Business Consultant or Business Analyst or Business Manager (NOT

____________________SUMMARY____________________ Highly accomplished Business Leader offering more than 20 years of project manag ement and analytical experience in the areas of information technology, healthca re information systems, policy and regulatory interpretation, and client technic al support. Recognized as a subject-matter expert in Workers' Compensation, Med icare, and Medicaid regulatory interpretation and the translation of policy into information technology systems. ____________________AREAS OF EXPERTISE____________________ * Managed multiple projects and successfully achieved milestones, ensuring proje cts complied with all cost and scope specifications. * Developed and implemented improved policies and procedures, resulting in impro ved efficiency and productivity. * Built and managed successful client relationships with representative, directo r, and deputy chief level contacts within the Centers for Medicare & Medicaid Se rvices (CMS), State of California Medi-Cal, and multiple workers' compensation s tates including Alaska, District of Columbia, Maryland, Texas, South Carolina, W est Virginia, and Wisconsin. * Implemented and maintained Web-based global informational websites to coordina te and share value focused information to clients. * Accomplished with the development of SQL queries. ____________________PROFESSIONAL BACKGROUND____________________ 2007 to Present - Business Analyst Coventry Health Care Inc., West Sacramento, CA Maintained responsibility for Bill Review 4 project implementations utilizing th e System Development Life Cycle process for state Workers' Compensation rules an d regulations. Responsible for interpreting and translating published state and federal regulations into scope, business requirements, business design, and use r acceptance testing documentation. * Served as subject matter expert for the Medicare Physician Fee Schedule, Acute Inpatient Payment Prospective System, Outpatient Payment Prospective System, Am bulatory Surgical Center Payment System, Clinical Laboratory Fee Schedule, and D urable Medical Equipment, Prosthetics/Orthotics, and Supplies Fee Schedule. * Expert in the interpretation of Workers' Compensations rules and regulations f or the states of Alaska, District of Columbia, Maryland, South Carolina, Texas, West Virginia, Wisconsin, and the Office of Workers' Compensation Programs. * Specialized in Bill Review 4 and fee schedule regulatory review to provide bus iness and technical support for Client Technical Services, Service Bureau Operat ions, and Leased Client teams. * Handled multiple major, intermediate, and minor system implementation projects simultaneously to meet critical project deadlines 2006 to 2007 - Business Analyst Sutter Connect, Rancho Cordova, CA Assisted with the implementation of new clients on the IDX system by using data, information, and reports from the client in the analysis and setup. Interprete d and built vendor contracts and ensures correctness in the IDX managed care and BAR system and gathers information for client data migration to IDX. * Participated in field installations, engineering, and customer support * Demonstrated ability to analyze, evaluate, and resolve hardware and software c onflicts 1996 to 2005 - Business Services Analyst Electronic Data Systems, Rancho Cordova, CA Supported the CMS Medicare Part B program, Medi-Cal program, and Blue Shield of California by providing technical, analytical, testing, and implementation suppo rt to existing interfaces. * Prepared product scope documents, product requirement specifications, product business designs, product system testing, and involved with final product deploy

ment * Managed systems configuration and maintenance, problem troubleshooting, planni ng and directing upgrades, and testing operations to ensure optimum system funct ionality * Specialized in project management, EDI (ANSI 837/835, NSF, flat file formats), reporting development, processor standards development, training, and technical writing * Proficient in handling simultaneous projects and meeting deadlines effectively Project Lead Responsible for writing, reviewing, negotiating, and presenting contracts for ap proval. * Successfully re-negotiated $3.8 million in contracts for Medi-Cal eligibility data transfers to various healthcare organizations * Evaluated and monitored contract performance to determine need for changes and to ensure compliance with contractual obligations * Temporary duty assignment 1990 to 1996 - Analyst Systems IV Blue Shield of California, Chico, CA Supported the CMS Medicare Part B program by providing technical, analytical, te sting, and implementation support to existing interfaces. * Prepared product scope documents, product requirement specifications, product business designs, product system testing, and involved with final product deploy ment. * Other positions included Auditor I and Claims Processor ____________________EDUCATION____________________ 2010 - B.S., Business Management Liberty University, Lynchburg, VA Anticipated degree in December 2010. 2006 - Associate of Arts, General Studies Foothill College, Los Altos, CA ____________________ADDITIONAL SKILLS____________________ * Critical Problem Resolution, Project Management, Project Coordination * Expediting Solutions, SQL Query Development, Organizational Development * Process Improvement, Computer Literacy, Creating and Mapping Solutions * Quality Control, Continuous Improvement, Decision Making * Training and Development, Interpersonal Skills, Microsoft Applications ____________________VOLUNTEER____________________ 2006 to Present - Associate Pastor of Global Online Ministries Oasis Bible Fellowship, Roseville, CA Developed global network for facilities and users in 20+ countries. The technica l subject matter expert, evaluating, selecting, and integrating all information security-related projects. Researched and prototyped new Web technologies and te chniques to realize benefits of the latest innovations. Developed trust, person al rapport, and strong working relations with volunteers and staff. 2005 to 2007 - Emergency Department and Trauma Center Volunteer Roseville Sutter Medical Center Auxiliary, Roseville, CA Performed all duties of a volunteer, including patient comfort, family interacti ons, checking in patients, and consulting with nursing staff. 1990 to 1998 - Paid-Call Firefighter Butte County Fire Department, Chico, CA Served as an on-call Paid-Call Firefighter for Company 42, North Chico Fire Volu

nteers. Specialized in structure and wildland firefighting, vehicle extricatio n, earthquake rescue, and over-the-edge rescue emergencies. Certifications incl uded: Volunteer Firefighter I/II, Rescue Systems I, EMT-1A, and Extrication I/I I.