WALLACE W.

BARTON

Jacksonville, Florida 32224

wb6365fc@westpost.net

EXPERIENCED BUSINESS ANALYST WITH EXTENSIVE PROCESS IMPROVEMENT EXPERIENCE

KEY SKILLS SUMMARY
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Extensive experience includes:
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eliciting business process and system requirements from individuals and groups
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facilitating cross-functional work groups with excellent results
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training staff in techniques for modeling processes and data flows
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improving system outputs and reports to obtain actionable
information
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Very effective in bridging communications between business and
information technology.
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Extensive experience in business process diagramming, process
analysis and improvement.
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Proven strength in interpreting and understanding statutes and
regulations
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A skillful and resourceful writer, meeting facilitator and creative
presenter with astute listening skills.
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Familiar with Lean Transformation, Six Sigma Project Methodologies, Business Pr
ocess Reengineering (BPR), Total Quality Management (TQM) including training oth
ers to understand the concepts and philosophies and to effectively use tools and
techniques.
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Broad consulting and problem solving experience.
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Graduated from West Point with BS degree emphasizing Management Engineering.
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Received Master of Arts degree in Human Resources Development in 2002.
CAREER HIGHLIGHTS
02/2010 to Present: Business Analyst Manager (Consultant), Major
Healthcare Insurance Company located throughout North America with
one of several main offices in Chattanooga, Tennessee:
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Brought into organization due to extensive experience as a thought
leader to work with Business Analysts (BAs) to help lead cultural
change within organization. Acting as mentor in transitioning to a
more agile software development process to increase business
satisfaction with results and decrease time to implementation.
Ability to sell alternate solutions and courses of action.
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Mentoring and training staff of 9 BAs in variety of areas to include
upgrading quality of business requirements, presentation to staff on
business rules, and the evaluation of Requisite Pro as an effective
tool for requirements management.
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Prepared Power Point presentations for training and proposals to
management for additional funding. Conducted WebEx training sessions
with staff. Organized and populated Sharepoint site with critical
training documents.
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Reviewed Business Analysis Body of Knowledge (BABOK) with BA staff
to facilitate understanding of key knowledge areas and appreciation
of scope of responsibilities.
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Providing key resources to develop creative thinking, problem
solving and critical thinking skills to help lead transition to
higher quality requirements and other work products.
03/2007 to 04/2008: Senior Business Analyst (Contractor), Children's
Medical Services (CMS), Florida Department of Health, Tallahassee and
Tampa, Florida:
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Successfully completed extensive As-Is To-Be Analysis and
documentation to facilitate integrating independently contracted
statewide offices into a new centralized claims payment, reporting
and information management system.
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 Interviewed staff members, directors and physicians individually and
in groups at nine independent non-profit organizations across state,
each operating with unique processes to meet program participation
requirements.
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Developed rapport with senior management and operations staff at
each location to facilitate gathering information needed to verify
and document current and future requirements along with a gap
analysis and issues log.
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Helped facilitate negotiations with University of Florida IT
Department and CMS Senior Management regarding future services to be
provided by the university.
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Documented and diagramed process flows, data flows and use cases
employing UML diagramming using Visio software.
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Presented analysis results including gap analysis and issues log to
CMS Senior Management with a well received PowerPoint presentation
and Q end-to-end, from providers offices through to adjudication
modules. Captured the myriad of sources and types of claims, all
input channels, throughput gateways, claim validation processes, and
decision points.
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Conducted extensive interviews of IT and operations subject matter
experts (SMEs) and researched and studied numerous artifacts
including various Rational (RUP) work products and UML diagrams.
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Assisted in joint application design (JAD) sessions with IT and
business operational personnel to collect business user requirements
and system functionality requirements for major projects.
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Effectively facilitated diagramming of processes conducted by the
Membership and Billing Department.
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Gained extensive knowledge of HIPAA requirements and EDI
transactions.
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Provided numerous process flow and data flow diagrams for various
departments.
Senior Medicare Hearing Officer, Medicare Division, Government
Programs, First Coast Service Options, subsidiary of BCBSFL: 07/1997
to 09/2004:
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Functioned in an autonomous capacity to adjudicate previously denied
health insurance claims by conducting formalized hearings with
physicians, medical staff and patients. Evaluated patients' medical
conditions and histories, the services provided and the specific
circumstances of each case to render formal written decision.
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Position required familiarity with and an ability to locate and
interpret the appropriate sections of the Federal Register Statutes
and Medicare rules and guidelines.
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Became very familiar with and effectively used medical references
such as ICD-9 and Current Procedural Terminology (CPT) and their
respective coding structures.
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Completed process improvement studies and developed performance
management reporting capabilities for management.
Senior Methods Analyst, Industrial Engineering and Consulting
Services, Medicare Division, Government Programs, BCBSFL: 09/1990 to
07/1997:
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Provided training and facilitation to several cross functional
groups and organizations in data collection, data analysis,
root-cause analysis and problem solving for improving quality and
productivity.
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Played key role on highly successful cross-functional team
established to recommend changes to company's Performance Measurement
and Management System.
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Project Lead for major effort resulting in significantly improved
effectiveness by the Florida Medicare Fraud Investigation Department.
Successful outcome of project was greatly reduced case backlog and
increased prosecutions as well as convictions.
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Successfully introduced Organization Development (OD) concepts
including "process consultation" (re: Edgar Shein) to department
staff resulting in a higher level of acceptance of department's
involvement throughout organization. Led to increasingly effective
interventions, improved productivity and greater quality control.
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Effectively trained numerous employees in process-mapping
methodology.
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Helped develop more effective performance measures and business
reports.
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Functioned as facilitator and technical advisor for several
successful cross-functional quality improvement teams.
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Assisted teams with determining appropriate goals, data collection
targets and techniques, business requirements development, problem
solving, group decision-making, and proper methods for applying
statistical analysis tools and evaluating results.
EDUCATION, TRAINING AND SKILLS
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Master of Arts degree in Human Resources Development from Webster
University
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Bachelor of Science degree (Management Engineering emphasis) from
West Point
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Computer skills include Microsoft Excel, Word, PowerPoint, and Visio
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Excellent research skills
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Knowledgeable of the Health Insurance Portability and Accountability
Act of 1996 (HIPAA) with over 10 years Annual HIPAA Certifications;
familiar with CPT and ICD-9 codes and coding procedures; and familiar
with Sarbanes-Oxley Act of 2002 (SOX)
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Completed Six Sigma Yellow Belt Certification training
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Over 200 hours of Management, Supervision, Facilitation,
Presentation Skills and various Software Training
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Trained and experienced as a Total Quality Management (TQM) Quality
Improvement Team (QIT) Facilitator (certified by American
Productivity and Quality Center: APQC) and as a Continuous
Improvement Tools and Techniques Instructor.
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Certified as a Leadership Development Training Facilitator for
AchieveGlobal (formerly Zenger-Miller) training modules.
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Familiar with and experienced in using the tools, principles and
concepts associated with: Six Sigma DMAIC techniques, Continuous
Quality Improvement (CQI), Business Process Reengineering (BPR),
Business Analysis Body of Knowledge (BABOK), Project Management, and
Knowledge Management
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Examples of training courses presented to others: Effective
Participation In Group Meetings, Solving Quality Problems,
Identifying Key Metrics, Effective Data Collection and Data Analysis,
Statistics for Managers, Group Problem Solving and Decision Making,
Process Mapping, and Continuous Improvement Tools and Techniques