Theresa Hearn

Accomplished professional with rich background in requirements gathering, data analysis, solution design, and data management strategy. Adept at providing strategic oversight and successful delivery of Medicare/Medicaid solutions in alignment with healthcare industry frameworks. Excel at conducting in-depth source system analysis, requirements definition, and data quality assessment to maintain excellence in project outcomes. Expert in driving Business Process Engineering to optimize operations and spearhead complex projects across Agile and Waterfall methodologies. Skilled in delivering comprehensive training and mentoring teams for higher levels of competency and performance. Known for offering valuable expertise in a suite of project management tools, including SQL, MS Office, and SharePoint, coupled with a strong grasp of healthcare standards to ensure project compliance and stakeholder satisfaction.

OptaFi Atlanta, GA (Remote)                                                                 09/2024 — 01/2025

Sr. Data Quality Analyst Sentara Health

Oversaw and improved end-to-end production and deployment of Data Quality solutions, ensuring alignment with Sentara’s healthcare framework. Conducted thorough source system analysis with focus on defining requirements and assessing data quality to maintain high standards.

• Successfully analyzed 100% of requirements for assigned data sources, leading to process improvements.
• Demonstrated expertise in industry standards, leveraging knowledge of HCPCS, ICDM, SNOMED, JACHO, FHIR and HEDIS to guide project compliance and excellence.
• Proficiently utilized SQL, MS Office, MS SQL Server, Visio, MS Project, JIRA, SharePoint, Purview, Informatica and Workday to streamline project management and communication processes.

Conduent, Inc, Atlanta, GA (Remote)                                                    01/2022 — 02/2024

Manager, Project Management Office

Oversaw and improved end-to-end production and deployment of Medicaid solutions, ensuring alignment with New Mexico's healthcare framework. Conducted thorough source system analysis with focus on defining requirements and assessing data quality to maintain high standards. Provided comprehensive training on application usage to new and existing staff, enhancing team competencies and performance. Led meticulous documentation of business and technical requirements, translating complex needs into actionable engineering tasks.

• Successfully managed 100% of project plans for the implementation of Conduent solutions for New Mexico Medicaid, ensuring timely and efficient delivery.
• Demonstrated expertise in industry standards, leveraging knowledge of HCPCS, ICDM, SNOMED, JACHO, and HEDIS to guide project compliance and excellence.
• Proficiently utilized SQL, MS Office, MS SQL Server, Visio, MS Project, JIRA, SharePoint, and Workday to streamline project management and communication processes.

Sogeti, Inc, Atlanta, GA (Remote)                                                         01/2021 — 01/2022

Manager, Consultant

Humana, Atlanta, GA (Remote)                                                              07/2021 – 01/2022

Senior Business Analyst

Managed and improved production and delivery of Medicaid solutions, ensuring alignment with industry standards such as HCPCS, ICDM, SNOMED, JACHO, HEDIS, SOX, MITA Framework, and STARS EDI. Directed business process engineering by improving current operations and planning for future enhancements. Oversaw training of staff on application with emphasis on enhancing team efficiency and knowledge. Led translation of business requirements into technical specifications, optimizing system functionality. Coordinated user acceptance testing for system iterations and sprints, guaranteeing quality and adherence to client needs. Utilized proficiency in SQL, MS Office, Visio, MS Project, JIRA, and Confluence to streamline project management in both Agile and Waterfall environments.

• Implemented Business Requirements Process for clients by establishing a standardized approach to capture and document needs.
• Facilitated source system analysis, ensuring accurate requirements gathering and metadata management.
• Enhanced project documentation and communication by effectively utilizing tools such as JIRA and Confluence.
• Played a pivotal role in business and technical requirements engineering for improved system performance and user satisfaction.

CareSource, Atlanta, GA (Remote)                                                         01/2021 – 07/2021 

Senior Business Analyst

Drove business process engineering by optimizing both current and future state workflows. Directed collection, documentation, and validation of business and technical requirements, facilitating user acceptance testing for product iterations. Served as a strategic consultant to both internal and external stakeholders. 

• Developed and maintained project documentation for clear communication across Agile and Waterfall environments.
• Provided expert consultation for development of project plans and integration of industry standards into organizational practices.

1.  
2. During 2020, took a sabbatical to attend to familial responsibilities, including settling my mother's estate amidst the challenges posed by the COVID-19 pandemic.

Change Healthcare, Inc, Alpharetta, GA                                                01/2017 — 12/2019

Manager, Business Systems Analysis (Clinical Review)

Managed production and development requirements for Clinical Review technology platforms, ensuring alignment with industry standards including HCPCS, ICDM, JACHO, HEDIS, and SOX. Directed business process engineering efforts, optimizing both current and future state workflows within a healthcare setting. Oversaw the integration of business and technical requirements with the Master Data Management Enterprise Strategy, maintaining data integrity across multiple sources. 

• Successfully managed $14M project to implement new Clinical Review System for enhanced organizational capabilities.
• Facilitated transition of project plans and communications within Agile environment for cross-functional collaboration.
• Leveraged expertise in SQL, MS Office, MS SQL Server, Visio, JIRA, Tableau, Confluence, and Workday for project success.
• Acted as key consultant to internal/external customers through valuable support for Clinical Review related queries.

Aaron's Inc, Kennesaw, GA                                                                    01/2016 – 12/2016

Lead Data Architect 

Managed the design, implementation, and ongoing support of the enterprise data warehouse and Master Data Management, ensuring alignment with business objectives and analytical requirements. Led new modeling initiatives and developed a comprehensive Master Data Management strategy for the Enterprise Data Warehouse. Engineered technical specifications from business requirements, optimizing source system analysis and data quality. Conducted thorough training for users in product functionality and data utilization, fostering an environment of knowledge and efficiency. Maintained and developed Agile project plans, ensuring clear communication across all management levels. Utilized advanced proficiency in SQL, Embarcadero, MS Office, MS Project, MS SQL Server, Confluence, and JIRA to deliver robust data architecture.

• Spearheaded integration of master data management into enterprise data warehouse for consistency and accessibility.
• Devised and executed strategic training program for user competence in leveraging data warehouse capabilities.
• Streamlined ETL processes, contributing to improved data integration and workflow efficiency.
• Acted as a key consultant to internal/external stakeholders, providing expert advice and solutions for data architecture challenges.
• Enabled transition of project management methodologies to Agile, resulting in more adaptive and responsive project execution success.

1.              In 2015, embarked on a sabbatical dedicated to providing primary care for my elderly mother.

HealthCore, WellPoint now Carelon                                                      01/2000 — 12/2014

Director, Clinical Data Integration, Atlanta, GA (Remote)

Drove design, implementation, and support of the enterprise and Real World Evidence (RWE) data warehouses, ensuring alignment with the Master Data Management Strategy. Directed source system analysis, metadata management, and data quality initiatives, leading to enhanced data integrity and reliability. Spearheaded new data modeling projects, translating complex business requirements into technical specifications to facilitate robust data integration. Oversaw staff training on product use and data handling by fostering a knowledgeable team adept in SQL, ERWin, MS Office, MS Project, ORACLE, SAS, Teradata, and Informatica.

• Managed a $22M project to implement a clinical data warehouse, significantly advancing data integration capabilities.
•  Engineered and documented comprehensive business requirements, establishing a framework for sustainable enterprise data architecture.
• Mentored and led a diverse team of 7-10 professionals, including Business Analysts, Quality Analysts, and Technical Leads, to achieve departmental goals.
• Effectively controlled all budgeting aspects and developed meticulous project plans, ensuring fiscal responsibility and project alignment with organizational objectives.

1. Additional experience available upon request.

Bachelor of Arts & Science

State University of New York, Stony Brook 

Certified Six Sigma Green belt | Certified Agile SCRUM Master | Certified Microsoft Azure Fundamentals