Quality Assurance Project Manager

Dominique Nedd’Blake

**********@***.***

Working in a challenging position in the area of networking that provides a highly motivated, progressive, friendly environment, which allows the pursuit of career advancement and expand my knowledge and skills.

Profile

As a result oriented individual! Expertise is broad in scope, as a Team Player for Reliance QA (RQA) with twelve plus years of progressive experience in the area of Software Quality Assurance (SQA) testing verification validation processes, responsibilities includes but not limited to ensuring compliance with all relevant QA projects/products requirements and guidelines. As a Business Analyst gathered requirements with product/project leadership, a skilled liaising in the IT community, excellent communication skills and experienced in across technical platforms and environments. Possess a technical aptitude and a high level of analytical ability, trained in the use and creation of multiple testing tools and applications customization for proprietary uses. I understand and believe in the integration of techniques; I learn more and do more while adding value to the team and I am able to handle complex situations and aggressive deliverable schedules in an organized fashion within multiple environment settings.

Industries:

Gained experience in various industries such as: IT Human Resource Recruiting Consulting, Insurance, Financial, Hospital/Health Care, Utilities, Banking, Mortgage, Textile, Architecture, Media, Solutions and Customer Care, Manufacturing, Industrial, Personnel Outsourcing, Distribution, Computer, Security, Retail and in the Accounting industries.

Summary of Qualifications

A team member who functions with the execution of high level IT plans in roles as a SQA Analyst, Business Analyst, Project/Product Manager, and in cross-functional, multi-location environment(s).

Strengths:

Software quality process improvement practices, software testing practices.

Best Use of Skill Sets:

While participating and contributing as a team member in multiple roles also recognize opportunities for improvements, propose recommendations and implementation of approved changes.

APPLIED SKILLES SUMMARIES

1. As a Director of Quality Assurance Division

Reliance QA, LLC: Reported to RQA President, CTO, and the Director of Solutions Engineering and took an active role as a member of the RQA management board and corporate project teams. Developed metrics and reporting tools that enabled managers to monitor their progress towards the attainment of quality objectives.

Responsibilities

Provided guidance to the RQA teams and responsible for handling and investigation of new and modified business partners, business resource clients and of the human resource processes. Participated in the development of RQA verification and validation strategies and processes, to ensure quality in the areas of customer satisfaction, operational compliance, continuous improvement, and new initiatives that supported the overall business results

Conducted consultations to determine clients consulting needs, worked closely with RQA clients hiring managers to determine the specific job requirements and compensation for each open requirement. Reviewed the carefully sourced, screened and through referenced checked candidates, and submitted only those who are the most qualified to the client hiring managers while scheduling interviews with all appropriate staff. Negotiated offers and closed with the right candidates. Recruited, hired, and retain QA staff including QA managers, engineers, and technicians, through coaching, mentoring and developing their QA and leadership skills. Duties include supervising the quality assurance (QA) division; providing strategic leadership and vision to the department as well as RQA on site contractors; establishing best practices and guidelines in the area of QA.

2. As a Product/Project Manager and Quality Assurance

Worked with Harvard Pilgrim Healthcare (HPHC) to replace the existing HIPAA 4010 transaction set to HIPAA 5010 transaction in order to promote greater use of electronic data transactions - ( 270/271, 276/277, 834, 835,837(I/P)) Quality Assurance HIPAA 4010/5010EDI Electronic Data Interchange and to begin preparations for the conversion of ICD-9 to ICD-10 projects.

Worked with Deloitte & Touché and USAA in-house IT organization serving their employees to ensure the product development process is not just manufacturing a technology, but creating a product that end users will be able to use. I was responsible as an advocate for the customer’s needs and desires. As separate entities I was part of the product development performed by a cross functional team whose goal was building, operating, and maintaining the product. Team members included Product Managers, Developers, Project Managers, Product Operations Engineers, Customer Support Managers, Quality Assurance Engineers, User Interface Design Engineers, Marketers, Financial Personnel, and Graphic Artists. I lead and coordinated my products toward the end goal of making the product a reality, by testing, launching, operating, and managing it throughout its life cycle.

Responsibilities

On the HPHC client site; plan, organize, direct, control and evaluate the activities and operations related to quality control and assurance. The goal of the project was to replace the existing HIPAA 4010 transaction set to HIPAA 5010 transaction in order to promote greater use of electronic data transactions - 837 I and P Claim Submission - 270/271 Eligibility Inquiry and Response - 276/277 Claims Status Inquiry and Response - 278 Referral Authorization Notification Request and Response; Inquiry and Response - Quality Assurance HIPAA 4010/5010EDI Electronic Data Interchange and to begin preparations for the conversion of ICD-9 to ICD-10 projects.

Develop and implement policies, standards and procedures for the engineering and technical work performed with QA contractors firms. Consult and negotiate with clients to prepare specifications, explain proposals and present engineering reports and findings. Assign, co-ordinate and review the business analyst and the technical work of the project teams. Recruit personnel and oversee development and maintenance of staff competence in required areas and participate directly in the design, development and inspection of projects

3. As a Software Quality Assurance (SQA)

Twelve plus years experience of Quality Assurance (QA) validating and verification processes, developing and managing software QA programs and teams. Possess strong written and verbal communication skills, problem solving skills and able to work well with and contribute in a team environment. QA Team Lead: Ten years of experience as a SQA and Quality Control engineer in a team environment and as a team lead in a cross-functional, multi-location environments, writing and executing high level test plans and test cases and performing all types of testing (system, functional, installation, acceptance, browser compatibility, load, stress, performance, volume); Five years of experience managing software QA programs.

Responsibilities

My first loyalty as a QA Professional is to the business purposes being addressed through the IT project. Provided timely verification and validation processes and independent and objective reviews of projects, their progress and their difficulties including but not limited to an assessment of the quality of deliverables. Processes: First: Created the test cases, scripts and scenarios. Second: Execute and or supervised the execution of the test cases, scripts and scenarios. Third: Facilitated and or performed random (ADHOC) testing of all components to ensure that there's not a random bug haunting the system.

Relationship: Provided ongoing advice, counsel and recommendations to a project team, steering committee and/or executive sponsor.

Requirement Conversion: Worked as a team to convert the requirements and design documents into a set of test cases, scripts, and scenarios which was used to verify that the system met the client needs. The collection of test cases, scripts and scenarios is collectively referred to as a test plan that provided an overview of each of the test cases. The testing cases, scripts and scenarios were also used to validate that there are no unexplained errors in the system.

Documentation: Developed test plans and strategies addressing all factors related to the successful completion of the project and its integration into production. Prior to an engagement, and as part of the QA plan, I clearly defined the roles and responsibilities of QA providers and mutually agreed upon by the client, the provider and approval authorities. The plan also addressed reporting relationships and governance, including but not limited to issue escalation and resolution.

Deliverables: Formalized the QA reporting established in the QA plan that was done at appropriate intervals and/or around major milestones, and addressed whether deliverables are acceptable, whether sufficient progress is being made to meet upcoming milestones; whether milestones are met on schedule; and, once met, the level of agency preparedness for subsequent phases.

4. As a HIPAA EDI Business Analyst / Test Specialist

Five plus years experience as a HIPAA EDI Project Manager, QA Lead, and Business Analyst and in the HealthCare environment. Worked with clients such as HPHC, ADP, PHCS, BCBS WellPoint , WebMD and Sentara Norfolk General Hospital and their external Trading Partners (TP) to develop, test, support, and implement transaction sets in accordance with ANSI X12, HIPAA 4010/5010 standards and client's standards. Experience with the Electronic Data Interchange (EDI) standards and process of ANSI transactions; including routing, transformation, messaging, audit and validation. Knowledge of the following HealthCare EDI Transactions: 834, 270/271, 837 I and P, 835, 276/277, 278, 997, 999, 277CA and TA1.

Responsibilities

To comply with HIPAA requirements, HPHC prepared to transition from the electronic health care transaction standards to version 5010 standards. Conducted gap analysis between 4010/5010 transactions with HPHC and their trading partners. No paper claims were affected by HIPAA 5010 implementation

Utilized the Companion Guides to supplement the HIPAA Standard Implementation Guides for documentation, testing and setup of the electronic claims-related transactions. Specifically, used the guides to clarify when conditional data elements and segments is to used, and to identify codes and data elements that does not apply to HPHC.

New England Healthcare EDI Network (NEHEN) provided access to transactions through their Web site. In order to simplify transaction information for providers, payers of NEHEN collaborated to produce new combined 837 Companion Guides.

Exchanged administrative data according to the Council for Affordable Quality Healthcare's (CAQH) Committee on Operating Rules for Information Exchange (CORE) rules.

TIBCO: Service-Oriented Architecture (SOA)-Web service platform supported the communications between services used as part of the cloud computing shared resources environment. TIBCO manages information, decisions, processes and applications in real-time

Work with ADP, PHCS, BCBS WellPoint, WebMD and Sentara Norfolk General Hospital business requirement protocol, Business SMEs and Carriers to define requirements for EDI Transaction Sets. Gathered business requirements (file frequency, layout, business rules, est.,)

Worked with HIPAA Implementation Guides and carriers Companion Guides for compliancy

Experience facilitating JAD Sessions and documenting requirements as well as verbal communication conducted via phone with multiple carriers.

Created gap analysis side by side client document into a high level design documents

Validation of data design, data validation and data mapping from ANSI formats to proprietary formats; and from the proprietary format back to ANSI formats. This also includes interpreting the data with familiarity of the structures.

Created logical and physical design documents for EDI Transactions and Code Sets.

Participated in conversations of upgrading from 4010a1 to 5010 and building a new infrastructure for 5010, using the new Service Oriented Architecture (SOA) platform. Part of the goal involved taking all the different moving pieces, including the current standards, the Client’s, and the 5010 standards and mapping them all together.

Created and develop the Test Plan, Test Scenarios and Test Cases - Tested format and content

Carrier Testing Validation to ensure HIPAA Compliance

Verified that the a TA1 Functional Acknowledgement for transactions received by the corresponding X12 response or a 997 response was not return

Experience working in complex environments with integrated systems

5. As an ICD9/10 Business and Test Specialist

To assist with enabling HPHC clients become ready for the October 1st 2013 International Classification of Disease (ICD) ICD-10 Compliance, Adapted adequate knowledgeable on ICD-10/ HIPAA 5010 requirements and implementation. Validation upon the Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) coding systems changes – that all providers currently using and reporting CPT and HCPCS codes for both the Clinical Modification System (CMS) UB-04 and 1500 claim forms will be able to continue to do so.

Responsibilities

ICD-9/10 Readiness Impact Assessment Approach/Mapping: Gained an understanding of ICD-9/10-CM (Diagnosis), ICD-9/10-PCS (Procedures Codes) – The mapping process: General Equivalence Mapping(s) (GEMs), ICD Code Set Mapping, CMS Reimbursement Mapping and the ICD 9/10 Code Set Maps.

ICD-9/10 Business Requirements: Assisted in the preparation for the conversion of ICD-9 Codes and understanding of ICD-10 initiative - Documented requirement analysis /impacts via (WHO) World Health Organization’s ICD-10, (AHIMA) American Health Information Management Association and the American Payer System (Health Claims – Institutional and Professional). Reviewed policies, procedures, contracts, and other business objects currently affected by the use of ICD-9 codes.

ICD-9/10 Quality Assurance: Examination of the ICD-10 Quality Initiative for the business functionality to determine the different actions needed to be taken due to new granularity and redefinition of diagnosis and procedure codes to provide the details for creating traceable requirements and estimates for resource planning. Interview end users to solicit the impact of the IT Systems and Processes to ICD-10 - gather and analyze input from a variety of sources including analysis results and feedback from the user and the vendor/trading partner’s community. Performed analysis of the business requirements and developed requirements and/use cases. Reviewed data (provider/client) and environments availability (payer, provider & trading partners) for testing along with multiple test data sets. Reviewed Integration Impact by validating the impact of what is currently coded and what will need to be coded with ICD-10 and understanding the different impact points of trading partners, vendors, payers, providers and physicians.

6. As a Business Analyst / QA Test Specialist

Gained experience with clients such as, Mount Vernon Mills Textile Company, Access CoverageCorp.com and Sentara Norfolk General Hospital as a Business Analyst. Gained three years of experience to include meeting with client, management and employees to determine what areas take top priority and need to be addressed. Analyze important data related to the business such as records, manuals, guides and other pertinent documents in order to decide how to proceed. Perform training sessions when applicable, constructed new procedure manuals, instituted new procedures and took other important and necessary steps towards resolving issues/problems within the business. Prepared graphs, charts and analyze documents which showed changes to be taken by the company and why. Showed steps taken to and for improvement by documenting the end report as a result of the analysis.

Responsibilities

Business Analyst experience include meeting with client, management and employees to determine what areas take top priority and need to be addressed.

Analyzed important data related to the business such as records, manuals, guides and other pertinent documents in order to decide how to proceed. Perform training sessions when applicable, constructed new procedure manuals, instituted new procedures and took other important and necessary steps towards resolving issues/problems within the business. Prepared graphs, charts and analyze documents which showed changes to be taken by the company and why. Documented the end report showing the steps of improvement taken as a result of the analysis!

TECHNICAL SKILLS

Extensive experience with Windows 2000 workstation and server operating systems , Microsoft Office products including Project and Visio, Mercury Interactive products Test Director and WinRunner.

SDLC: Software Development Life Cycles Methodologies: Software engineering methodologies and logical process used to develop information, including requirements, validation, training, and user ownership.

o Waterfall: Sequential software development process, through the phases of Conception, Initiation, Analysis, Design (validation), Construction, Testing and maintenance. (downward movements)

o Agile: Requirements and solutions collaboration between self-organizing and cross-functional teams.

o Extreme Programming (XP): Improvement of software quality and responsiveness to the changing of the client requirements.

o Six Sigma: Improvement of the quality of process outputs by identifying and removing the causes of defects/errors and variation in manufacturing and business processes.

o V-Model: An extension of the waterfall model. Instead of moving down in a linear way, this process steps move upwards after the coding phase.

o Verification and Validation: Checks that the software system meets specifications and that it fulfills its intended purpose. This is normally part of the software testing process of the project.

o Open Source: Determine whether or not the software license can be considered open source permits users to use, change, and improve the software, and to redistribute it in modified or unmodified forms.

o Rational Unified Process (RUP): Based on content elements, describing what is to be produced

o Others: IEEE Systems Life Cycle, Application Solutions Life Cycle Consulting Methodology (IBM), Solution 2000 (IBM's Y2K methodology)

Internet-Based Applications: Twelve plus years of QA experience verification and validating processes, developing and testing database-driven applications with web interfaces; experience with Windows NT and UNIX server environments; thorough knowledge of Internet standards (HTML, HTTP, CSS, CGI, etc.), web site design principles and software usability practices.

Limited SQA Automation: HP Quality Center, Mercury WinRunner, TestBench 400, EZ-T, Rational Test Manager and ClearQuest.

Platforms: UNIX, Linux, Windows (95, 98, Me, NT, 2000, XP, 2003), Macintosh, MS-DOS

Programming Languages Environments: Experience writing SQL queries and XML and EDI data creation. Perl, SQL, JavaScript, PHP, UNIX shell, SilkTest 4Test, SilkPerformer Benchmark Description Language, HTML, CSS

Database Systems Environments: J2EE, Access, SQL, DB2, Mainframe, CICS and other Database Testing Skills, Oracle, MySQL, PostgreSQL, Microsoft SQL Server, Microsoft Access, Trizetto Facets Workstation 2.961, Rational Clearquest, Sybase SQL Advantage database.

Other Software: VistA, TIBCO, Test Director, VISIO, Microsoft (VSTS) Visual Studio Team System, TOAD, Microsoft Exchange, Windows domain administration, Lotus Notes administration, Linux, Sun OS, Solaris, MVS/OS, DOS/VSE, OS/2, MS/DOS, AS/400, IBM Mainframe, Guardian, Best X, Post Closing 2000, HUMDA, Legacy System, TKO, Solomon. Rational Tool Set. MS Project, Word, Excel

Financial Applications: AP Loan Bridge, Peoplesoft , Matrix, Closing Agent, and LOS System (Loan Origination)

Operating Systems: Windows 95/98/NT/2000/XP, Unix/Linux, Novell Netware

HIPAA EDI Validation Tools: EDI HIPAA Transactions HIPAA Desk -EDIFecs, ClearEDI, FacilEDI, Pervasive and American Coders. Foresight EDISIM 5.0 Test Data, Validator Community Manager, HIPAA Validator on-line Analyze and Compare Data against EDI, AIMS 2002 Status Report Database, Access Test Scripts Database. EDI Complete, HIPAA Accelerator, Washington Publishing Company. E-Price, CSV, XML,

Knowledge of the following HealthCare EDI Transactions for 4010/5010

o (834) Benefit and Enrollment:

o (270/271)Eligibility Request/Response:

o (837 I & P) Institutional and Professional HC Claim

o (835) Payment & Remittance Advice

o (276/277) Status Inquiry/Response

o (278) Referral Certification and Authorization

o (997) Functional Acknowledgement

o (999) Replaces the (997) Functional Acknowledgement of HC Insurance

o (277CA) Claims Acknowledgements

o (TA1) Interchange ISA/IEA

ICD-9/10 Readiness:

o ICD-9/10 Readiness Impact Assessment Approach/Mapping

o ICD-9/10 Business Requirement Documentation Preparation

o ICD-9/10 Quality Assurance Assessments

CLIENTS(s): Contracting Work History

June 2011 – Present: Reliance QA - Dell/Harvard Pilgrim Health Care Wellesley, MA

o HPHC - Project Manager - HIPAA 4010/5010 Conversation June 2011 – August 2011 www.HarvardPilgram.org

o RQA - Director of Quality Assurance Division - June 2011 – Present www.RelianceQA.com

June 2009 – Present: Express Yourself Talk Therapy – San Antonio, TX www.ExpressYourselfTalkTherapy.com

Contemporary Talk Therapist

May 2009 to June 2009: TekSystem - ADP – Miami, FL http://www.ADP.com

HIPAA 4010 EDI Electronic Data Interchange: Business Analyst/Senior Test Engineer

Nov 2008 to Jan 2009: RMS - Dell – Round Rock, TX http://www.Dell.com

QA Lead: Senior Test Engineer

Dec 2007 to Sept 2008: TekSystems – Limited Brands - Columbus, OH http://www.LimitedBrands.com

QA Lead: Senior Test Engineer

Sep 2007 to Dec 2007: TekSystems - Bank of Oklahoma - Tulsa, OK http://www.bok.com

Software Test Engineer: QA Lead (STE)

April 2006 to June 2007: TekSystems - Deloitte & Touche - Nashville, TN http://www.deloitte.com

Senior Quality Assurance - Product Manager

October 2005 to March 2006: Sigma Systems Inc - PHCS (Private Healthcare Systems)– Waltham, MA http://www.phcs.com/

HIPAA EDI: Business Analyst Senior Quality Assurance Team Lead (Acquired by MultiPlan in October 2006)

June 2004 to August 2005: TekSystems - USAA - San Antonio, TX https://www.usaa.com

Senior Quality Assurance Team Lead - Product Manager

August 2003 to April 2004 TekSystems - Anthem BCBS (WellPoint) – Indianapolis, IN http://www.Anthem.com

HIPAA: Senior Quality Assurance Team Lead

March 2003 to August 2003: TekSystems - WebMD - Nashville, TN http://www.webmd.com/

HIPAA: Business Analyst Senior Quality Assurance Team Lead

November 2002 to March 2003: TekSystems - Deloitte & Touche - Nashville, TN http://www.deloitte.com

Senior Quality Assurance Team Lead - Product Manager

May 2002 to November 2002: Ajilon - Total Systems – Columbus, GA http://www.tsys.com

Quality Assurance Team Lead

February 2002 to May 2002: Tek Systems - Mount Vernon Mills Textile Company - Columbia, SC http://www.mvmills.com

Business Analyst Senior Quality Assurance Team Lead

May 2001 to September 2001: Modis - D1/HouseHold International Mortgage - Charlotte, NC http://householdwatch.com

Senior Quality Assurance Team Lead

June 2000 to April 2001: Modis - Access CoverageCorp.com - Charlotte, NC http://www.accesscoveragecorp.com/

Business Analyst /Quality Assurance Testing Team Lead

December 1998 to February 2000: Maxim Group/Tek Systems - Sentara Norfolk General Hospital – Norfolk, VA http://www.sentara.com

Quality Assurance Test Lead / Business Analyst/Y2K~HIPAA

September 1998 to November 1998: Computer Horizons - Convergys - Jacksonville, FL - http://www.convergys.com

QA Group - Y2K Test Engineer

Other Professional Experience

Contemporary Talk Therapist: ExPress Yourself Talk Therapy is dedicated to helping empowering individuals to live more responsibly in every area of life. To optimize health, maximize life and prevent disease by guiding individuals toward naturally restoring balance and harmony from within.

Further work elaboration and further employment history from June 1977-August 1998 would be furnished upon request.

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