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Click here or scroll down to respond to this candidateCandidate's Name
Waldorf, Md Street Address PHONE NUMBER AVAILABLE EMAIL AVAILABLESummaryDedicated and results-driven professional with strong background in Healthcare and Integrated Eligibility, Training and Organizational Change Management. Proven expertise in analyzing business processes, identifying improvement opportunities, and driving successful change initiatives. Seeking to contribute my skills and experience to a dynamic organization to enhance efficiency and drive sustainable growth.Core CompetenciesHealthcare and Integrated Eligibility: Expertise and working knowledge of the Eligibility Determination and Benefit Calculations and knowledge of Medicaid (Medical Assistance), SNAP (Food Stamp), and TANF (Cash Assistance) programs.Change Management and Leadership: Ability to lead and guide organizations through significant changes, including developing strategies, managing resistance, and ensuring successful adoption of new processes or technologies.Business Process Analysis: Proficiency in analyzing and assessing existing business processes, identifying areas for improvement, and redesigning processes to enhance efficiency and effectiveness.Stakeholder Engagement: Strong interpersonal and communication skills to engage with and influence stakeholders at all levels of the organization, building consensus and support for change initiatives.Data-Driven Decision-Making: Skill in gathering and analyzing data to provide actionable insights that inform decision-making, support change strategies, and measure the impact of change efforts.Training and Development: Expertise in designing, developing, and delivering training programs and materials tailored to various audiences, ensuring smooth transitions during change initiatives, and fostering user adoption.SkillsHealth and Human Services, Business Process Analysis, Requirements Gathering, Quality Assurance, Change Management, Policy Training, System Training, Training Program Development, Stakeholder Engagement, Data and Gap Analysis, Agile Methodologies, Systems Integration, Cross-Functional Team Leadership, Documentation, Communication, Problem Solving, Leadership, Risk Management, Tools and Software Proficiency (Microsoft Project, Microsoft Visio, JIRA, Smartsheet, SharePoint)EducationMaster of Arts in Business: Management and Leadership (MAML) 05/2013Liberty University Lynchburg, VABachelor of Science: Psychology 05/1999Towson University Towson, MDAssociate of Arts: Elementary Education 12/1996Dundalk Community College Dundalk, MDProfessional ExperienceSr. Business Analyst, Deployment and OCM Lead IV&V 01/2019 to 12/2023DCAS/DHCF - DC Access System/Department of Health Care Finance Washington, DCSuccessfully serve as an integral member of a IV&V team for the DCAS R3 Project, achieving high compliance rate.Successfully completed all IV&V phases, ensuring on-time delivery and adherence to quality standards.Conducted 200+ ongoing checks to verify DCAS compliance, resulting in a successful requirement satisfaction rate.Validated DCAS alignment with 100% of requirements, organizational standards, and stakeholder needs.Efficiently managed assigned IV&V service provider, identifying and mitigating 25+ project risks.Cultivated positive relationships with program areas, facilitating streamlined IV&V management.Reviewed and approved 150+ work products and testing artifacts - Deliverables, expediting CMS attestation successfully.Conducted detailed analysis, resulting in the implementation of more than 30 technical design improvements.Actively contributed to daily meetings (JARS, JADs, Requirements & Design Sessions, etc.), document reviews, and stakeholder consultations, achieving high satisfaction rate.Scheduled and conducted stakeholder interviews to identify business goals they are concerned with, that allowed increased support for overall project success.Evaluated resource performance, recommending development opportunities, and improving overall resource efficiency.Deployment and OCM Lead - IV&VProvided guidance to and led 3 Functional IV&V BAs, ensuring the successful completion of project milestones.Successfully served as the primary point of contact for all change-related activities within the core project, ensuring effective coordination.Reviewed and provided feedback on OCM deliverables, contributing to more than 10% improvement in document quality and alignment.Advised district OCM leads, resulting in significant increase in compliance and change project success.Attended regular meetings, serving as the POC for IV&V Team, facilitating streamlined communication and 20% reduction in review time.Collaborated with OCM team to assess user involvement and buy-in, leading to significant increase in system functionality adoption.Manage Call Center vendor contract and provide leadership to the team in the delivery of high standards of customer service and delivery of established objectives and KPIs.Sr. Business Analyst II/Medicaid SME 12/2013 to 01/2019Cognosante Falls Church, VAReduced 1095A case errors by 10% through meticulous analysis and feedback to the Customer Outreach Team.Supervised and mentored team of 5 EDI Analysts, achieving 15% reduction in error rates in 834 and 820 transactions.Enhanced efficiency by 20% through data extraction and processing from HICS for health insurance claim reconciliation.Spearheaded 20% reduction in discrepancies in eligibility reconciliation process, boosting stakeholder satisfaction.Contributed to successful testing and development across multiple work streams, ensuring efficient business processing improvements.Quality Assurance/ Business AnalystEnsured 98% alignment of the Maryland Health Benefits Exchange (MD-HBE) eligibility systems with design specifications and requirements.Spearheaded the Noridian MD-HBE Error Rate project, resulting in increased improvement in IBM Curam's performance.Conducted daily quality analysis, leading to identification and resolution of 300+ defects in eligibility systems.Executed rigorous testing in IBM Curam, achieving 98% compliance rate with Affordable Care Act (ACA) regulations and Maryland eligibility policies.Validated 1000+ test case scenarios, ensuring precise mapping to programs in strict accordance with ACA rules and policies.Subject Matter Expert (SME) Medicaid Eligibility 07/2013 to 10/2013State of Hawaii, Honolulu, Hawaii (Hawaiian Islands), KOLEA Project Honolulu, HIImplemented KOLEA system, reducing processing time by 20%.Supported establishments of new interfaces, improving application accuracy by 15%.Automated eligibility, reducing errors by 25% and speeding up benefits assessment by 30%.Streamlined processes, increasing program enrollment by 10%.SMEEnhanced Medicaid eligibility processes, reducing processing time by 15% and increasing accuracy by 20%.Resolved 50+ organizational needs through eligibility solutions, cutting operational costs by 10%.Provided ACA guidelines to Federal and Local Government projects, maintaining a 98% compliance rate with ACA and Medicaid policies.Supported projects throughout their life cycle, improving outcomes through system deployment and Go-Live.Test AnalystManaged testing efforts in Siebel 8.2.2 for multiple projects, contributing to 98% on-time delivery rate.Conducted 200+ manual test scenarios for Unit Testing, UAT, and SIT, ensuring comprehensive coverage and 95% defect-free rate.Played key role in identifying and tracking 300+ defects, facilitating their resolution and achieving 90% defect closure rate.Led end-to-end testing, ensuring seamless integration and 100% readiness rate for production.Collaborated in AGILE software development life cycle projects, resulting in 20% reduction in project timelines and 15% increase in project efficiency.Program Analyst/Trainer 07/2012 to 07/2013Department of Human Resources, Office of Programs/Bureau of Policy Baltimore, MDCreated and updated training documentation and achieved 98% compliance with Federal and State laws for all FIA programs in Maryland.Improved program efficiency by reducing errors by 25% through policy and procedure enhancements.Trained 200+ case workers and management, enhancing their knowledge of Medicaid, SNAP and TANF policies.Enhanced departmental efficiency by 30% through needs assessments and policy updates.Increased program effectiveness and compliance by 20% through policy and system implementations.Spearheaded Change Management processes to stakeholders for the state of MD.Led training expansion from in-person only to Web-based remote training.Program Specialist 11/2011 to 07/2012Department of Public Welfare, Bureau of Policy Harrisburg, PAManaged and provided guidance to and led 3 Program Analysts for Inmate Medicaid Program, ensuring the successful completion of project milestones.Facilitated 10+ successful Joint Application Development (JAD) sessions for program creation and modification.Contributed to 25% increase in policy clarity and accessibility by updating policy manuals and publications.Reduced program errors by 30% through development and execution of test scenarios and scripts.Conducted 50+ test scenarios for Unit Testing, UAT, and SIT, ensuring comprehensive coverage and 95% defect-free rate.ManagedEfficiently managed 50+ defect logs and triage processes during end-to-end testing.Income Maintenance Case Worker (IMCW) 01/2008 to 11/2011Department of Public Welfare, York County Assistance Office York, PAGathered information and performed interviews to determine whether a person is eligible for public assistance (Medicaid, Snap and TANF), or access to other social programs.Achieved 95% accuracy in eligibility determinations for state and federal programs (SNAP, TANF, Medicaid).Assisted 2500+ clients in removing financial barriers, enabling more than 25% to qualify for additional support services and enhance self-sufficiency.Counselor III/IOP Coordinator 08/2007 to 01/2008Gaudenzia, Inc., Behavioral Health Substance Abuse Treatment Program Harrisburg, PAUtilized the Stages of Change and Severity Index to note medical necessary and clinically appropriate levels of care for each client.Developed Treatment Plans to track treatment goals, barriers, and overall progress with input of the client.Conducted weekly/monthly therapeutic individual and group counseling sessions.Achieved 98% compliance with state and federal regulations while overseeing daily program operations.Managed records for 100+ clients, enhancing program effectiveness by 15% through quality improvement initiatives and crisis intervention.Certified Supervised Counselor/Clinical Coordinator - Alcohol & Drug (CSC-AD) 11/2003 to 08/2007Institute for Behavior Resources (IBR) Baltimore, MDLed team of counselors in Methadone Maintenance program, increasing efficiency by 75% while ensuring compliance with state and federal regulations.Received repeated rating of top performing counselor in service delivery and documentation.Utilized the Stages of Change and Severity Index to note medical necessary and clinically appropriate levels of care for each client.Developed Treatment Plans to track treatment goals, barriers, and overall progress with input of the client.Conducted weekly/monthly therapeutic individual and group counseling sessions.Conducts weekly medication vs. illicit substance use to determine required medical intervention.Maintained 80% compliance with regulations, resulting in 90% success rate in patient treatment outcomes, including sustained sobriety and reduced relapse rates.AccomplishmentsLed change management efforts for more than 10 new program transitions, achieving 90% satisfaction rate among stakeholders surveyed post-implementation.Led business process analysis project that resulted in 20% increase in process efficiency.Designed and implemented tailored training programs for new software system, leading to 30% increase in user adoption within first quarter.Utilized data analysis to identify cost-saving opportunities, resulting in 15% reduction in operational costs, equating to $500,000 in annual savings.Managed complex project with cross-functional team, delivering it ahead of schedule, reducing project timeline by 20%, and ensuring timely implementation.Led change management efforts for major organizational transition, achieving 90% satisfaction rate among key stakeholders surveyed post-implementation.CertificationsCertified Professional Change Management (CPCM) The Knowledge Academy September 2023Change Management Specialist (CMS) Management and Strategy Institute (MSI) Feb 2020Certified Risk Management Professional (CRMP) ) The Knowledge Academy July 2023Certified Scrum Product Owner (CSPO) Scrum Alliance October 2020Certified Scrum Master (CSM) Scrum Alliance September 2020Independent Verification and Validation Technical (IVVT) Independent Verification and Validation Institute (IVVI) August 2020Independent Verification and Validation Associate (IVVA) Independent Verification and Validation Institute (IVVI) May 2020MembershipSAFeIVVI MembershipBRYDGES A non-profit organization for youth and young adultsCenters for Medicare & Medicaid Services - Health Insurance Exchange Discussion Forum |
