HHS Office of Medicare Hearings and Appeals

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Sr. Agile Business Analyst (Lead Web Services)

Jul 2016 – Sep 2016

 

Summary

Sr. Agile Business Analyst to CACI International, Inc. hired to support their contract under the congressionally mandated Medicare Modernization Act of 2003 for the Level 3 Office of Medicare Hearings and Appeals (OMHA) within the U.S. Department of Health & Human Services.  Electronic Case Adjudication and Processing Environment (ECAPE) is being developed using MicroPact’s comprehensive entellitrak case management solution.  ECAPE is designed to streamline and increase the efficiency of the Medicare recipients right to have an Administrative Law Judge review their case after coverage denial at Level 2 of the 5 level structure..

Highlights

• Agile/SCRUM software development methodology.  Using Atlassian JIRA Software as the ALM.
• Lead Analyst for two major Web service interfaces of the Level 3 Hearings and Appeals Adjudication Process.  The design supports the sending of data as a SOAP message over HTTPs using transport level security certificates, and sFTP for big data.
• Performed the analysis, wrote the user stories and designed the user interface/experience for the backlog migration of 1M appellant appeal claims and claim line-items coming from the Level 2 by Web service/sFTP.  As well as the supporting documents for each Appeal.
• Performed the analysis, and wrote the user stories for the sending of Appeals that have been closed at Level 3 and need to be sent back to Level 2 for record and Claim/Line-item updating.
• Created Workflow Diagrams and Story Maps to simplify complex processes.
• Created a complete comprehensive Cross-functional diagram of the full adjudication process from Central Operations Intake to Send Level 3 Closed Appeal data to Level 2 for driving out requirements and writing user stories.
• Ensure User Stories are complete, unambiguous and comprehensible for the DEV/QA teams.

Environment & Tools

• Java, Oracle, MicroPact entellitrak Case Management Tool
• Web services SOAP Messaging over HTTPs – sFTP for big data
• Transport level security – using certificates
• Atlassian Jira for Agile Development Project ALM
• Visio 2016 for Story Mapping/Process Modeling/Cfross-functional Diagrams
• Alta XML Spy for reading and validating XSD/XML