| Candidate Information | | Title | Software Development Information Technology | | Target Location | US-GA-Stone Mountain | | Phone | Available with paid plan |
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Click here or scroll down to respond to this candidateBiographical SummaryInformation systems professional with 15 plus years of experience encompassing software development life cycle, Project Management supervisory experience in addition to Database design and normalization. System Administrator in systems development for clinical imaging, business unit workflow, call center backend systems, and member/provider web portal(s). I possess an exceptional work ethic with proven on target high performance results in the areas of data software development, software interfacing, software conversion, data mining, data storage, and customer service. Data Conversion preparation for database input using EDI integration layer supported system design. Data mapping, and testing activities to enable business rules to process enrollment, claim, eligibility, claim status, and accumulator data cleansing. Lead in CMS data collection coordination and collaboration for QRS (NCQA, HEDIS). Measure analysis using SQL and SAS to evaluate elemental data set requirements and testing of statistical output of data concerning claim system processing.EDUCATIONUniversity Of PhoenixBachelor Of Science in Information Technology Cum Laude - 3.51Associate Of Arts with A Concentration in Information Technology Honors - 3.46Phoenix, AZJuly 2016 November 2019July 2016 March 2018City University Of New York BMCC CampusNew York, NYMajor: computer science minor in mathematicsSeptember 1988 - June 1993System Technical SkillsCertificationsSCRUM MASTER AD# PHONE NUMBER AVAILABLE, SAFe 4.5 PM/PO ID: PHONE NUMBER AVAILABLE,EPIC Certification with Piedmont Hospital in Atlanta GA 2019,ITIL Management cert.Software Development Tools:Jira, Jira Align, Confluence & Rally experience. API Interfacing Tableau, MS SharePoint, MS Visual Studio, SSRS, SSIS, MS SQL Management Studio, Crystal Reports, SaaS, MS Project, Visio, Excel, Word, Access, PowerPoint, Visual Basic/.NET, XML, JSON, HTTP, SSH, SSL, and DNS, HTML/CSS/JavaScript, Java, AEM (Adobe Experience Manager), Adobe Digital suite, Python, AHA.Databases:Oracle, PL/SQL, MySQL 12, Sybase, Ingres, MS Access, Mongo on AWSMilitary ExperienceUNITED STATES ARMY RESERVESFort Hamilton, NYStaff Sergeant (Warrant Officer Candidate)Military Police (31B) - Personnel Record Specialist (75D), Training Instructor (H)May 1986 March 2000Responsible for managing contraband searches and inspections, inventories, maintains physical control of logs, keys, tools, weapons, and related equipment.Accountable for all team members' development and training to meet each task assigned technically and tactically proficient. Managed the maintenance and updating of all personnel files in the database for all national units assigned by or to unit command.Oversaw and managed the initiation and development of work and security procedures supporting all Company Battery and Troop Detachment or other organizations under and outside of Unit command.Responsibility for the custody, security, and care of all personnel through adherence to policies and standard operating procedures.I supervised 30-45 team members during the movement of prisoners for all stateside and foreign shore military police units. I managed a staff of 25 plus to accomplish updates of prisoners personnel files within all units in the region.Supervise normal military police activities such as weapons, troop movement, schedules, and tactical performance details.Professional ExperienceAutomation Personnel ServicesKennesaw, GAConfiguration AnalystFebruary 2024 CurrentPerform new system and updated imaging to servers and personal computers in accordance with business requirements and the standard operating procedures.Apply new and updated system BIOS to project designated systems to be distributed to selected end clients.Handle enrolling systems for selected end clients with preselected/predetermined enrollment configurations. I provide hardware configuration (i.e. hard drive, memory, Monitor Vesa mounting, Video Cards, etc. I apply asset tag on all distributed servers, personal computers, and laptops with corresponding system imaging.I possess a strong technical background in software engineering, with a focus on mainframe technologies and real-time processing. Provide customized laptop and personal computer etching. Update systems into the Warehouse Management Systems for inventory management accountability.Capgemini (Sogeti) USADayton, OHProduct ManagerOctober 2022 February 2023Responsible for defining & communicating the overall vision, objectives, and goals of the business with the development and quality assurance team in relation to the minimum viable product in the Commercial & DHP data synchronization of Claims domain. Manage the link between development, QA, and business clients by ensuring the technical solution developed satisfies the requirement value. Provide managerial oversight and final review of all product backlog user stories, unit testing, QA testing, and production readiness release of the product vision. Provided reports regarding reviews.Responsible for the product backlog management, prioritizing user defined stories, and prioritizing. the business requirements. Document functional specifications as well as vetted contingency plans in case of risks or roadblock occurrences. I have successfully implemented clinical data interfaces utilizing Application Protocol Interface (API) for internal and external value-based care partners.Prepared data structures for sending and receiving information to be translated for both internal databases and external database systems in formats such as JSON, XML and UML to complete member clinical business processing.Successfully provided product structure for market r elease through the following collaboration team channels of research and discovery, finance, public relations, legal, business operations, business development, executives (stakeholders) and users (customers) to ensure product viability value.Tata Consulting ServicesIsland, NJProduct Owner/Product ManagerJuly 2021 October 2022Responsible for defining & communicating the overall vision, objectives, and goals of the business with the development and quality assurance team in relation to the minimum viable product. Manage the link between development, QA, and business clients by ensuring the technical solution developed satisfies the requirement value per the future Oncology/Non-Oncology inventory items within an application.Provide managerial oversight and final review of all product backlog user stories, unit testing, QA testing, and production readiness release of the product vision. Contribute to defining wireframes, prototypes, MVPs, KPIs, features, and pilots with all stakeholders. Responsible for the product backlog management, prioritizing user defined stories, and prioritizing the business requirements. Document functional specifications as well as vetted contingency plans in case of risks or roadblock occurrences.Ensure high-level design is included with the project management requirements by creating an excel matrix that accurately accounts for approved data and user requirements. Utilize AEM (Adobe Experience Manager). This tool was used to manage multiple website content for user experience. Cultivate partnerships with cross-functional teams to ensure each integration is fully supported.HCL TechnologiesCary, NCProduct Owner/Product ManagerFebruary 2020 May 2021Manage the link between our development teams, business clients and project stakeholders. I do this by ensuring that the technical solutions being developed satisfy their needs in terms of value per CMS guidelines. This is also for Medicare, Medicaid, ACA, Government & Commercial claims.Provide managerial oversight and final review of all product backlog user stories, unit testing, QA testing, and production readiness release. Contribute to defining wireframes, prototypes, MVPs, features, and pilots with all stakeholders.Make available clarity of Commercial, ACA, Medicare, Medicaid Claims adjudication and billing, as it pertains to coverage of each member in a clinical setting. Document functional specifications as well as vetted contingency plans in case of risks or roadblock occurrences.Ensure high-level design is included with requirements by creating a requirements matrix that accurately accounts for approved requirements. Cultivate partnerships with cross-functional teams to ensure each integration is fully supported.eReceivablesSecaucus, NJProduct Owner (Programmer Analyst)February 2019 December 2019I designed a new ETL platform to replace the existing outdated Sun-settled FoxPro DB and programs with SQL and XML as the primary transfer code. I independently built and integrated the older database with both a new Document distributed database (Mongo) and a MySQL database that handles the bulk of these data processes.I managed the reviewing of all SDLC processes from unit testing to QA testing and production release. Responsible for Modifying all current ETL customers to the newly designed Platform with SQL. This includes writing SQL scripts and XML scripts to load into the billing system, and billing returns to all clients.Work with current 837i/p and 835 billing processes to evaluate the data for input into our source claims billing system. Provide oversight and final review of all unit testing, QA testing, and production release of design specifications, as well as vetted contingency plans in case of risks or roadblock occurrences.Managed Commercial, ACA, Medicare, and Medicaid Claims billing pertains to the benefit plans covering each member in a clinical setting.AnthemAtlanta, GAProduct Owner/Product ManagerJune 2017 February 2019Define functional, usability, reliability, performance, and support of current state documented requirements of the WGS & Facets claims systems for Medicaid, Medicare, ACA, and commercial business books.Configure benefits and entity group contracts and other claims elements to meet adjudication criteria for Medicaid, Medicare, ACA, and Commercial Claims processing within the Facets claims system and WGS claims system. Ensures high-level designs, including architecture requirements, are accurately documented and map to approved requirements.Manage quality assurance for integrated functionality, usability, reliability system performance in support requirements. All QA test case data are built and reviewed and performed on an Oracle database platform with SQL as the main code for process analysis.Create feature use cases & strategies in Confluence/Jira, Jira Align for the WGS claims environment regarding all business books for internal and external client relationships. I provide a link between our development team and business users of the system by ensuring that the technical solutions are developed to satisfy the needs of Medicaid as per CMS guidelines, Medicare, ACA, and Commercial claims.GalaxE SolutionsSomerset, NJProduct OwnerFebruary 2016 June 2017I configured key data migration elements for client entities such as Argus Pharmaceuticals, AHA Pharmaceutical Corporation & IBC Pharmaceuticals, Inc. regarding pharmacy benefits management system conversions and new benefits plans.Collaborate with a team of developers and quality assurance analysts to map specific business retail rules and conditions to be configured within the SQL (GxCare) application benefit management system to be migrated to the RxClaim mainframe system.I worked on the Coach retail account where I provide application support, working in the data warehouse monitoring customer utilization options for product replenishment. We also analyzed seasonal trends for product changes based on statistical analysis. Answer questions regarding GxCare coded elements configured for the plan benefit. I would review request approvals for the release of coded element configurations.Document functional & technical specifications for drug formulary application enhancements. Advise and collaborate with IT team members and business customers to ensure business requirements and technical and functional documentation are synchronized and compliant.VALENCE HEALTH (CONTRACTED POSITION)Chicago, ILSenior Quality Assurance AnalystJuly 2015 November 2015Wrote ad-hoc queries for dataset conversions queries and stored procedures with MS SQL for data analysis drilldowns. Research, assemble, examine, and cleanse data. I provided reports to senior management and project-related entities created in MS SQL SSRS.Tested, analyzed, and presented data to confirm Facets application configuration during the initial implementation of the new ICD10 codes compared to ICD09 codes in system inclusive of the claim financial, clinical, and benefits configuration for all business books to include Medicaid. Configure new Pay Classes, Service Qualifiers, Keywords, Remark codes, Fee Schedules, etc.Maintained test database in MS Access. Provide technical lead assistance to staff members in Test Rails testing application. Develop, configure and maintain current workflows and Benefit Pricing service qualifiers for claims adjudication. Created and executed test matrices for SIT/UAT, test plan, and test cases based on functional requirements.Managed QA testing teams are following the Solution Delivery processes on all projects and applications. Perform VB scripting for Access test planning data entities. Created excel macros for conditional QA test case data.Product Manager for the Macess imaging system. Assisted in building a provider portal to be utilized by internal medical staff for case management work. |
