Experience

Neighborhood Health Plan of Rhode Island

• Insurance
• 300 - 400 Employee

• Senior Healthcare Systems Analyst, IT Innovation

  • Mar 2021 - Present

  Provide technical support with the design, testing and implementation of healthcare applications Perform configuration, maintenance, and monitoring of the production environment Execute HIPAA 837/835 and 834 transactions and trouble-shoot failures through successful resolution Process outbound 834 files to trading partners according to expected delivery timelines Manage payment cycles for two claims systems through issuance of 835s and remittance advices Trouble-shoot and resolve payment cycle issues Provide technical support to external trading partners and providers Create and maintain technical documentation Communicate with internal users in IS, Claims, and Enrollment and external trading partners to resolve issues promptly and to fulfill SLAs Identify opportunities for process improvement and outline and implement solutions Work with the development team to support and enhance Neighborhood's Healthcare applications and EDI infrastructure Provide production support for managing HealthRules Technical skills: Jira, Liaison EDI Notepad, SQL, HealthRules, Amisys, Paycom, MS Word, Excel, PowerPoint, Sharepoint Show less



MathWorks

• United States
• Software Development
• 700 & Above Employee

• Senior Quality Assurance Analyst

  • Aug 2007 - Apr 2020

  Salesforce Test lead for Sales, Marketing, Accounts, Contacts, Customer Training, and Project objects and integrations with homegrown commerce, licensing, and website purchasing application Led the test effort of conversion implementations from Siebel to Salesforce by preparing the test plan, test cases, issues triaging, status reports, and attending daily scrums. Managed the test cases execution by team members. Managed priorities/assignments. Tested functionality by user profile, role, and permission sets validations. Planned for and executed of Salesforce Winter, Spring and Summer upgrades. Drove planning discussion for test environment needs for Salesforce upgrades and monthly Salesforce releases. Smoke tested production following deployment releases and Salesforce upgrades. Acted as test lead for larger scale projects spanning across multiple teams. Finalized test plans from each QE. Defined deliverable due dates and motivated team to meet deadlines. Encouraged team members to provide timely identification of any roadblocks. Proficient with agile methodologies, including the Jira project management tool, scrums, sprint planning, user story scrubbing and point assignments. Functioned as ad hoc scrum master for project manager. Provided testing and technical assistance to QE’s, Developers and Analysts of integrated systems Coded, debugged, and maintain automated Salesforce UI tests with Selenium and Java Wrote and executed queries using Workbench and Microsoft SQL to data mine and validate results. Utilized UDEMY online training courses on introduction to programming, object-oriented programming, and Java Expanded technical knowledge through Salesforce’s Trailhead training and to achieve certification Used GearSet to copy/load data Browsers: IE, Microsoft Edge, Chrome, and Firefox Onboarded new CRM Quality Engineers Technical Skills: Java, Selenium, Jira, Perforce, GearSet, Confluence, Microsoft Teams, MS Word, Excel, PowerPoint, MS SQL, Workbench, Intellij Show less



Tufts Health Plan

• United States
• Insurance
• 700 & Above Employee

• Sr. Quality Assurance Analyst

  • Oct 1997 - Aug 2007

  Wrote and execute test plans for the ETL of group, member and benefit data for HMO, POS, PPO, and Medicare into the company’s Oracle staging tables and ODS. Utilized TOAD to perform SQL queries to validate ODS testing. Tested HIPAA EDI transactions: 270/271, 276/277, 278, and 837/835 Executed testing of translation mapping of inbound HIPAA transactions to proprietary files. Functioned as team lead for five staff members for HIPAA 837 testing Provided testing expertise to the eligibility and premium billing business team. Prepared and executed testing of company’s Intranet project. Managed the testing of the extranet system. Performed usability test on initial extranet system. Drafted system test plans from business and technical specification documents. Interviewed programmers and user staffs to define business and technical requirements. Executed system test plans. Documented and tracked testing issues by utilizing a Lotus Notes database. Wrote Test Summary Reports. Mentored Quality Assurance Analyst I staff members. Provided oral and written status updates to Quality Assurance, programming, and user staffs. Prepared functional Year 2000 test plans for benefits and EDI online programs. Documented the business flows of the benefits and electronic data interchange systems. Verified the results of executed mainframe batch jobs utilizing Quiz, Query, and Qedit. Tested the company’s mental health referral system, a client server application. Technical Skills: SQL, Toad, Quiz, Qedit, Query, Microsoft Word, Project, Excel, and Access Show less



Keyport Life Insurance Company

• Boston, MA

• Quality Assurance Analyst II

  • Sep 1994 - Oct 1997

  Performed testing on Keyport’s annuity client server system Prepared test plans and provided technical assistance on the conversion project of Keyport’s life insurance from a mainframe system to a GUI-based, client server system Reviewed specifications for accuracy and adherence to project goals. Conducted testing of GUI-based, remote access query system. Maintained business knowledge of new products and new features of its existing products. Represented the Quality Assurance Team at meetings and on committees. Mentored new QA team members. Show less



Massachusetts Department Of Transitional Assistance

• United States
• Individual and Family Services
• 200 - 300 Employee

• Business Systems Analyst

  • Jul 1984 - Sep 1994

  Prepared and executed testing on the Massachusetts Medicaid Management Information (MMIS) system. Interviewed users to determine business requirements. Interfaced with users of all levels of the organization. Prepared business specification documents. Reviewed vendor-prepared data flow diagrams and system flowcharts. Reported system coding errors and monitored their successful resolution. Troubleshooted system problems. Provided ad hoc support to users. Reviewed system documentation for accuracy. Trained system and user staffs on completed software projects. Provided technical assistance to training staff during formal training classes. Show less