Senior project manager, senior business analyst

PROFESSIONAL SUMMARY

An accomplished Senior Business System Analyst, Technical Delivery Lead, and Project Manager

Well versed in gathering complex business system requirements using both agile, waterfall, hybrid, and other methodologies and formulating the requirements into BRD’s, Epics, Features, and user stories based on project needs

Dependable, experienced IT professional that enjoys designing business systems and solutioning problems for customers

Customer focused, strong problem-solving skills, and proven leader

Motivated team player that works well with all levels of the organization to ensure projects are completed on time and on budget

SKILLS

Successful Technical Delivery Lead with strong technical and analysis skills, seasoned project management skills, proven track record for delivering projects on time and budget, and motivated people leader

Experienced lead Business System Analyst with strong solutioning and customer service skills

Proven Product Owner, responsible for defining the roadmap, managing releases, refining and prioritizing the backlog of User Stories for programs

Well versed at defining current state and future state workflow and data flow definition diagrams

Experienced with Gap analysis techniques and transitioning to new business systems

Successful IT Project Manager from small to large Development and Technical Infrastructure Projects

Experienced with requirements gathering methods & tools

Motivated, Adaptable to change, multi-tasks well, and organized

Exceptional problem-solving skills

Incident / Issue Management and Root cause analysis1010

Effective communication and listening skills

Experienced using the following methodologies: Agile/Scrum/SAFE, Kan Ban, Sixth Sigma/DMAIC, IE, Object Oriented, RAD, Waterfall, Phased, SDLC, and Hybrid

Requirements and Technical Tools: IBM UCEE, Adobe/Cloud marketing tools, Casetrakker, Roadmunk, Jira, Rally, Service Now, Workfront, Clarity, Jama/TFS, Nexus, Tech Direct, HP-ALM, CA-TOOL- ITIL, Nim-soft and RM Track

Project Dashboards, project metrics, project statuses, project plans, RAID management

Stake Holder Meetings, Client presentations, UAT Sessions, and Project Demos

Client presentations

Project Resource Management

Project budgets, cost tacking, and cost reduction experience

Escalation Management

Experienced with Microsoft Project Suite: Word, Excel, Viso, Power Point, Access, MS-Teams, and Office

Microsoft Office 365 Suite

Meeting tools: Microsoft Teams, Zoom, Web Ex, and Live Meeting

IT INDUSTRY EXPERIENCE

Healthcare Insurance – Advocacy & Employee & Individual Digital Marketing campaigns, Medicaid, Medicare, D-SNP contracts, Dental, Eye, Pharmacy, Claims Adjudication, Call Center, Contact Tracking, Appeals, Grievances, Quality, UM: In Patient / Outpatient, and Blood Management

Public Utilities, Tax Industry, Banking, and Telecommunications

Insurance: Property & Casualty, and Specialty

Transportation: Trucking and Airline

PAST ROLES

Technical Delivery Lead

Lead Business System Analyst

Product Owner/Sr. Business Analyst

Back up Scrum Master

Business Analyst

Sr. Project Manager

Technical Project Manager

PROFESSIONAL EXPERIENCE

10/21 – 11/24 Embel Assist / United Health Group

Technical Delivery Lead

Started as a Business System Analyst, and advanced to a Technical Delivery Lead working with UHG’s Advocacy business clients and Employee and Individual Marketing Campaign Clients. Maintained all the Advocacy business area API driven and batch campaigns for three years including new development, maintenance, and issue resolution as needed.

Key Delivery Leader to help transition all campaigns from the IBM/UCEE marketing tool and marketing databases to the Adobe Cloud marketing environment and tools. This also entailed dismantling campaigns from the Wunderman Thompson portal and hosting environment by June of 2025

Responsible for gathering requirements with marketers and business partners for UHG marketing campaigns that deal with Employee and Individual health plans when a member is about to go Out of Network(OON). The campaign communications goal is to redirect the member to stay In Network(INN) using multiple digital channels to inform eligible members that they have received a prior authorization stating their Provider is OON and that this could cost them more for an already incurred service or a future appointment’s service and try to redirect the member to stay INN to save costs.

The role entails coordination with all AES teams (Sales Force Marketing Cloud for creative emails, SMS Manager team for SMS text campaigns, Genesys phone system for outbound calls, the Analytics Reporting team, Architecture, and the Campaign Delivery team to ensure that campaigns get done on time. Lead test planning, participate in campaign data validation, and UAT testing.

Other campaigns dealing with member & dependent Benefits and consumption of benefits, also Predictive campaigns, Price Alerts and Rewards, Advocacy campaigns, Orthopedic Health Services, and more.

Working with near real-time API driven campaigns and batch campaigns in a complex Azure Cloud environment with multiple data sources.

Currently working to transition off the IBM Unica campaign tool to the Adobe campaign tools and to have all data in the Azure / Cloud

Mentor / coach junior business solutions analysts with their campaign requirements

Helped to define & implement Business Solution team processes, and document cross-team processes and coach out the processes with the business partners

Campaign incident management and resolution, campaign support and new campaign development

Tools: AZURE Cloud / Sales Force Marketing Cloud, Choreographs Intellisight / ODS process, IBM / UNICA Campaign tool, UCEE DB, Snag-It, Adobe Workfront ticket system, Microsoft SharePoint, AHA / Rally, Microsoft Office Suite/Windows 365

1/21 – 8/21 Molina HealthCare

Lead Agile Business System Analyst

Magellan Health was bought by Molina Healthcare; all IT systems and employees were transitioned to Molina as of 1/1/21.

Defined the core business processes for the Medicare Magellan Casetrakker Call Center/Contact Tracking module that tracked all the member’s medical coverage, eligibility and contract detail, grievance, appeals, authorizations, utilization management, inpatient, and outpatient service information and mapped these requirements to the Molina Salesforce system that handles call center and contact tracking functionality. All gap functionality was defined as user stories so that Molina’s Salesforce, Pega, CA, and UMK2 systems can be modified so that Casetrakker can be replaced in 2022.

Define business requirements into Epics and user stories for the new California State program dealing with Medicaid Provider payments for certain member populations and their defined services. This new program will replace the current CA Home Health program and modify current business system processes for capitation payments using the existing CA system for Provider 837 claims data, utilizing the Encounters, QNXT, and Claims adjudication processing and state reporting functions for the new CA program.

Tools: Casetrakker, Salesforce, Jira, Snag-It, Service Now, Microsoft SharePoint, QNXT, ODS, Encounters, and Microsoft Office Suite/Windows 365

1/19 – 1/21 Magellan Healthcare

Senior Business System Analyst

Define complex business requirements and formulate into BRD’s for projects dealing with Call Center/Contact Tracking, Grievances, Appeals, Quality, Authorizations, Utilization Management for Inpatient and Outpatient medical services for the states of NY/MA, VA, and AZ for contracts dealing with Medicare and Medicaid, and dual Contracts for Magellan Healthcare’s Senior Whole Health program.

Provide production support for three Casetrakker environments (NY/MA, AZ, and VA members), which entailed Service Now incident ticket resolution, testing in multiple Casetrakker environments: DEV, QA, UAT, and implementing production fixes.

One of the Lead Analysts on the MCC Arizona Medicaid acquisition and implementation from Arizona’s MCC legacy member case management system to stand up AZ on Magellan’s Casetrakker system with its own AZ Casetrakker stand-alone environment in 9 months during 2020. Also, gathered complex requirements for AZ Member State Reporting Requirements for the Magellan BI team.

One of the Lead Analysts for the VA DSNP dual Medicare / Medicaid acquisition initiative which entailed standing up a separate Casetrakker stand-alone entity for Virginia.

Lead Analyst for the Casetrakker version 5.2 to 6.0 upgrade project which consisted of upgrading twelve Casetrakker environments (Dev, QA, UAT, and Prod) for the states of AZ, VA, and MA/NY Casetrakker systems. This entailed defining project plans, test plans, defect management and resolution, conduct user acceptance demos and presentations, upgrade documentation, client training, and Go-Live support.

Conducted testing, for the 837 medical claims adjudication processes that send data from QNXT to ODS to Casetrakker each day for claims payments.

Defined, Implemented, and tested state Medicaid and Medicare program compliance letters that reside in Casetrakker and are mailed to members for Inpatient and Outpatient service authorizations, grievances, appeals, and denials. Tested the batch processes that pick up the letters and transmit them to external vendors for foreign language translation, printing, mailing, and processing of the return order file letter status updates for member’s case file data stored in the Casetrakker system.

Tools: Casetrakker, Jira, Snag-It, Service Now, Microsoft SharePoint, QNXT, ODS, Encounters, and Microsoft Office Suite/Windows 365

4/18 – 11/18 WellSky (formerly Mediware)

Product Owner – Senior Agile Analyst

Product Owner responsible for WellSky’s #1 software product called Transfusion within the Blood Management Family of products. Transfusion is an FDA/510k approved software application used in Blood Banks and hospitals to manage patient records, specimen records, perform blood testing, Emergency Management Records, allows transfer of patient records and specimens across multiple hospitals and facilities.

Gathered complex business requirements for the Transfusion product for four key initiatives in 6 months using business analysis techniques such as: current state/future state workflow diagrams using Visio, data mapping documents, client interviews, user stories, proof of concept designs, and UI/wireframe designs.

Gathered all the business requirements and wrote user stories, as well as help create the design for the new Alberta Canada client consisting of 117 new hospitals.

Wrote User Stories to resolve 100% of the existing HCLL software bugs.

Gathered requirements and wrote all users stories for the next general release coming out for 2019, helped release services packs for security and performance upgrades for the DOD, and other US based hospitals.

Collaborated daily with the remote Sr. Product Mgr. & Clinical Product Mgr., the IT Dev team that were on-site and remotely dispersed, as well as offshore, and Quality Assurance Team to manage/refine the backlog, and keep it prioritized to meet the roadmap goals.

Helped motivate and lead the scrum team, remove team impediments, and keep refinement & demo meetings organized and on track.

Participated and conducted in sprint retrospectives to capture what we did well and what we could improve upon.

Helped lead a demanding development team in a cross functional, multiple location environment.

Tools: JIRA, Roadmunk, TFS, Java, C++, configurable HCLL(Transfusion) software system, Microsoft SharePoint, Salesforce, snag-it, and Microsoft Office Suite/Windows 365

9/17 – 3/18 GEHA – Advantage Tech

Senior Agile Business Analyst

Gathered complex agile business requirements for the Connection Dental Network 2.0 website redesign using the agile / scrum methodology. This website had interface data coming from Salesforce as well as the Connection Dental History database tables.

Lead the annual 1099 Project for GEHA, updated swim lane project Visio workflow diagrams depicting their current 1099 process and defined the future state 2017 tax year workflows and system designs.

Monitored and resolved project Incidents using Service Now within department SLA’s

Built successful relationships with stakeholders, SME’s, Implementation Consultants, and the IT cross functional project teams.

Delivered clear, concise, User stories following agile alliance formats, including acceptance test requirements.

Conducted unit and system testing for the Connection Dental website for multiple platforms including PC, tablet, and mobile devices in multiple test environments.

Groomed the project backlog and kept work prioritized with the Stakeholders. Lead Refinement and Demo Ceremonies. Participated in project retrospectives.

Wrote test cases and performed acceptance testing for all project User Stories to ensure the application was defect free before handing off to the QA team.

Coach and follow IT / Business Analysis processes, using Jama and Microsoft Team Foundation – TFS 2013-17) and methodologies as defined by the BA Architecture rules.

Used Balsamic and snag-it for wireframes.

Used Urban Turtle / TFS add on to help manage scrum board work tasks for daily stand-up meetings and for managing the backlog priorities and sprint/release management.

Tools: Jama/TFS, Urban Turtle, Service Now, Balsamic, SnagIt, and Microsoft Office Suite, Agile and Waterfall projects

2/17 – 8/17 KCP&L – Power IT

Senior Project Manager

Responsible for a 4.7-million-dollar project, budget, forecasting, and tracking project actuals against the budget using the tool, Clarity.

Manage the project team, consisting of business marketing team leads, consultants, vendors, and internal KCP&L employees.

Stood up new Oracle Sales Cloud / Eloqua environments and converted the legacy customer care and billing system data into the new Eloqua system.

Replace current IBM Silver Pop CRM System with Oracle’s Eloqua and Oracle Sales Cloud CRM

Lead meetings, manage the project plan, project team, and produce project artifacts.

Presented Power Point project status to Project Stakeholder’s quarterly meeting.

Managed the Project SharePoint documentation, including the Project risks, actions, issues, and decision (RAID) log spreadsheet.

Tools: Microsoft SharePoint, Windows 365 Office Suite, Oracle Sales cloud, Clarity and Eloqua

9/15 – 1/17 H & R Block

Senior Agile Business Analyst / Backup Scrum Master

Gathered complex cross system business system and API driven requirements and wrote the applicable user stories. We followed the Gherkin method for our user stories.

Defined and documented complex Visio diagrams, depicting the current and future state of the business workflow, helped with project management and project communications using agile/scrum methodologies and 3-week sprints. Groomed the project backlog, sized user stories, lead refinement ceremonies and meetings, and attended retrospective meetings.

Designed and implemented a customized solution to read the Phone IVR to auto select the calling client so the agent could auto book tax appointments via the Verint Phone System IVR data. The solution also automated the connection to the H & R Block legacy tax appointment system called Cast.

Help Lead the daily scrum meeting when needed (acting back-up Scrum Master).

Gathered complex business requirements, using interviews and workflow analysis, designed, developed, and created test plans, and conducted testing.

Designed and implemented a customized web-based Tax Pro workflow management system that allowed a virtual client tax experience for the Tax Pro by creating an interface from the KANA phone system to pass workflow messages into the Tax pro’s daily workflow web application. This enhancement was implemented for Tax Pro’s in five tax offices for tax season 2016.

Customized the KANA CRM - call center Agent phone system software to meet the needs of the Retail CSO clients to add an Appointment Management Interface for the Tier 1 & Tier 2 Agents so they could book tax appointments.

Designed a new web Tax Identity Shield Membership Information Profile system interface.

Creative, innovative thinker, with strong follow through, delivers on time, and earned the stakeholders trust in my leadership.

Participated in QA testing using Bear SOAP UI tools, MDM data, Cast Data, Client Engagement Hub data, and applicable Tax database tables as needed.

Lead a team of BA’s, helped mentor/coach best practices, and review their work.

Tools: Kana Phone system, Phone IVR, HP-ALM tool, Block Notes, Excel, Visio, Power Point, Microsoft Project, Clarity, and First Data interfaces

10/12 – 7/15 BCBS of KC and NC with Trizetto (now Cognizant) – Consultant – Tek Systems

Technical Delivery Lead, Project Manager, and Business Analyst

BA, PM, and Technical Delivery lead roles for BCBS of Kansas City, BCBS of North Carolina, and Trizetto Health Software company to stand up Trizetto’s Facet’s Core Health System Software and integrate to third party, vendor, and legacy systems. This entailed standing up a new company called Topaz Shared Systems with these three companies for the 2014 Affordable Healthcare Government Reform Mandates.

Gathered complex business requirements, contributed to the design and development of custom interface solutions, and installing the new Trizetto Software Core Facets Healthcare software.

Working with the Trizetto System Integrations (SI) Custom Development teams (off-shore & on-shore), BCBS KC and NC teams to design and code customized functional and technical specifications for system integration requirements from their Core Legacy and Third-Party Vendor Systems (Salesforce/McKesson) to the Core Facets Trizetto Healthcare system.

Designing interfaces, extracts, and web services to connect to the core Facets System functionality (consisting of business functions and processes surrounding the Core Medical Care Benefits including Providers, Billings, Payments and Claims adjudication).

Worked hand in hand with Trizetto’s Hosting, EDI, Database, Release Management, Batch team, Configuration Mgt, and CAB Governance Board to deliver releases.

Assisted in the management of the Trizetto Custom Development Team member assignments, provided SME consulting to the Internal & Off-shore Resources for functional and technical specification deliverables.

Quality Assurance checking, standards validation, and conduct peer reviews of Functional & Technical Specifications for the SI Team.

Custom Development Requirements Mapping and Management to the Topaz Requirements Portfolio System in HP-ALM Quality Center.

Requirements traceability management from the Functional Spec to the Technical Specifications to the respective coded interfaces/programs.

Work with Trizetto, NC & KC testing teams from design to code and through testing cycles. Lead defect analysis to root cause analysis, code fix, and to defect management and closure.

Requirements Management Reporting, Deliverable Status Reporting, and Management of the Weekly Dashboard Status Summary Reporting for the Custom Development team and BCBS NC & Topaz Management Teams.

Project Management duties included the management of a complex Excel spreadsheet – called the Master Tracker used to manage the project schedule for the SI interface deliverables and resources.

Tools/Skills: Facets, Nim-Soft, Team management, CA-Tool, HP-ALM, Excel, Word, Waterfall and Agile/scrum methodologies, Requirements Traceability, and Incident Management

8/10 – 10/12 Bank of America – Consultant - Genesis10

Technical Project Manager

Technical Project Manager working for Genesis10 for the client, Bank of America. Managed multi-million-dollar technical application projects, including infrastructure projects, and joint application development and infrastructure, database, disaster recovery, hosting, and security projects. Managing 5- 6 projects at a time depending on their scope and duration including the budget, forecasts, and keeping the project to within +5% or -5% of forecasted budget.

Managed project resources consisting of Bank of America clients (SME’s) and other Bank team members (DBA’s, BA’s, Engineers, and Developers) with on-shore/off-shore and U.S. based resources.

Managed projects in the Finance, Credit Card group for Banks of America with their clients using the Six Sigma DMAIC methodology.

Escalate project issues/risks to the Bank Program Manager, develop go to yellow; go to green plans as needed to get the project plan back on track.

Project lead for all Bank Governance Project Approval Meetings, ensured all required paperwork and Governance approvals were received, and lead projects through to successful implementations.

Developed project fallback plans, testing plans, and on-call resource documentation for production implementations.

Lead project / client support calls; ensured all required cross functional team representatives were engaged to resolve project issues when a development or production implementation issue occurred.

Manage multiple projects & teams/resources at the same time, report weekly or biweekly statuses, and update project plan work break down structure weekly using the sixth Sigma DMAIC Methodology.

Managed a 1.5 year, multi-million-dollar project, working hand in hand with the Application Development Manager & Director for Bank of America, Atlanta Georgia. Standing up a large ASP.NET Revenue Med application system package to replace a 25-year-old Legacy Health Logic System.

Skills/Tools: Governance, Requirements gathering, project management, vendor management, off-shore, on-shore, and remote team management, Six Sigma DMAIC

Past employers and experience: Embel Assist, United Health Group, Molina Healthcare, Magellan Healthcare, Bluemoon Solutions, Embarq, Universal Underwriters Group, Sprint, Pars Service Partnership, Yellow Freight (YRC), and TWA (See my LinkedIn Profile).

EDUCATION & CERTIFICATIONS

Bachelor of Science in Computer Information Systems

Central Missouri State University, Warrensburg, MO

CERTIFICATIONS

Scrum Fundamentals Certified Credential – 1/27/17 - #564577

Scrum Master Certification in 2/2017 – Scrum Study - #565763

TECHNICAL TOOLS / SKILLS SUMMARY

Sales Force Marketing Cloud (SFMC), AZURE Cloud, IBM UCEE, ODS, and Genesys/Phone for marketing campaigns requirements

AHA, Rally for Agile project delivery and requirements

IMA’S – Casetrakker Software

Jama, Jira, Confluence, HP/ALM, Roadmunk

Microsoft Team Foundation (TFS), Urban Turtle

QNXT, ODS, Encounters, and Claims Adjudication

Web Azure Cloud, mobile phone apps, and Web portals

Client Server, API, and Web Development

Multiple Infrastructure experience, IBM, UNIX, Linux, and Microsoft

Service Now, Nexus & Clarity Tools

Oracle SQL, SOA, Oracle Cloud – Eloqua and Salesforce CRM Sales Cloud

Microsoft Office 365: Microsoft PowerPoint, Project, Word, Excel, Access, & Visio

Microsoft SharePoint Services

UX/UI - Wireframe tools: Figma, Snag-it, and Balsamic

Phone/IVR: Verint/Kana software

IBM Mainframe Cobol/CICS/IMS/DB2

Case Tools: IEF/Cool: Gen & ADW

PHP, HTML, SQL, Oracle, UNIX & Microsoft Servers, and Hosting Providers

Project Manager

IT Consultant

Team Lead

Subject Matter Expert

Information Engineering SME

Testing, and Quality Assurance

Web Design

Case Tool Developer

Liaison to the Business

Application Developer

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