Business Analyst Management

JOSEPH EGBE / US CITIZEN

**** **** ******** ****, ******* Mill, MD. 21244 TEL: 443-***-**** EMAIL: *****@*******.***

SUMMARY:

Joseph is an accomplished Senior Business Analyst with a track record in Healthcare IT (EHR, EMR, Medicare, Medicaid and PBM). He has over 12 years of experience with Electronic Health Records Systems to include:- Epic Care(EMR), eClinical Works(EMR), Facets healthcare(EHR), and TrueCare(EHR). He is very knowledgeable in Epicare (i.) Willow(Pharmacy:-inpatient/outpatient, inventory, and (ii.)medication admin records), (iii.)Nurse Triage, (iv.)Behavioral Health, (v.) Orders, (vi.)Referrals, (vii.)Beacon:-Oncology, (viii.)Immunization,(ix.) Admissions Discharges and Transfers(ADT), (x.)ASAP(emergency room ), (xi.)Clinical Case Management, (xii.)Beaker(laboratory Information Management System-LIMS, (xiii.)Computerized Provider Order Entry(CPOE), (xiv.)Radiant(radiology) and other Clinical Practice Model and workflows, Automation Testing, UAT & Requirements documentation in the EHR/EMR Care Plans processes. He has Served as a facilitator in core healthcare EHR/EMR IT programs. He Liaised between IT and business Stakeholders, and Managing project matrix. He is proficient in design, build and Validation of Clinical workflows for several Care Plans with the Epic Healthcare Product Modules, Facets Healthcare product modules, eClinical Works Product Modules and TruCare Product Modules

TECHNOLOGY TOOLS:

FACETS Healthcare Product module Configuration

EpicCare: EMR, Clinical Practice Management

eClinical Works EMR Care Plans Management

TRUCare EHR Artifacts Config, and TruCare Security

SQL Server: - RDBMS, T-SQL,

Project Management: MS Project, Share Point & Jira

Microsoft Office 2024 Suite

Data Modeling: Erwin 7.3.1

Workflow Design with Visio 2024

Agile/SCRUM Master

EDUCATION:

Master of Science in Manufacturing Systems Engineering, Minnesota State University, Mankato, MN

Bachelors of Arts in Economics, Minnesota State University, St. Cloud, MN

Bachelors of Science in Computer Science, Southwest State University, Marshall, MN

PROFESSIONAL EXPERIENCE:

KENTUCKY STATE MEDICAID/MEDICARE SYSTEM JUNE 2023 – PRESENCE

BUSINESS ANALYST MEDICAID/MEDICARE (Gainwell View-360 EHR)

Document the as-is” infrastructure of the legacy system. Analyze of Provider Enrollment Management System(PEMS)

Managed Provider Onboarding, Credentialling/recredentialing, Provider Data Management, Sanctions and Monitoring

Analysis and Designing Provider Data Management and Unifying ProviderID, NPI, MedicaidID, and Taxonomy code.

Analysis, requirements and design of Contracted providers in MCOs and FFS

Maintain real time Provider information to include: MCO affiliations, PCP status Type and Start and End date, & Specialty

Define Business Strategies on how to deploy EHR tools and managed multiple interfaces

Manage the patient Portal to enable patient facing communications with providers.

Documented Medicaid and Social Program Management services to include; Low income, disability, mental health and primary health while according these services with specialty providers(organization).

Experienced in Agile/Scrum methodologies within healthcare environments, facilitating rapid adaptation to evolving requirements and ensuring efficient project delivery while maintaining focus on patient-centric outcomes.

CENTENE HEALTHCARE – Configuration and Security Access Control. JAN 2022 – JUNE 2023 CONTRACT ROLE: BUSINESS ANALYST, QA, and UAT/HEALTHCARE IT

Managed Security Access for TruCare Classic Controls (Add and Remove, Modify) access for Provider Services

Used the Role Metrix Information to determine the right application access role for each provider

Conduct a QA analysis of the Role Metrix Table and Test Functionality of the roles granted and Validate with UAT.

Proactive in Security Team Discussions to modify, fix and or re-organization various clinician Practice access modes.

Ensure the patient-Provider communications portal(HUB) is simple and user friendly.

Planed and led JAD sessions and creating functional design documents

Conducting UAT/unit testing, ensuring System is working as designed and Using SQL to validate data.

Functioned as part of an integrated team sharing, advising and receiving peer reviews of products, and best practices,.

Take the first shot at UAT by completing the Unit Testing of every completed task to see how it matches with the requirements

EBLEM HEALTH - NEW YORK / NY- MEDICARE / MEDICAID APRIL 2019 – NOV 2021

COGNIZANT / FACETS HEALTHCARE PRODUCT CONSULTING BUSINESS ASSOCIATE

Part of Configuration team, and Change management plan to migrate from legacy systems to Facets Modules

Mitigate the anticipated impact of change on resolve

Supported the Provider Enrollment Management System(PEMS) in the Facet Model, TRUPROVIDER.

Work with IT in a Collaborative effort to identify opportunities for increasing process efficiency

Supported Facets Healthcare Product models” Member enrollment and Eligibility, Plan Benefits, Provider Networks,

Trained Team Members on TruProvider:- Configured and Supported Provider Credentialling and Provider Data Management, Provider monitoring and sanction into an automated digital process.

STATE OF MARYLAND- HEALTHCARE SYSTEM (DPSCS) JUL / 2017 – APRIL 2019

PMO / BUSINESS ANALYST – ELECTRONIC PATIENT HEALTH RECORDS (EPHR)

Worked as member of a PMO team, acting as a business analyst to outline, Project Purpose, Scope and directives.

Developed contingency plan and Directives for the new EHR Product Design and Configuration.

Conduct JAD sessions with teams of different clinical Units/stake holders of the HER

Analyzed the Impact of Change Management,

Manage the Change Management implementations in Modular steps to minimize errors and resistance

Documented the current and Future State of the EHR.

Documented requirements for the following clinical service units: Labs, Medical, Mental Health, Dental, Pharmacy, Outpatient and Inpatient encounters.

Provided Human Service while assisting patient with the organization.

Facilitate communications across functional tracks of the project for the project Management Team

HEALTH PARTNERS HOSPITAL SYSTEMS (EpicCare CONTRACT), OCT 2015 - JULY/2017

BUSINESS ANALYST / Electronic Medical Record (EMR)

Gather Clinical/Revenue cycle reports requirements in JAD sessions with Clinical/ Financial Management teams

Developed and build Clinical/Revenue cycle reports in BO Crystal Reports XI and visualization Dashboard reports in Reporting Workbench, and Verify all Diagnostic codes, CPT codes, and Revenue billing codes.

Develop Test Case and Test Scripts for User Acceptance testing.

Design contingency plan for new Clinical / Financial Report Release or Optimization

Support all the phases of EpicCare Ambulatory Product Configuration and Change Request.

Design and Build Clinical and Claims/Financial Reports for the Clinical Practice Management team.

Modify existing clinical Reports, Design and build new ones, and make data available for Dashboards

Work with IT to resolve, optimization issues, Data Deprecation and Data Inconsistences.

Exert knowledge of HIPAA and Healthcare Compliance standards

EAST BOSTON, NEIGHBORHOOD HEALTHCENTER, BOSTON, MA APRIL 2013 - SEP 2015

FUNCTIONAL BUSINESS ANALYST-Electronic Medical Record (EMR): -

Analyzed data, logical data modeling, created class diagrams and ER diagrams in Rose for designing databases

Build, maintain, and support Ambulatory Clinical Reports in Epic RWB system and SAP BO Crystal Reports

Build, maintenance, and support Clinical Reports in Epic RWB system and BO Crystal Reports

Provide expert advice to Epic report Users on BO Crystal and Reporting Workbench (RWB).

Configured Mychart-Oncology:- procedure logs, flow charts, and outpatient synopsis

Design Clinical Workflows to support anesthesia billing-charges from clinical Systems, Anticoagulation therapy, Behavioral health – intake Department, Clinical labs sendouts, bone Marrow transplant recovery, Clinical support Visit and Immunization just to name a few.

With Team Effort put together Mychart Functionality documents.

Utilize ticket tracking software to manage priorities and optimize customer support

KAISER PERMANENTE HEALTH SERVICES, PLEASANTON, CA

BUSINESS ANALYST-(EPIC Care) JUL 2010 – MARCH 2013

NCAL RBO: ePremis Billing and Claims Processing System

Managed Configuration Build and maintenance for Epic Care Ambulatory

Gathered Requirements, write specifications, design work flow analysis

Managed Off-Shore data base Development Team and Coordinated onsite teams to resolve major build issues

Manage new facility enrollment in ePremis and Facility mapping issues

Manage the User security Access by User Group Templates or by Role Access Point

Manage Updates of Provider Data and Specialty Types ETL from CPM to ePremis

Managed, Capture and Analyze all NCAL RBO ePremis Issues and resolved with ePremis-IT Acs

Supported Medical Device Management, MAR, Oncology Management, Clinical Orders, and Referrals

Conduct JAD sessions to fine solutions to outstanding billing errors on ICD-9 transition (4010 - 5010) to ICD-10

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