Windsor Mill, Maryland, United States
SUMMARY: An accomplished Senior Business Analyst with a track record in Healthcare IT (EHR, EMR, Medicare, Medicaid and Pharmacy Benefit Management(PBM)). He has over 12 years of experience with Electronic Health Records EMR, EHR / Healthcare IT. He is very knowledgeable in QA/Analysis/Manual and Automation Testing, UAT & Requirements documentation in the SDLC process. He has Served as an Agile/Scrum Master facilitator in core healthcare IT programs. He Liaised between IT and business Stakeholders and managing project Metrix. He is proficient in design, build and Validation of clinical workflows with the Epic Healthcare Product Modules(Ambulatory, Willow RX, Beaker., Facets Truprovider app, and TruCare app. Has worked on Utilization Management(evaluate patient care plans), Specialty Pharmacy Benefits Management (SPBM)(to evaluate specialized Pharmacy services), PBM Administrative Services(RX Networks, Mail Order Operations, Contracts and Pricing, and Member Services). Joseph Has also Used CURAM SPM to Manage the evidence gathering of low-income member profiles to determine qualifications for multiple Social Benefits Programs. • More Over, Joseph has worked on multiple Projects and Products, as a Business Analyst in IBM-CURAM SPM V7.x and CURAM SPM V8.x • He also worked to Ensure EDI transactions comply with HIPAA regulations. o Communicate EDI connectivity issues with stakeholders. o Identify process improvement opportunities with IT, operations, and business teams and o Strong knowledge of transaction sets (270/271, 276/277, 278, 837, 835) • Managed projects as Business Analyst in Smart Sheets, SharePoint, and Jira with complete and full Knowledge of Microsoft office suite of prod