management
Microsoft Office Project & SharePoint Server
Application & Unit Testing
Java: Affordable Care Act, Medicare Advantage, Stanley Morgan Financials)
HIPAA & Cyber Security CMS
Pega7 & Cloud
Marketing and Salesforce Management
Client Relations Manager
Master Data Management
Credit Card Processing: Health Savings Account
Earned Value Management Analyst
Disaster recovery Implementation
Excel and Microsoft Project 2016
Mainframe 3500, Mainframe 3270
CMMI- Enhance workflows according to Mandates
Microsoft Office 36
IAM Microsoft Azure Active Directory
IAM Oracle Identity Management.
Morgan Stanley Financials
BI Tools used for CMS Project
ACA Website Processes and Procedures
Education and Certification
Bachelor of Arts in Communications from Lincoln University, Lincoln, PA 2008
IC Agile Certified Agile Professional, Agile Trailblazers 2017
Scrum Alliance Certified/ Licensed SCRUM Master 2018
PMP Course work completed
Versione provided Dashboard updates
Performed Daily as Scrum Master ceremonies
Performed day-to-day management of the cloud platform operations, identifies issues and risks and recommends possible issue and risk mitigation strategies associated with the project.
Lead operations team in providing tier 1 and tier 2 support for cloud platform.
Designed develop and maintain incident management workflows.
Monitored issues and provides resolutions for up-to date status reports.
Coordinated emergency response for severity 1 and 2 incidents.
Monitored and coordinate all system operations, including security procedures, and liaison with infrastructure, security, DevOps, Data Platform and Application team.
Ensured that necessary system backups are performed, and storage and rotation of backups is accomplished.
Monitored and maintain records of system performance and capacity to arrange vendor services or other actions for reconfiguration and anticipate requirements for system expansion.
Coordinated major/minor software installation, upgrade and patch management.
Demonstrated a broad understanding of client IT environmental issues and solutions and be a recognized expert within the IT industry.
Demonstrated advanced abilities to team and mentor and possess demonstrated excellence in written and verbal communication skills.
Department of Defense DTMO Transportation Modernization. 11/ 2019 – 1/30/2019
Project Manager, Team Lead
Conduct Daily SCRUM
Client Face Relationships
Team and Relationship Building
Provide Test Records & User Stories
Ensure all data records are Cyber Secure and in compliance of PII and HIPPA.
RUN Tests according to SPECS and Requirements Qualifiers for all Scenarios. Stipulate Blackout dates and correlation with systems start and end dates for Transition and Migration IIImplementations. Include crosswalk interaction for data when following ETL provisioning. Program phase 1 of initial load of 6,000 members of military and 1,000 civilians. Present projected load of Army Travel Modernization 3 million.
TIFF, Baltimore, MD 01/2017 – 03/2019
Project Manager/ Scrum Master
As a Certified SCRUM Master and Certified Agile Professional I am responsible for gathering requirements and performing gap analysis, and have illustrated current & existing workflows, developed organizational network management plan.
Performed the following functions:
Updated all artifacts
Daily Scrum stand ups
Product Owner one-on-ones
Provided user stories for developers so that Scrum ceremonies could be done during daily SPRINT exercises
Incorporated the use of Cloud & Pega 7 to distribute data in the Disaster Recovery workflow and used Agile tools for scrum exercises.
Coordinate the successful release of high-quality, stable software
Coordinate proper collaboration across all the scrum teams
Break down cross-team barriers
act as a leader to foster collaboration and communication between team members on technical issues, on process improvements, and in addressing and escalating project risks and issues.
Facilitate Program Increment (PI) planning
Oversee the schedule and manage PI deliverables
Track, analyze, and report standard agile metrics
Work with stakeholders to develop and maintain the roadmap
Identify, communicate, and resolve program-level roadblocks for multiple geographically distributed scrum
Act as a unifier helping individual goals become program goals
Integrated Cyber security, Microsoft Office Project & SharePoint Server.
Utilized tools for sprint planning increments to determine what the team should complete in the coming sprint from the backlog or list as work to be done
Tracked & managed sprints, led daily stand
Identity Management Software
Trained staff on Agile. Waterfall, and Kanban features.
Performed requirements gathering from the business users of the system while adhering to SDLC (Software Development Life Cycle) industry best practices
Performed Data Modeling and features for Kanban, SAfe, Waterfall & Agile methodologies
Federal Insights, Baltimore, MD (Part time remote) 11/2015 - 05/2016
Sr. Business Analyst/Scrum Master
As the SME for Change Management Consultant provided change management principles
Provided SWOT & Gap Analysis (performed requirements analysis to provide user stories for the Product Owner)
Capitalized on illustrating future state business requirements and process management workflows to perspective contractors for CMS for the ACA website.
Train and Managed resources on Identity Management and Cyber Security principles
Consulted with client about SDLC artifacts and setting up repeatable processes for the project management staff.
DST Health solutions, Birmingham, AL 08/2016 - 12/2016
Project Manager/Scrum Master
Implemented configuration management practices of mandates to be developed, coded, loaded, & tested for claims and Cyber Security
Implemented Regulatory Affairs via Jira Mandates
NIEM: NIEM, the National Information Exchange Model, is a partnership of the U.S. Department of
Justice and the Department of Homeland Security. It is designed to & DODefense
enterprise-wide information exchange standards and processes that can enable jurisdictions to
effectively share critical information in emergency situations, as well as support the day-to-day
operations of agencies throughout the nation.
BackwardInvolved in UAT (User Acceptance Testing), Microsoft Office Project & SharePoint Server
Agile tools for scrum tools for sprint planning.
Performed gap analysis for coded, loaded, & tested claims processing on current & future platforms then applied this data to guide the transformation of the systems using Agile methodologies.
Processed claims in compliance with policies & procedures as defined by the Centers for Medicare & Medicaid’s (CMS) Regulatory Affairs.
Used SCRUM Responsibilities & Agile Methodologies as needed perform checks & balances as needed to perform according to priority set by the product owner.
Identity Access Management training and Executed Scrum Master to handle backlog as the Project Manager, making sure that deliverables are on time with production quality.
Updated changes for IT development & product enhancements
Conducted configuration analysis to gather impact to data in the Data warehouse so that adjustments could be made for universal and isolated challenges. Bachelors of Arts in Communications
TIFF, Owing Mills, MD (part-time remote) 02/2015 – 05/2018
Baltimore County Gov’t, Schools, Community College, Library
Worked as part time for cross-functional Change Control Board to evaluate using either Agile or Waterfall methodologies. Ensure that all sprints were shippable and UAT were DONE.
Provided requirements as stated by client so that departments can apply quality to deliverables provided via training & onboarding of new hires
Built group structures identifying COBRA members via Enrollment, Billing & Eligibility as well as contracting & compliance benefits
Administered contracts, including onboarding, off-boarding, resolving issues, & coordinating periodic reviews with management & other stakeholders. Managed risk by identifying issues & then allocating appropriate resources.
Initiated project milestones then scheduled, executed, monitored & controlled the program through to completion.
Trained providers on payment services & options provided by the health care plan.
Streamlined Remedy ticket processes, writing guidelines for completing a ticket analysis.
Performed a gap analysis for call center deliverables, used Microsoft Office Project & SharePoint Server.
Led in the development of the technical solution, in translating the business needs into technical requirements.
Identified, impact & the risk profile in the technical solution(s), & provided technical support.
Daily Scrum stand ups
Product Owner one-on-ones
Credit and Debit payment towards premiums
Provided training towards Health Savings account via Oracle
Provided user stories for developers so that Scrum ceremonies could be done during daily SPRINT exercises
Identified any challenges developers are faced with that may encumber their progress
Provided up-to-date Backlogs so that progress is shown, and dependencies are carried out with priority
Reported to management and stakeholders via the 5 process groups and workflows Initiate, Plan, Execute, Monitor and Control, & Social Responsibility
Used application programming interface specification to support sales in client retention. This focused-on Business Intelligence and pointed to any migration and data integrations via website queries and included specifications for routines, data structures.
System Migration for GMIR, FLXX facets, AS400 moved applications from one premise to another. (example enterprise server to cloud or cloud to cloud)
Assisted in training users pointing out the out dated legacy system and the need to undergo digital transformation.
QuTech: Quality Technology (Call Center/ Helpdesk)
Affordable Care Act
CMS, Falls Church, VA, Largo, MD 09/2013 – 02/2015
Tier 3 Business Analyst
Center for Medicare & Medicaid/ Quality Technology Federal Project
Worked with QSSI, CGI, & CMS to field open enrollment QA, using CALT, FEPS, CISCO, Remedy, CMS WEBMAIL, Navigator, HIOS, SHOP, Edge Server, QHP, EIDM, & HUB.
Used Remedy ticketing Software to ticket and track research workflows for efficiency
Ensure that all artifacts are complied with corporate SDLC policies and guidelines.
Produced a statement of work, supported project development & planning, & developed a communications plan
Sailpoint and Azure was used for Identity Management and access Management for Providers needing to have access to various systems. Key identifiers were used to set up end users according to department. This was for DHHS for CMS. Provided end-to-end security, and activation. These capabilities enable seamless and safe customer experiences while providing business with actionable customer insights Maintained a website with WordPress to communicate the latest SOP changes required by CMS.
Provided Tier3 support for edge server used to provided assistance for ACA Reinsurance & Risk Adjustment.
Used Oracle when building requirements for Enrollment and Identity Management for Providers
Supported the DHHS-operated risk adjustment methodology to determine each plan’s risk adjustment transfer amount based on the actuarial risk of enrollees, the actuarial value of coverage, utilization & the cost of doing business in local rating areas
Triaged customer support issues regarding member enrollment from Agent/ Broker, Issuers, & Submitters. Involved in Microsoft Office Project & SharePoint Server and in SCA (Security Control Assessments).
BI Tools used for CMS Project
TIFF, Baltimore, MD 01/ 2011 – 12/2012
Certified SRUM Master (remote)
Facilitated daily stand ups, retrospectives, planning, status meetings to provide updates on system conversions and integrations projects incorporating ICD10 compliance with CMS Mandates as well as EDI requirements for providers & carriers.
Employed Pega Systems Software to run test claims processes during
ICD10 training, incorporating Ruby tools to validate that the correct, updated ICD codes were used.
Coached and trained staff according to CMS Guidelines on the ICD10 Implementation Phases.
Worked in a cross-functional team to scope the project, assess risk, & assign
resources in a work breakdown structure.
Monitored project progress, coordinating & documenting changes to the scope, schedule, & costs.
Performed a systems analysis to convert Care of Service products from ASO to fully-insured enrollment.
Conducted, on behalf of payer organizations, gap analysis, requirements analysis, & risk analysis – saving millions of dollars in streamlined oversight procedures.
V-Soft Consulting, Tampa, FL 05/2012 - 08/2012
Change Management Consultant
Managed technical & functional personnel in support of the automated billing integration process, enhancing the credit & returns IT capabilities using both Agile & Waterfall.
Documented changes for beta testing and developed requirement specs for scope, quality, & software development requirements to determine cost for review by underwriting and coordinated with IT to establish the ETL timeline.
UnitedHealth Group/ OptumHealth, Columbia, MD 11/2007 – 12/2009
Sr. Retail Provider Relations Supervisor
Band Name Change from Spectera to OptumHealth
Key contact for Providers
Responsible for getting new contract with name change signed by all existing Providers and Retail locations countrywide systems matched legal contractual document
Run test claims to ensure reimbursement payment using EDI were accurate.
Provide training for storefront locations via Webinar. Provide CD training to highlight changes for outside venders.
Responsible for systemic changes to be done
Negotiate Fee Schedules depending upon region
Troubleshoot to determine if there is an isolated incident or universal issue
Prepared SOP’s for Brand Name Changes
Updated Fee Schedules according to regions
Documented the SOP’s for contract technicians.
Coordinated the signing & processing of a wide range of previously unaccounted for legal contracts from numerous CEO’s of large corporations regarding rate & reimbursement adjustments required for the brand name change from Spectera to OptumHealth.
Identified retail chains needing performance monitoring & reporting systems then acted as a liaison between Providers & Operations for UAT & Model Office Evaluations.
Managed projects, using MS Project to communicate to the cross-functional work group & management.
Analyzed data for rate variances based on region, creating reports illustrating utilization from both providers & members.
Implemented the use of EDI to process retail claims for Provider reimbursements.
CareFirst BlueCross BlueShield, Owings Mills, MD 1999 – 2007
Implementation Project Manager/ Change Control Board
Workgroups included representation from all areas of impact and Stakeholders
Implementation Cross-functional Workgroups consisted of:
Performed configuration management, change management, & disaster recovery
Responsible for new & renewing accounts who have elected Benefits. If the client chose a non-standard or completely customized option, Waterfall Methodology would be the style of Implementation.
Served as Leadership as point-of-contact for National, Local, and State Accounts
Serviced accounts that were Nationwide, with membership in every state
Involved in Microsoft Office Project & SharePoint Server
Performed control & monitor user acceptance testing
Evaluated risk adjustment as it relates to the Affordable Care Act BCBS Boston, Massachusetts.
Adjusted or denied retro-activity claims according to account request or as mandated via Regulatory Affairs.
Ensured that teams could recognize changes necessary for existing processes & take a lead role in ensuring that the changes are made & communicated to other users
Taught & provided its role in verifying performance on business-critical functions
Integrated an understanding of its role in confirming the integrity of data
Demonstrated roles in assessing system final production readiness
Showed resources its responsibility in executing the test cases & ensuring that the final outcomes of the tests are satisfactory
Performed analysis for Participating Plans (nationwide) compliant with HIPAA
Provided leadership to teams & exhibited strong relationship skills
Encouraged interactive input from team members so that their concerns & ideas were heard & applied if practical & essential for the project
Delivered and participated in Migrations, Conversions, and Integrations for all platforms
Updated change requests information & verify that the proper documentation has been submitted.
Oversaw processes associated with auditing, categorizing, & distributing of Credit & Returns in accordance with policy & procedures
Performed as SME for issues pertaining to software configuration to the change control board
Ensured all change request & supporting information were accurately entered into the change control system
RFR RESUME FORM – insert labor category
Instructions: Enter resume information in the fields below; do not submit other resume formats. Submit only one resume per Labor Category described in Section 1 of the RFR.
Subject Matter Expert
Candidate Legal Name:
A.Education / Training
Institution Name / City / State
Degree / Certification
Field Of Study
University of Maryland, College Park, MD
Masters in Healthcare Administration
Lincoln University, Lincoln, PA
Bachelor of Arts
B.Relevant Work Experience
Describe work experience relevant to the Duties / Responsibilities and Minimum Experience / Knowledge / Skill described in Section 3 of the RFR. Starts with the most recent experience first; do not include non-relevant experience.
The Irvin Fenwick
01/2017 – 04/2018
Mrs. McLeod-Washington was responsible for the development of the remediation plan. She helped to gather requirements to perform gap analysis and illustrated current and existent workflows. She developed organizational network management plans and utilized the most recent warehouse file to stay up to date and reload using ETL to populate software for as needed data analysis. Mrs. McLeod-Washington incorporated the use of Cloud and Pegs 7 to distribute data in the Disaster Recovery workflow. Additionally, Mrs. McLeod-Washington attended Sprint planning meetings that determined what the team should complete in the coming sprint from the backlog or the list of the work to be done. She also tracked and managed sprints.
11/2015 – 05/2017
As a Business Analyst Consultant, Mrs. McLeod-Washington consulted client for CMS contract for ACA website. She provided SWOT and gap analysis, as well as facilitating meetings with users and stakeholders. She conducted requirements analysis and acted as a Developer for Change Management. Mrs. McLeod-Washington conducted testing for systems and analyzed the Business Process Management.
Medicare Advantage/DST Health Solutions
Technical Sr. Project Manager/Sr. Business Analyst
08/2016 – 12/2016
In this role, Mrs. McLeod-Washington implemented configuration management practices of mandates to be developed, coded, loaded, and tested for claims processing. She conducted Sprint planning meetings to determine what the team should complete in the coming sprint from the backlog and the list of work to be done and tracked/managed sprints. She also conducted daily scrums or stand ups. Mrs. McLeod-Washington confirmed clients were current on mandates, banners, and bulletins for Medicare Advantage and Medicaid by using test scenarios that followed the full claims processing lifecycle. Additionally, she also provided gap analysis for coded, loaded, and tested claims processing on current and future platforms then applied this data to guide the transformation of the systems using Kanban, Safe, Waterfall, and, or Agile methodologies. Mrs. McLeod-Washington was responsible for processing claims in compliance with policies and procedures as defined by the Centers for Medicare and Medicaid’s (CMS) Regulatory Affairs. She used SCRUM responsibilities and Agile methodology as needed and performed checks and balances as understood according to priority set by the product owner. Scrum Master was executed to handle backlog as the Project Manager, making sure that deliverables are on time with production quality. Lastly, Mrs. McLeod-Washington conducted sprint and reconciliation ceremonies and updated changes for IT development and product enhancements. She planned and defined scope, resource planning and developed schedules and created artifacts and supporting documentation.
Irvin Fenwick Foundation, LLC.
Sr. Project Manager
02/2015 – 05/2017
Owing Mills, MD
As a Sr. Project Manager, Mrs. McLeod-Washington provided requirements as stated by client so that departments can apply quality to deliverables via training and on-boarding of new hires. She also demonstrates experience with COBRA. She built group structures identifying COBRA members via enrollment, billing and eligibility as well as contracting and compliance benefits. Mrs. McLeod-Washington was responsible for identity and cloud management and worked as part of a cross-functional Change Control Board to evaluate using either Agile or Waterfall methodologies. In addition, she administered contracts, including on-boarding, off-boarding, resolving issues, and coordinating periodic reviews with management and other stakeholders. She also managed risk by identifying issues and then allocating appropriate resources and initiated project milestones then scheduled, executed, monitored, and controlled the program through to completion. Mrs. McLeod-Washington trained providers on payment services and options provided by the health care plan. She also streamlined Remedy ticket processes, writing guidelines for completing a ticket analysis and performed a gap analysis for call center deliverables.
Center for Medicare and Medicaid
Project Manager/Tier 3 Support Supervisor – ACA FFM
09/2013 – 02/2015
In this role, Mrs. McLeod-Washington worked with QSSI, CGI, and CMS to field open enrollment QA, using CALT, FEPS, CISCO, REMEDY, CMS WEBMAIL, NAVIGATOR, HIOS, SHOP, Edge Server, QHP, EIDM, and HUB. She produced a statement of work, supported project development and planning, and developed a communications plan. She also maintained a website with WordPress to communicate the latest SOP changes required by CMRS. Mrs. McLeod-Washington was responsible for providing Tier3 support for edge server that is used to aid with ACA Reinsurance and Risk Adjustment. Additionally, she supported the HHS-operated risk adjustment methodology, and determined each plan’s risk adjustment transfer amount based on the actuarial risk of enrollees, the actuarial value of coverage, utilization and the cost of doing business in local rating areas, and the effect of different cost-sharing levels on utilization. This methodology, which HHS applied in 49 states and the District of Columbia for the 2016 benefit year 3 transferred funds from plans with low risk enrollees to plans with high risk enrollees. Lastly, Mrs. McLeod-Washington triaged customer support issues regarding member enrollment from Agent Brokers, Issuers, and Submitters.
Sr. Project Manager
05/2013 – 07/2013
Mrs. McLeod-Washington supported the cross-functional development efforts for a mobile version of their web site and supported Business Analysts with access to existing, impacted work flows. She established workflows across business membership and accounts including those with ASO and fully funded arrangements incorporating Flexx/ Facets/ Medicare D incorporating CMS Mandates with HIPPA Compliances. She also used market data management principles to establish marginal requirements.
BlueCross BlueShield of Massachusetts for Highmark Solutions
Sr. Project Manager
01/2013 – 02/2013
As a Sr. Project Manager, Mrs. McLeod-Washington managed a cross-functional team to develop a charter and technical/functional project plans in MS Project, including assessing risks for Healthcare Reform products and processes such as enrollment, reinsurance, and providing rates. She analyzed risks for performing proposed system enhancements and developed contingency plans and maintained a documentation library on SharePoint for charters and project plans. Mrs. McLeod-Washington was responsible for scheduling kick-off meetings to present final deliverables and processes, identifying milestones and testing criteria. She implemented SOP’S for all systems based on CMS requirements and worked with consumer driven healthcare, health savings accounts and health reimbursement accounts. Product sold to Membership where funds could be debited and or credited.
The Irvin Fenwick Foundation, LLC.
Project Manager Coordinator/Consultant
01/2011 – 12/2012
Mrs. McLeod-Washington was responsible for facilitating status meetings to provide updates on the system conversions projects incorporating ICD10 compliance with CMS Mandates as well as EDI requirements for providers and carriers. She employed Pega Systems Software to run test claims processes during ICD10 training, incorporating Ruby tools to validate that the correct, updated ICD codes were used. Mrs. McLeod-Washington also coached staff according to CMS Guidelines on the ICD10 Implementation Phases and worked in a cross-functional team to scope the project, assess risk, and assign resources in a work breakdown structure. In addition, she monitored project progress, coordinated and documented changes to the scope, schedule, and costs. Mrs. McLeod-Washington also performed a systems analysis to convert care of service products from ASO to fully-insured enrollment and conducted, on behalf of payer organizations, gap analysis, requirements analysis, and risk analysis – saving millions of dollars in streamlined oversight procedures.
Phamerica for V-Soft Consulting
05/2012 – 08/2012
As a Project Manager, Mrs. McLeod-Washington managed technical and functional personnel in support of the automated billing integration process, enhancing the credit and returns IT capabilities using both Agile and Waterfall. She documented changes for beta testing and developed requirement specs for scope, quality, and software development requirements to determine cost