Kimberly McLeod

Servant Leader

adcwma@r.postjobfree.com

443-***-****

Upper Marlboro, Maryland

Clearance: Fully vetted Secret on 8/8/2019 03 27 DOD CAF

https://www.linkedin.com/in/kimberly-mcleod-washington-b465832/

PMP 5 Process Groups: Initiate, Plan, Execute, Monitor, Control, Social Responsibility

Certified SCRUM Master: ID 000767626 Scrum Alliance

Certified Agile Professional: ID 123-7488-e1c17346-1dbb-491b-a75b-1063a195194c

Summary:

Agile Coach: As Implementation Project Manager and Facilitator of the Change Management Control Board for a National Organization, I have taught and mentored Sales, Resources, Stakeholders, and Management of the Agile Values and Principles. I did this by providing the Agile Manifesto and Valuing.

- Individuals and Interactions over processes and tools

- Working software over comprehensive documentation

-Customer collaboration over contract negotiation

-Responding to change over following a plan

I have performed this professional style throughout my career history repeatedly from one project to another as it has proven to give me the best results.

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

PBM

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

Technical Skills:

QA, Developers, UAT, Claims, Reimbursement, MDM, Enrollment & Billing

Remedy/ Identity Management

Configuration Management

Release Management

Microsoft Office Project & SharePoint Server

Application & Unit Testing

Java: Affordable Care Act, Medicare Advantage, Stanley Morgan Financials)

Access Management

HIPAA & Cyber Security CMS

Pega7 & Cloud

Marketing and Salesforce Management

Change Control

Client Relations Manager

Master Data Management

Legacy

GMIR

NASCO

Business Intelligence

Credit Card Processing: Health Savings Account

PeopleSoft 9.2

Earned Value Management Analyst

Agile Professional

Defect Tracking

Disaster recovery Implementation

SAFe

Kanban

Agile

Lean

Workgroup Facilitator

Excel and Microsoft Project 2016

AS400

Mainframe 3500, Mainframe 3270

CMMI- Enhance workflows according to Mandates

Microsoft Office 36

IAM Microsoft Azure Active Directory

IAM Oracle Identity Management.

Excel

Access

Integrations

Migrations

Mapping

Scheduling

Medicare Advantage

Jira

Morgan Stanley Financials

UX/UI Design

BI Tools used for CMS Project:

Five 9

Oracle

Adobe

Microsoft

Defect Tracking

Hub

Finance

Customer Service

ACA Website Processes and Procedures

Oversight

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

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.

Release Management

Scrum Master:

Lead, manage, and coach teams on delivery controls and compliance to minimize risk

Daily Stand-ups, Grooming, Planning, Retrospectives, Team Building

Comprehend dependencies to support team in risk management

Identify impediments and resolve appropriately

Increase velocity by ensuring team stays focused on quality and continuous delivery

Professional Experience:

Department of Defense DTMO Transportation Modernization 11/ 2019 – 12/25/2019

Change Management

Mark Center

Arlington, Virginia

Project Manager, Team Lead

Conducted Daily Stand ups

Focused on Client Facing, Relationships

Initiated, Planning, Execute, Monitor and Controlled

Retrospectives

Provided Artifacts

Team and Relationship Building

Provided Training

Presented presentations

Reviewed Functionality

Facilitated Meetings

Discussed Team User Familiarization

Provided Test Records & User Stories

Ensure all data records are Cyber Secure and in compliance of PII and HIPPA. Member of Change Control Board

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 Implementations. 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.

DanSource Solutions, Rockville, MD 20852. 4/2019 – 10/2019

Change Management

SCRUM Master

Performed SCRUM Ceremonies

Met with Product Owners

Facilitated meetings

Update Artifacts

Negotiate changes

Met with Sales Teams

Trained and advised Marketing and Production

Used User Stories

TIFF, Baltimore, Baltimore MD 01/2017 – 03/2019

Project Manager/ Scrum Master

Change Management

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

Retrospectives

Grooming

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

teams

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

TIFF

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.

Intellisource/TIFF (Remote)

DST Health solutions, Birmingham, AL 08/2016 - 12/2016

Project Manager/Scrum Master

Medicare Advantage

Change Management

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 & DO Defense

Develop

Disseminate

Support

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.

Models

Forward

Backward Involved 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. Bachelor of Arts in Communications

TIFF, Owing Mills, MD (part-time remote) 02/2015 – 05/2018

Baltimore County Gov’t, Schools, Community College, Library

Project Manager

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

Retrospectives

Grooming

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 outdated 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

Five 9

Oracle

Adobe

Microsoft

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.

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

Salesforce Support implementing Full Life Cycle including 3-6 months after GO LIVE

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

Salesforce support from Proposal through Full Life Cycle including 3-6 months after GO LIVE

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 retroactivity 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

Nasco

GMIR

FLEXX/ Facets

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

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