Twenty four years experience in systems development, management and production support. * Consistently (Throughout his career) maintains close business interaction/collaboration to achieve system objectives. Has taken products from beginning to end on implementing Provider automation of Credentialing processing from the SQL based CARDS application to the Mainframe based EPDB (Provider) based application. This supported re-pricing Workers Compensation claims using Aetna Providers networks. * Strong background developing and implementing quality system solutions, team mentoring, coaching, etc. to bring upon speed to market system enhancements (Business, QA End-user). Managed a team of 8-10 IT professionals to implement quality systems. * Able to adapt in a fast paced environment as well as quickly comprehending different technical platforms and applications. * Strong relationship building and documentation. Interaction, establishing and writing business requirements with internal and externals clients. * 7+ years in a position providing support to his team (s). This included project delegation, conflict management. * System integration projects (E.G. Mainframe to vendor applications, Mainframe, Server based applications to Web based applications or Visual Basic). All with business interaction to ensure all parties are in agreement with the outcome. * In addition, adhering to project methodologies (SDLC / APLC): * Project Definition. * User Requirements. * System Requirements. * Analysis and Design. (Data mappings, data model designing, etc.) * System Build / Prototype * Information and training * Hands on background in all aspects of IT& Business Development (Design/Data & system Modeling/ infrastructure/ system development. Production implementations and ongoing production support. All aspects of the system lifecycle. * Mainframe development under a variety of database technologies and operating systems (DB2, COBOL, RDMS, CICS, SQL-Server, IDMS, VSAM, IMS, MVS, VM, JCL, Endeavor). * 12+ years of supporting mainframe production systems. This is included the full spectrum of day to day systems enhancements, nighttime production support, project work and new product introductions. * Client Server development (VB 6.0, VB.NET, Powerbuilder). * 8+ years of client server development primarily using VB6.0 to support a variety of applications accessing a variety of databases (SQL server, UDB, DB2 Mainframe). * Powerbuilder Graphic user interface was developed utilizing a Informix database under a Unix based (AIX-IBM and Solaris-SUN) operating system. Consistently communicated to the end user that was meeting the business needs. * Web development (JAVA, Websphere and messaging/ communication tools): * - Leading/Developing a team of developers and business analysts to maintain and support a Mainframe COBOL/J2EE n-tier, Powerbuilder application to enhance multiple products under the Business Alliances domain within Aetna. These products vary widely in nature and are not part of Aetna's core Health Care business * In the past 3 years, lead a team of developers to rewrite VB 6.0 applications to conform to a fully web based architecture utilizing J2EE running under Websphere /RAD environment. All re-design work architected under an n-tier environment utilizing DB2/COBOL Mainframe environments. Implemented a Crystal Enterprise (BO) solution to meet the reporting needs of the business constit uents within the J2EE environment. Implemented a J2EE front end to a COBOL, Crystal to give the reporting environment an easier look-and-feel to the end-user. * Demonstrates consistent Initiative and solid judgement. * Outstanding communication skills (oral and written) with the business constuients .Strong leadership of development teams in a positive or constructive nature. * Extensive testing experience. * EDI Development and analysis (HIPAA compliancy). Worked daily with EDI development teams on gateway mappings to support multiple transactions (834 - Benefits enrollment, 835 - Payment transactions 837 - Claim transactions, Encounters). NDM and FTP processes were implemented to transfer data. * Worked and developed mappings with the EDI Gateway team to translate EDI transactions to a proprietary format to be compliant with company systems. * Built client relationships and interfaces. Dealt heavily with one-on-one client communications with internal and external constituents (Business and development). Worked on business process improvement. Adhered to all Service Level agreements (SLA's). Daily triage was involved, etc. * Proficient in all Microsoft products (Word, Excel, Outlook, Powerpoint etc.). In addition to database reporting using raw SQL structures on relational databases. * Worked on design sessions for ICD9 - ICD10 conversions (Modeling, Architecture, etc.). * Interface design with the FACETS system (Vendor system). * Designed and developed Interfaces into the Informatics database (Data Warehouse, Batch files loaded by ETL). * Change Management: Remedy, ClearQuest, ClearCase, Agile, SCRUM, etc. * Performance monitoring and system modifications as needed. * Mentored entire development team on COBOL, CICS DB2, SQL PL/SQL, Microfocus COBOL, Powerbuilder & Visual Basic standards and best practices. * HIPPA transactions (837's, 834's, etc.) * Lead contributor on Triage of Production enhancements/Service Request Fixes (SR's) CSC-Applications (Vantage-one). * Experience working with various business process work areas, such as claims, benefits, membership, health management, Credentialing/Provider to develop a Business Process toolkit (SIPOC, Swim Lanes, process workflows, gathered requirements from client SMEs. Have overseen development of user stories into test cases and application configuration, supporting testing effort to ensure functionality is represented in the application. * Recruiting hiring, reviews. * Took on lead role to convert a financial VB.6 application to VB.NET application to support business processing of billing and payment processing for Workers' Comp repricing. * Extensive experience on individual and group billing systems. * Extensive experience on individual and group payment systems (Mainframe, Client-server, web, etc.) DETAILED PROFESSIONAL EXPERIENCE:
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