add photo
Sheila
Casonsheila29@gmail.com
757-439-3796
Norfolk, VA 23551
Healthcare Consultant
20 years experience W2
0
Recommendations
Average rating
116
Profile views
Summary

  • Experienced as a Business Analyst, understanding the stakeholder's business culture and priorities to effectively identify business problems and assess proposed solutions. Experience leveraging appropriate company and industry approaches and modeling techniques to gather requirements, support supplemental data team with HL7/EDI process with extracting data from Immunization Registry and EMR.
  • Maintaining group focus and leading meetings toward stated goals. Managing group dynamics in facilitating requirements gathering and review sessions, including writing Agile epics and user stories. Additionally skilled in building, sustaining, and leveraging professional business relationships when gathering, validating, and approving requirements.
  • Responsible for monitoring and reporting on the status of departmental projects: Anticipate and identify issues that could inhibit achieving project goals and objectives and implement corrective action and mitigation strategies.
  • Analyze key metrics, such as top diagnoses, clinical procedures, and operational performance, to enable the development of sound and valid recommendations regarding and prioritization of clinical and service improvement initiatives to meet 5 Star rating for each CMS category.
  • Responsible for responding to inquiries received from regulatory agencies for one or more states or functions and/or for responding to inquiries/complaints received by executive leadership. Responsible for providing support to legal, manage executive level associates through a variety of assignments and projects which utilize knowledge specific to the company.
  • Monitor and analyze outcomes to ensure goals, objectives, and desired outcomes are achieved.
  • Maintaining group focus and leading meetings toward stated goals. Managing group dynamics in facilitating requirements gathering and review sessions, including writing Agile epics and user stories. Additionally skilled in building, sustaining, and leveraging professional business relationships when gathering, validating, and approving requirements.
  • Create reports on value base purchase State measures that have risk dollars.
  • At Amerigroup my task was to create reports and build databases for the health plans to use to help them meet their state target goals with risk dollars attached.
  • 13 years of experience of using agile methodology working with the scrum team on creating stories from enhancements to the server that the HEDIS data is stored. Also, applying agile methodology to business owners request working with IT or outside vendors such as Ciox or Sharecare to complete the project within the sprint.
  • Able to recognize inconsistencies and gaps in a complex business process and maintain requirements traceability throughout the project's lifecycle.
  • Meet the 4-star HEDIS paid for performance goals. Hold meetings with the regulatory team and Health plan to ensure that they were on target and assess any benefit changes that occurred within the year or potential impacts on lack of data from vendors. For example, immunization registry were providers not submitting members vaccines to help close out gaps for CIS and Ima measures.
  • Assist the development teams in understanding and elaborating requirements and transitioning them into a comprehensive solution. Assist with the preparation and execution of User Acceptance Testing, mentor other team members, and assist the project manager in developing the requirements phase plan.

Experience
Education
Attended in Business Administration
Old Dominion University 2010
Minor: Information System & Technology
Attended in Accounting
Tidewater Community College 1998
Attended in
Frank W. Cox High School 1993
Skills
Cost Analysis
2011
5
Data Management
2011
5
Data Mining
2011
5
Medicare
2011
5
Microsoft Excel
2011
5
Regulatory Reporting
2011
5
Data Analysis
2012
1
Hadoop
2012
1
SAS
2012
1
SQL
2012
1