Information Technology System Integration
Resume:
Jana McAllister Resume’
*** ******** ****, ***** ********, GA 30083 678-***-**** ****.**********@***.*** Business BusinessMayPurdue3.2
Qualification Summary
Seasoned healthcare IT professional with over 30 years of experience in state and federal healthcare systems, specializing in Healthcare Information Technology, system testing, and business analysis. Proven expertise in system integration, regression, parallel, and performance testing, with a strong focus on aligning technical solutions with healthcare compliance standards. Known for planning and coordinating complex initiatives, delivering accurate documentation, and collaborating effectively with stakeholders. Adept at working independently, exercising sound judgment, and navigating high-pressure environments with professionalism.
Core Competencies & Specializations
• Requirements & Documentation
o Develop Software Requirements Specification (SRS) documents, including high-level and functional requirements
o Create and manage Change Request (CR) documents
o Provide Level of Effort (LOE) estimates for enhancements o Prepare User Stories, Test Cases, Test Plans, and Meeting Minutes o Draft and maintain user manuals and process documentation
• Stakeholder Engagement & Communication
o Schedule and lead meetings with business stakeholders to demonstrate system enhancements
o Capture action items, decisions, and follow-ups for stakeholder accountability o Assist stakeholders during User Acceptance Testing (UAT)
• Testing & Analysis
o Perform and document System Integration, Regression, Parallel, and Agile Testing o Conduct detailed claims research and analysis
o Create and manipulate vendor test files for accurate validation o Use tools such as JIRA, Confluence, and ALM to track issues, log defects, and report testing results
o Assist in automating daily production checks for the Medicaid and Medicare systems
• Systems & Tools Expertise
o GAMMIS (Georgia Medicaid Management Information System) – Panel development and testing
o EAMS (Enterprise Access Management System) – Supported transition from paper to electronic form submission
o JIRA & Confluence – Dashboard creation, defect tracking, and reporting o ALM (Application Lifecycle Management) – Defect logging, test planning, and execution
o RMS (Request Management System) – Opened the ASR to track the project until completion
• Healthcare Domains & Regulations
o Member Eligibility Medicare Claims Health Check Reporting Care Management Organizations (CMO)
o Familiarity with HIPAA Privacy Law and compliance requirements o Experienced trainer for new employees, especially within the Member subsystem
• Project Management
o Provided project management support, including planning, estimating, scheduling, and coordination
o Determined project timelines, resource needs, and tracked delivery milestones Business Skills
Applications: MMIS (Medicaid Management
Information Systems), MHN (Multi-House
Network), EDS Medicaid System
(Interchange), and MetaVance
DHS Applications: e-Intranet, Online
Directives Information System (ODIS), Ga
Kinds, Residential Childcare Care Licensing
(RCCL), Refugee Program Grant Invoicing
System (RPGIS), Enterprise Access
Management System (EAMS), Pandemic
Electronic Benefits (P-EBT), and Disaster
Card Inventory Management System (DCIMS)
MMIS Subject Areas: Provider, Claims,
Member/ Health Check, and Care
Management Organizations (CMO)
Methodologies: Agile, Waterfall (SDLC)
Phases: Technical Design, Claims
adjudication, Requirements definition,
Planning, System Testing
Standards & Protocols:
EDI (Electronic Data Interchange)
X12 Transaction Sets (837, 835, 270/271)
FTP (File Transfer Protocol)
Tools & Technology: Mercury Test Director,
ALM, Jira, SharePoint, Agility, Snagit, RMS,
Balsamiq, Microsoft Office Suite (Word, Excel,
PowerPoint, Visio, Outlook)
Leadership/Management Skills:
Team Size: Led cross-functional teams of up
to 60 resources, which included the
stakeholders, Business Analysts, and
Developers
PMI Disciplines: Scheduled Management,
Risk Management, Issues Management,
Resource Management, and Scope
Management
Jana McAllister – Senior Business Analyst
Healthcare Information Technology Testing, Research and Analysis Page 2 of 5
Jana McAllister Resume’
479 Carillon Lane, Stone Mountain, GA 30083 678-***-**** ****.**********@***.*** Professional Experience
Georgia Department of Human Services
Senior Business Analyst January 2022 – Present
● Conducted business analysis for eight state-level applications, ensuring each system met business and technical requirements.
● Gathered and documented requirements for new applications and enhancements in collaboration with stakeholders.
● Partnered closely with Business Owners to understand needs, priorities, and proposed system changes.
● Opened and managed Application Service Requests (ASRs) in the Request Management System (RMS) upon project approval; ensured timely closure upon completion.
● Facilitated Joint Application Group (JAG) and requirement-gathering sessions to align business and technical teams.
● Recorded and distributed meeting minutes within 24 hours to all participants to ensure transparency and accountability.
● Created and maintained project documentation, including Change Requests, Comment Logs, and User Acceptance Approval forms.
● Contributed to the development and automation of the EAMS form to improve efficiency and accuracy.
● Logged and tracked system defects in ALM, collaborating with development and QA teams for resolution.
● Monitored application functionality and performed routine maintenance to ensure optimal performance.
● Authored Software Requirements Specification (SRS) documents to clearly define functional and non-functional requirements.
● Reviewed enhancement requests from Business Owners to assess feasibility and scope.
● Created and updated User Manuals to reflect system changes post-enhancement.
● Performed system testing in SIT and UAT environments, validated data accuracy in Production.
● Provided support to end users during UAT testing to ensure issues were resolved promptly and testing ran smoothly. BlueCross BlueShield of South Carolina
Senior Business Analyst September 2021 – December 2021
● Business Analysis and requirement gathering experience.
● Review business requirements and understand business impacts and product-related technical requirements.
● Support the Product Owner in writing functional specifications.
● Assisted with automating the daily system check within the Medicare system to ensure that the system was able to work as efficiently as possible.
● Write user stories for Development to understand the technical solutions needed.
● Support “grooming” sessions with Product Owners and the Team for Product and Sprint Backlogs
● Test in the Testing environment to ensure that the code is working correctly before moving to the UAT environment for the client to test.
● UAT support during testing.
● Support development resources on the team and research questions as needed with the client.
● Act as the liaison between the client and the technical team.
● Logged defects into ALM and tracked the process of the ticket to completion.
● Conducted tests in ALM in the Test and Qual environments.
● Created ASRs (Application Software Request) in the system to house the important documents associated with a project.
● Updated the manuals and other training materials when new functionality or enhancements were introduced.
● Responsible for coordinating weekly Production Deployments to move code into the system. Page 3 of 5
Jana McAllister Resume’
479 Carillon Lane, Stone Mountain, GA 30083 678-***-**** ****.**********@***.*** Advantasure
Jira BPO Coordinator May 2020 – September 2021
● Monitor predefined dashboards to identify tickets approaching or surpassing client SLA’s.
● Create, update, edit, and publish views of dashboards within the ticketing tool.
● Influence the closure of tickets by contacting and persuading the ticket's assigned owner to resolve and close the ticket.
● Escalate tickets to their respective operational leader where the assignee is unable to resolve within a timely manner.
● Generate weekly reports to leadership that include the number of open tickets, rate of tickets created versus resolved, time to resolve, and related service type/root cause, by solution and client.
● Identify problem areas and recommend operational solutions to enhance the quality of service.
● Identify and recommend end-user training to increase departmental self-sufficiency and reduce time to ticket closure.
● Efficiency recommends Jira system changes to increase customer experience, quality, speed to closure, and operational efficiencies.
Senior Business Analyst April 2019 – May 2020
● Business Analysis and requirement gathering services.
● Review business requirements and understand business impacts and product-related technical requirements.
● Support the Product Owner in writing functional specifications.
● Write user stories for Development to understand the technical solutions needed.
● Support “grooming” sessions with Product Owners and the Team for Product and Sprint Backlogs
● UAT support
● Support development resources on the team and research questions as needed with the client.
● Support UAT and testing of releases as needed.
● Develop documentation, reports, and presentations for all levels within the organization, including executive leadership.
● Collaborates with Subject Matter Experts to develop accurate documents.
● Designed test cases and performed UAT for HIPAA 834 and 820 implementations for MCOs
● Proven experience in Claims/Encounter, X12 mappings like 837 claim, 270/271, 834, ICD10, NCPDP & 835 in 4010 and 5010 formats using Spec builder HIPAA Validator
● Validated test results for EDI X12 transactions, including HIPAA 834, 820, and 837
● Worked with all types of Claims, including Medicare, Medicaid, and Commercial business.
● Troubleshoot payer claims reimbursement or Insurance payment issues for Medicare, Medicaid, and Commercial Insurance 837 electronic or paper claim submissions.
● Participated in the Business Requirements gathering process for GAMMIS, for the ICD-10 Codes and ANSI 5010 X12 Claims EDI Conversion.
● Analyze, define, and document Business Requirements for Business Stakeholders and Development for ICD-10 Remediation and Conversion for the organization's Mainframe Claims Adjudication System for Payer Claims submission.
● EDI processing and interpretation of ANSI X12 files to include formats 837I, 837P, 835, 834, 276/277 and 999.
● Knowledge of CMS-1500, UB04, CPT and ICD-10.
DXC TECHNOLOGY Formerly HEWLETT PACKARD ENTERPRISE SERVICES Georgia Medicaid Business Analyst II June 2008 – April 2019
● Act as Liaison between the Georgia Department of Community Health and HP’s technical development team in the design, development, maintenance, and implementation of the Georgia Medicaid Management Information (GAMMIS) system.
● Participate in meetings and projects with client staff, project managers, and developers to automate, upgrade, or expand applications that accomplish the business operations of assigned work.
● Create, design, and format technical specification documentation, including process flows, and other information or processes needed to describe required system changes or enhancements to GAMMIS for development and other internal customers.
● Assist with Claim Systems Testing approach and Strategies as a Claims SME. Page 4 of 5
Jana McAllister Resume’
479 Carillon Lane, Stone Mountain, GA 30083 678-***-**** ****.**********@***.***
● Claims/ERA/EFT/ enrollment expert
● Develop queries, analyses, or reports from applications for operations or other staff to assist with testing or for general reporting.
● Participate in the delivery of the General and Detailed System Design documents.
● Facilitate and take notes in meetings as needed.
● Develop, execute, analyze, and document system test plans, test cases, and test results.
● Coordinate defect resolutions with the technical developer and retest resolved defects.
● Update iTrace to show the status of the changes to the client and upper management.
● Able to manipulate and mock up different test files from the vendors to perform testing accurately. (SUCCESS, Peach Care for Kids, P4HB, SSI, and SDX input files)
● Determine project estimates and targeted completion dates for projects.
● Provide technical assistance and training to the Department of Community Health analysts, vendors, and coworkers.
● Perform assignments according to the Project Work Plan to ensure tasks are completed on time and in accordance with the project standards.
● Document status reports, issue tracking, and work plan management.
● Record time in the Time Management Tool and CATW.
● Mentored co-workers who were interested in becoming Business Analysts.
● Provide guidance or technical supervision to less experienced staff performing similar functions.
● Trained employees on the functions in the Member subsystem.
● I interviewed potential business analysts for the member subsystem. ELECTRONIC DATA SYSTEMS
MetaVance Business Analyst II January 2005 – June 2008
● Performed research and problem resolution on issues identified by the client from the processing of claims through the MetaVance claims system.
● Developed scope and requirements documents for new enhancements for the MetaVance system desired by the client. Facilitated and scribe meetings as needed.
● Developed, executed, analyzed, and documented system test plans, test cases, and test results.
● Coordinated defect resolutions with the technical developer and retested resolved defects.
● Performed assignments according to the Project Work Plan to ensure tasks were completed on time and in accordance with the project standards.
● Documented status reports, issue tracking, and work plan management. Georgia Medicaid Business Analyst II April 2003 – December 2004
● Served as the primary liaison between the South Carolina Department of Community Health and the System Engineers to implement HIPAA.
● Interviewed the customer and provided Business Process Documents to increase knowledge of claims processing through the South Carolina Medicaid Management Information System (SCMMIS).
● Tested and updated the Dental, Transportation, Nursing Home, and the Professional portion of HIPAA, ensuring that all local codes were cross-walked by national codes.
● Served as backup to the Institutional program for HIPAA, assisting in creating claim data for testing. Tested and documented the adjustment process for HIPAA.
● Completed system testing as directed by the Testing Coordinator and prepared detailed system test plans and System Life Cycle (SLC) worksheets.
● Composed memorandums to the SCDHHS following departmental standards, which fully explain the problem, solution, or situation.
● Composed/edited non-technical documentation through the ENDEAVOR environment. Page 5 of 5
Jana McAllister Resume’
479 Carillon Lane, Stone Mountain, GA 30083 678-***-**** ****.**********@***.***
● Independently researched customer service requests and provided alternative solutions. Interpreted technical narratives to create detailed test plans for the 2003 conversion effort.
● Supported SURS (Service Utilization Review) Subsystem.
● Updated and created defects for the Bug Central report.
● Tested and documented reports for EPSTD, Member, Prospective Payment System (PPS), Retro Newborn, Case Management, and Family Planning.
● Acted as team SME in creating 837 transactions for Institutional, Dental, and Professional claims processed through the SCMMIS Translator.
● Assisted team members with the use of the National HIPAA Implementation Guide.
● Updated status reports weekly; updated working hours by submitting time through SAP. ELECTRONIC DATA SYSTEMS
Georgia Medicaid Electronic Media Claims Unit Lead March 1998 – April 2003
● Managed daily activities for the EMC (Electronic Media Claims) group.
● Assigned and reviewed the work of employees supervised.
● Monitored adherence to schedules and procedures.
● Made recommendations to management on personnel and project-related actions.
● Hired and terminated employees.
● Responded to and resolved customer inquiries and concerns.
● Explained company software and our services, along with recommending EDS products and services to meet the customer's needs.
● Maintained a log of customer inquiries and concerns.
● Followed procedural guidelines to respond to and research the customers’ questions.
● Provided provider training sessions and visited the providers if the field reps could not resolve their issues promptly.
● Worked closely with the System Engineers to implement the Bulletin Board System for Y2K to continue to accept claims electronically.
Major Project Accomplishments
Disaster Card Inventory Management System (DCIMS) – New Application Implementation
• Collaborated with state stakeholders to define high-level and functional requirements
• Created SRS documentation, test plans, and UAT scripts
• Supported the development of system panels for card assignment, reporting, and disaster tracking
• Provided training support and developed detailed end-user documentation
• Logged and managed defects using ALM and JIRA during SIT and UAT testing phases Pandemic Electronic Benefit Transfer (P-EBT) – Data Collection Process Development
• Collaborated with state stakeholders to define high-level and functional requirements
• Designed and implemented the application spreadsheet used statewide to capture and organize student data for P-EBT eligibility and issuance
• Ensured data consistency, improved accuracy, and streamlined submission processes for participating school districts Georgia Medicaid Management Information System (GAMMIS) – Member/Health Check Subsystems Enhancement
• Led requirements gathering, testing, and documentation for updates to the Member/Health subsystems
• Developed Software Requirements Specifications (SRS), Change Requests, test cases, and user manuals
• Trained new team members on eligibility processes and system functionality
• Performed system integration and regression testing in UAT and Production environments Education
Purdue University formally Kaplan University January 2023 – December 2026 Business Administration (Project Management)
Contact this candidate