Joan Cadenhead, Ph.D.

J. CADENHEAD, Ph.D. E-mail:- PROFESSIONAL EXPERIENCE TriZetto at Cognizant Professional Services – Systems Implementations and Upgrades Valley Stream, New York 2007 to 2019 Senior Manager/Senior Consultant - - - - - - - - - Participated in Project Kick-offs, Project Leadership, Implementation, Go-live and Post Go-live discussions in an effort to drive quality assurance and testing initiatives, make qualified decisions on approach (Agile, Waterfall, etc.) and meet timely deliverable goals. Evaluated project financials, goals and resources with Project Manager in order to determine manhours, project hours and other timeline and time sensitive deliverables – cost over expense for QA and Testing team in alignment with overall project design based on Service Level Agreements (SLAs). Created Quality Assurance and Testing Test Strategies, Detailed Test Plans, Test Summaries based on project specification including Service level Agreements (SLAs), Statements of Works (SOWs), Project Plans, Business Requirements (BRs), etc. Developed workflows to address gaps and customer requirements for new solutions and applications, customer’s existing home-grown and/or Third Party vendor product(s) -legacy) applications, and peripheral systems- to ensure data integrity, seamless processes and continuity of operations. Analyzed data migration processes to monitor, validate and verify testing initiatives for environments, architecture, developers and client(s). Reported results and summaries via written and oral presentation (MS PowerPoint and MS Excel) over the lifetime of the project to project stakeholders; archived project workbook documents on MS SharePoint and highlighted all relevant Quality Assurance and Testing initiatives. Validated systems’ impacts on core batch processes; back-end processes and reports including Crystal Reports; Electronic Data Interchange (EDI ) Transactions sets to ensure data integrity is upheld and claims operations, Web Interfaces, and Managed Care processes are aligned with expected results via SQL queries, reports and systems output, analyses real-time processes -queued and manual inquiries and transactions. Utilized team meetings to effectively elicit and convey project information through weekly Project Leadership meetings to onshore and offshore teams via MS Lync/Skype for Business and Go-toMeeting; collaboration, analysis and archiving via MS SharePoint, MS Office Suite, HP ALM, etc. Lead On- and Off-shore QA and Testing project teams through rigorous system development lifecycle (SDLC) software implementations and enhancements to meet project deliverables dates, report timeliness, integration and collaboration initiatives. Analyzed QA and Testing’s Critical Success Factors (CSFs) and Key Performance Indicators (KPIs) to align with Project Management expectations for resources, cost, and budget. Consulted and provided guidance to clients’ on the development of User Acceptance Testing (UAT) and Regression Testing test beds in an effort to ensure all testing phases including End-to-End (E2E) were delivered and approved for Go-live (code promotion to production environment) and project shutdown. Quality Assurance & Testing Lead/Defect Manager - - Assessed, tested and analyzed functional requirements for viability and project quality. Participated in System Testing (ST), System Integration Testing (SIT), End-to-End Testing (E2E), Regression Testing (RT), User Acceptance Testing (UAT) overviews to provide strategic and detail approaches to align with PMBOK and BABOK planned outcome(s). Designed testing framework in HP ALM to export Test Requirements, Test Plans including test scenarios, and suite of test scripts for execution and analysis for onshore and offshore Testing teams. Managed archived data and testing outcomes for training, reporting, forecasting and Defect Management and Tracking. Utilized statistical analysis to provide quality estimates and reports to project stakeholders for project kick-off, forecast and projections, completion and archive. Assessed processes for navigation of software integration and interface - new portal solutions and applications- with customers’ existing web portals for seamless and real time user experience. JOAN CADENHEAD - - Page 2 Managed DEFECTs for projects from identification to resolution through collaboration with developers, configuration analysts, architecture and hosting teams, and client subject matter experts (SMEs). Facilitated meetings and training sessions to discuss, clarify and resolve software and interface issues during the project, go-live and post go-live phases. Senior Product Consultant/Senior Business Analyst/Senior Configuration Analyst - Discuss and develop Web products and service solutions to Healthcare clients and their constituents. Gather clients’ business requirements for services and enrollment web solutions. Participated in design sessions, prepared design documents and configuration specifications. Assessed core solution’s interfaces with web portals during systems integration testing, and user acceptance testing phases to promote level of confidence and train all end users. Worked with the clients to develop Web portal use cases and test plans, participated in testing phases, and oversaw the clients' testing and subsequent roll-out processes. Collaborated with the Product and Consulting Development team(s), Configuration Analyst(s), Project Manager(s), and clients’ Subject Matter Expert(s) to drive deliverables. Managed and troubleshot issue from identification to and resolution, and posted “known” product incidents via Oracle, NimSoft and Service Now ticketing systems. Provided guidance to clients on the use and function of software including custom designs during implementation and post-implementation phases. Health Insurance Plans of New York New York, New York Lead Information Systems Business Analyst 2004 to 2005 - - Liaison between Information Systems Executive Strategic teams and Internal Business Partners to ensure accuracy and timely project deliverables through Business Requirements, Design Documents, System and User Acceptance Test Plans. Managed Project Life Cycle in order to adhered to and prescribe successful project outcomes. Oversaw and advised developers on the creation of Systems design and User Acceptance Testing Plans for software enhancements and implementations. Worked with Business Partners (Operations leaderships in the C-Suite) -Claims, Provider Relations, Benefits and Eligibility, Care Management, Finance, and Network and Development- to properly create and implement systems projects, advised on industry trends and current approaches in Claims and Managed Care operations and software usage. CONSULTING      EConsulting Services Group, LLC - Information Technology, Healthcare & eBusiness. Afshar Consulting Group, Inc. - Membership and Enrollment (Individual and Groups). TSGIT Healthcare Division - Provider Reimbursement Coding. Jacobson Solutions - Health Insurance Provider and Member Services. CSRG - Health Insurance Claims Adjudication, Payment and Reconciliations. Experience: - - Facilitated clients’ request for software through Business Requirements and Configuration of Diamond Claims Operations solution. Analyzed Diamond solution to identify Claims Processing, Membership and Eligibility, Provider Information, Networks and Pricing, Benefits and Managed Care (Pre-Authorization and Referral) modules based on define corporate methodology. Configured claims systems based on clients’ business rules and approved requirements for health insurance operations and constituent delivery. Analyzed requirements and developed PLASM testing scenarios to remedy changes required by customers and end users on PC Systems 90 claims processing solution. JOAN CADENHEAD - - - - - Page 3 Participated in the full testing life cycle from Integrated testing to Regression Testing and PostImplementation maintenance of software application –Change Requests (CRs) and Action Requests (ARs)- based on Project Management Office’s (PMO’s) software escalations and upgrades. Wrote test plans and testing approach for presentation to IT work groups based on PM’s forecast and project timelines. Harvested Acceptance and Regression test beds for archival use based on newly implemented codes in IBMs INFOman (TSO) tool and PC Systems 90 test regions -health plans, benefit policies and mandates, exclusions and non-covered services, Membership and Eligibility including terminations and reinstatement of individual and group policies. Audited Claims financial information to determine compliance with corporate guidelines, benefit policies, eligibility and regulatory agencies –New York State Department of insurance, Centers for Medicare and Medicaid (CMS), Healthcare Effectiveness Data and Information Set (HEDIS), and National Committee for Quality Assurance (NCQA) standards. Adjudicated complex surgical, therapy and prescription drugs claims based on Utilization Management, corporate and contractual plan information, benefits, and membership and enrollment current status to derive appropriate assignment of benefits, pricing, payment, or denial – Explanation of Benefits (EOBs), Explanation of Medicare Benefits (EOMBs) and Explanation of Payments (EOPs) for healthcare providers. Handled individual and group customer service appeals and adjustments to streamline claims operation and correspondence inventory escalation using Customer Service Inquiry Delivery Systems. Tested Inter-Plan Teleprocessing Services (ITS) -Blue Card and NASCO accounts information to validate compliance with Home and Host Plan business Rules and test scenarios. EDUCATION Doctor of Philosophy in Organization and Management, specializing in Information Technology Management, 2014 - Capella University - School of Business and Technology. Master of Business Administration, specializing in Information Technology Management, 2004 - Capella University - School of Business and Technology. APPLICATIONS/SYSTEMS/PLATFORMS                 Microsoft Office Suite/Office 365 – Word, Excel, PowerPoint, Outlook, OneNote, Access, SharePoint, Skype for Business, GoToMeeting Microsoft Live Meeting Microsoft Project Microsoft Visio Microsoft SQL WebCT/Blackboard, Breezes TriZetto – Facets (Configuration) TriZetto – QNXT (Configuration) TriZetto – NetworX (Integrated and Stand-alone applications - (Configuration) TriZetto – Constituent Web Solutions (CWS) – Services (Member, Provider, Group/Employer) TriZetto – Constituent Web Solutions (CWS) – Enrollment and Billing (Member, Provider, Group/Employer, Broker, Administrator) JIRA Crystal Reports HP Application Lifecycle Management (ALM)/Mercury Quality Center (QC) Electronic Data Interchange (EDI) - 834, 837(Professional, Institutional, Dental), 835, 270/271, 276/277, 278.