Trizetto QNXT Solutions
Thompson Acquah
Senior Business Systems Analyst, Data Analyst, Project Manager, Business Consultant
Richmond,VA
Summary
- Creative, solution-oriented, innovative and articulate business analyst & data engineer with 10 years of success assessing, configuring, reconstructing, presenting and managing IT business projects and systems
- One with a passion for problem-solving; skill in communicating with stakeholders and project teams, and an ability to plan, execute and deliver great results.
Overview
10
10
years of professional experience
14
14
years of post-secondary education
Work History
Senior Business Systems Analyst
Virginia Premier Health Plan
Richmond, VA
01.2019 - Current
- Used QNXT to test, configure, adjudicate, review over 50,000 healthcare claims pertaining to benefits, membership, providers, contracts, and more
- Analyzed, researched and configured pricing, processing, eligibility, enrollment, modeling and other changes to 25,000+ healthcare claims and business processes in relation to money recovery, billing, eligibility, case management, data exchange efficiency, authorizations, risk, contracts, customer service, and more using SQL queries and QNXT configuration knowledge.
- Used functional knowledge of Medicare, Medicaid & healthcare claim databases and systems in order to find business solutions and improve system inefficiencies on 40+ projects
- Worked on 15+ financial recovery projects culminating over $4.5 million in financial retractions from providers, after investigating and confirming how and why funds should be returned to VPHP
- Gathered, tracked and verified requirements for 40+ projects, and implemented technical and non-technical solutions to issues related to finances, client management, claims management, system testing, and more.
- Managed project risks and plans, along with user, client and contractor communication, schedules and ensuring deliverables are seen in time and cost-efficient manners on 40+ projects.
- Led or organized analysis and requirements gathering sessions using methodologies such as JAD, JAR, SCRUM, to define, analyze, and document business needs and requirements and helped with system migration from IDX to QNXT
- Was a part of the conversion and implementation processes for new and existing health plans
Senior Project Manager - Data Analyst
MalMarIT
Falls Church, VA
12.2012 - 08.2018
- Managed a team of 8 professionals (both onsite and remote) while coordinating and managing them, by scheduling and leading bi-weekly 1 on 1 meetings, monthly team meetings, and project-specific meetings, to achieve project goals in the most cost and time-efficient manners as possible
- Developed, optimized, and implemented strategies for business solutions and testing by using the Software Development Life Cycle/Agile system, Commercial-Off-the-Shelf (COTS) processes, gap analysis to boosting clients' revenues by between 10% and 300%
- Coordinated and negotiated between clients, stakeholders, QA analysts, software development teams, and support teams on 50+ projects to use requirements to create user stories, identify, plan, review, and execute effective solutions to save money, time & effort
- Worked in multi-system environments to create & present 300+ business intelligence models, flowcharts, diagrams &, spreadsheets and reports using Business Objects, along with HCM Systems like QNXT, Oracle & PeopleSoft as well as software including but not limited to: Workday, Tableau, SQL & Excel
- Led, organized & managed data management & efficiency projects for 10+ companies including but not limited to: DHRM Department of Human Resources, Virginia Department of Transportation, & Department of Medical Assistance Services - and worked within all security guidelines i.e. HIPAA to keep private info secure.
- Analyzed and identified system components using Oracle databases, and Hadoop to reverse-data engineer, analyze, design and audit enterprise architectures, performed human-computer interface analysis, data communication, data modeling, gap analysis, systems conversion, and e-governance to show how data-related issues can cause deep organizational problems now and in the future
Education
Virginia Commonwealth University
05.2001 - 05.2015
Skills
Software Development Life Cycle/Agile
Gap Analysis
Project Management & Organization
Public Speaking
Software
Oracle Database & SQL
Microsoft Excel
Microsoft Sharepoint
PeopleSoft
Tableau
Microsoft Access
Hadoop
Timeline
Senior Business Systems Analyst
Virginia Premier Health Plan
01.2019 - Current
Senior Project Manager - Data Analyst
MalMarIT
12.2012 - 08.2018
Virginia Commonwealth University
05.2001 - 05.2015