Business Analyst Architecture Manager
Resume:
Jane Koogle
Manchester, MD *1102
Cell: 410-***-****
Email: ****.******@*****.***
PROFESSIONAL SUMMARY
I have worked in the health care industry for 25+ years in various positions including claims examiner/adjuster, business analyst, and data architect. My strengths include data architectural design, problem solving and technology leadership on an enterprise level. I have over 17 years’ experience working on corporate initiatives following system design lifecycle standards, interacting with diverse levels/types of associates, and ultimately delivering effective, reliable production solutions. Effective analytical and problem-solving skills have been the crux of my professional achievements.
TECHNICAL PROFICIENCIES
Enterprise Data Modeling and Application-Specific Data Modeling (Entity Relationship Diagram, Logical Data Model, Physical Data Model, Data Definition Language) in the following realms – EDW, OLTP, OLAP, ODS, Metadata Management.
ERwin Data Modeler and Model Manager (4 years)
Oracle data base platforms (12 years)
SQL Server database platforms (5 years)
DB2 mainframe data base platforms (15 years)
Structured Query Language (15 years)
SQL Developer (12 years)
Toad (12 years)
TSO/FileAid (15 years)
Microsoft Office (Access, Excel, Outlook, PowerPoint, Word, Visio)
PROFESSIONAL EXPERIENCE
CareFirst BlueCross BlueShield – Owings Mills, MD
Lead Enterprise Data Architect – 2013 to present
Research, develop, and implement more complex data solutions at both the project and corporate architecture levels.
Translate business needs/requirements into sound, sustainable data designs from an enterprise perspective.
Provide leadership for data architectural design, problem solving, and technical process application by ensuring project compliance at all project lifecycle phases.
Perform enterprise level profiling, metadata, quality, and master data management.
Assist the Data Architecture Manager and other Enterprise Data Architects with application of corporate standards and establishment of architectural building blocks within the organization.
Maintain current data artifact inventory while assisting in creation of new metadata standards and innovative architectural patterns.
Senior Data Architect – 2006 to 2013
Deliver quality Data Architecture artifacts for assigned corporate initiatives with emphasis on Claims Domain.
Provide leadership direction during solution-development phases of assigned projects to ensure enterprise information objectives are realized.
Design conceptual and logical/physical data models, generate data definition language, and assist business in production of ETL mapping documents.
Troubleshoot and provide resolutions for data quality issues.
Actively participate in creation and adoption of Data Architecture guidelines and standards.
Create all foundational Data Architecture documentation in support of assigned projects.
Provide input for estimation of Data Architecture deliverable dates.
Proactively anticipate and manage issues in Claims Domain.
Lead Business Analyst – 2001 to 2006
Perform primary Business Analyst role on HIPAA X12 837 I & P implementation including design and functional specification creation for electronic front-end system (CCA)
Maintain and support all logical data mapping for 837 HIPAA X12 Transactions (originally developed as well)
Track and monitor 837 EDI receipts for all CareFirst platforms. Perform trend analysis on overall EDI volume and rejection rates.
Define and document new business and system requirements as well as create functional specifications for various corporate system initiatives using System Design Lifecycle methodology.
Participate in analysis of existing processes to identify defects and recommend enhancements.
Business support including file maintenance, ad hoc reporting, and consultation with internal/external users.
Serve as Subject Matter Expert for EDI 837, Medicare Crossover claims, CCA, and CARE.
Provide coaching and mentoring to other team members on various issues and projects.
Senior Business Analyst – 1998 to 2001
Track and monitor 837 EDI receipts for all CareFirst platforms. Perform trend analysis on overall EDI volume and rejection rates.
Define and document new business and system requirements as well as create functional specifications to assist software developers.
Participate in analysis of existing processes/systems to identify defects and recommend enhancements.
Develop, execute, and document test plans and results.
Coordinate with other staff and users to maintain systems in accordance with priorities and scheduled target dates.
Business support including file maintenance, ad hoc reporting, and consultation with internal/external users.
Business Analyst – September 1997 to 1998
Define and document new business and system requirements as well as create functional specifications to assist software developers.
Participate in the analysis of existing processes and systems to identify defects and recommend enhancements.
Develop, execute, and document test plans and results.
Performs business support responsibilities to include production monitoring, file maintenance, ad hoc reporting, and consultation with internal and external users.
Provide internal and external customer support for miscellaneous system issues.
Claims Processor and Area Specialist – August 1990 to September 1997
Process health insurance claims and adjustments for the Individual Market Division
Assist other examiners with complex claim services
Keep management aware of system issues experienced by claims processors within the unit
EDUCATION AND TRAINING
B.S. Information Technology – University of Phoenix (July 2010) GPA – 3.77
SQL Server Database Administration Training – June 2013
Dimensional Modeling Training – Kimball University / May 2012
Relational Database Design Training – August 2007
HIPAA X12 Implementation Guide Training – May 2000
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