Sohaib Zaib

Sohaib Zaib-- CAREER SUMMARY ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● A Digital health Consultant with almost 15 years of diversified experience in the healthcare industry. Worked as a Consultant, Project/Product Manager,Business/QA analyst, and Trainer on various projects of Healthcare integrations, EHR Implementation, Telemedicine and Healthcare Mobile Apps. Managed the complete requirements for an in house RCM development & integration with NPHIES (KSA) platform. Proposed and assisted in implementing the HL7 standards on Elm EHR Well experienced about the functional components of various international EMR systems including but not limited to EPIC, CERNER, INTERSYSTEMS, Allscripts, Medicasoft, BestCare & Kameda Skilled in preparing Executive level reports, business cases & Research articles. Well familiar with healthcare standards of HL7 (FHIR), ICD-10, SNOMED, IHE, CDA, DICOM & PACS Experience of working with numerous PACS vendors including AGFA, GE, INFINITT & PHILIPS Knowledge of Central Board for Accreditation of Health Care Institutions (CBAHI), Joint Commission International (JCI), Institute Health for Health Care Improvement, (IHI) etc. Designed workflows for clinical end users Conducted research and prepared survey content Created the structure of file sharing throughout the enterprise Participated in enhancing the KPIs & budget utilization sessions Extensive project/program management experience across the healthcare domain Experience in creating detailed use cases; use case diagrams, and activity diagrams. Expert in providing change management & end user training Detail oriented nature that facilitated understanding of complex systems and processes Strong knowledge of EDI Claims, member enrollment, billing transactions, Medicaid & Medicare. Involved in technical aspects of SDLC including but not limited to Mobile Apps development, Web Portals, Quality Assurance , XML, SQL/Oracle DBs, & Load Runner TECHNICAL SKILLS Methodologies: Requirement Tracking: Change Management Tools: Office Tools: UML, RAD, RUP, JAD, Agile, Waterfall, PRINCE2. IBM DOORS, Rational RequisitePro, Mercury’s Test Director JIRA, Rational ClearQuest, Test Director, SharePoint MS Word, Excel, MS Project, MS Outlook, MS Visio Sohaib Zaib-- EXPERIENCE Al-Elm Security Co. (Health Sector) Riyadh, KSA Health Informatics Specialist Mar 15- Present Elm is the provider of some of the well know e-services in the kingdom including the likes of Absher portal, Muqeem, Yakeen, Efada and many more. Part of the development and deployment of Elm HIS for the MoH which will be covering 2400 PHCs across the country. Responsibilities: ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● Acted as a health consultant on the following projects o RCM/NPHIES Integration o ePrescription o Appointments Integration o EHR workflow enhancements o Laboratory integration o Online Docotrs Portal o Telemedecine o Home healthcare device integration o SNOMED/ICD 10 implementation o Patient portal & Provider Portal o Health Management Mobile apps o Nationwide Health Observatory Dashboard (BI) Ensuring all project milestones and deliverables are met on time and on budget Prepared executive level reports & research papers Managed and guided the complete requirements for the Revenue Cycle Management (RCM) & NPHIES Integration. Managed documentation for the MoH eHealth Transformation Program Analyzed and documented requirements for the in house developed EMR (Elm HIS) which included ICD 10 & SNOMED Trained end users on the Elm HIS (EHR) Comprehensively involved in the technical/functional evaluation of various EMR systems including but not limited to EPIC, CERNER, INTERSYSTEMS, Allscripts, Medicasoft, BestCare & Kameda Worked with Agfa for the National Tele-Radiology Solution (TRS) project Acted as the consultant for the health related projects Successfully planned, managed and controlled the SEHATECH (Health) Mobile App Project from initiation until closure (being the Project Manger) Created Project Charters and Project Plans for various projects Analyzed and documented requirements for the Health Licensing System (HLS) Project Managed documentation of 30 plus projects at a time Created document sharing structure and file naming guidelines to enhance accessibility Responsible for the weekly meeting to document updates/issues regarding all ongoing projects Participated in enhancing the KPIs & budget utilization sessions Sohaib Zaib-- ● ● Created multiple templates to be used across various projects Conducted and led improvement sessions for numerous initiatives Executive Office of Health & Human Services, State of Massachusetts (EOHHS) Sr. Business /System Analyst Nov 10- Jan 15 EOHHS serves the needs of over 6 million residents of the Massachusetts Area and provides healthcare coverage through its family health plans and Medicare & Medicaid programs. Worked on some of the top projects in the country including Health Information Exchange (HIE), Health Insurance Exchange (HIX), HIWay Phase 2 and Master Data Management (MDM). The goal of these projects is to improve electronic transport of patient information including access of Electronic Health Records and detecting fraudulent activities in insurance claims. Responsibilities: ● Created project plan for multiple projects ● Conducted requirement feasibility analysis with the developers to ensure the project was in scope with the timeline defined in the project plan ● Made the project charter & vision document during the inception phase of the project ● Proposed the UI design for HIE clinical and patient portal. ● Suggested workflow enhancements for HIE after reviewing clinicians comments ● Performed GAP analysis as pertains to membership management and claims processing to evaluate the adaptability of the new application with the existing process ● Analyzed and documented ICD 10 requirements related to data elements, data exchange and data transmission. ● ● ● ● ● ● ● ● ● Reviewed the end user content for accuracy of the HIE project Understood MMIS, the MA state's electronic Medicaid eligibility verification system & the Medicaid & Medicare intermediary along with their roles in claim processing Produced Activity diagrams with defined swim lanes as part of claims process analysis Used HIPAA Gateway to comply with HIPAA standards (270/271, 276/277 & 837) for EDI transactions Gathered, analyzed, documented business and technical requirements from both formal and informal sessions and validate the needs of the business stakeholders for HIE and MDM project. Attended Use Case Review and Design Review Meetings. Coordinated with the developers and IT architects to design the interface of the new system according to the X12 (270, 276, 278, 834, 837 (I,P,D) and 820) standards Took part in the meeting held for the analysis of migration to HIPAA 5010 from 4010. Created detailed use cases, use case diagrams, and activity diagrams using MS Visio Sohaib Zaib-- ● ● ● ● ● Led and managed the User Acceptance Testing (UAT) for the implementation of Facets Extended Enterprise administrative system with emphasis on ensuring that the HIPAA regulation are met across all the modules Responsible for Medicaid Claims Resolution/Reimbursement for state health plan using MMIS. Clarified to claims personnel the new Affinity payments and Explanation for payments (EOPs) for same claim processing cycle Monitored the execution of complex SQL queries for QA testing and data validation Conducted user training pertaining to HIE. BCBS, Jacksonville, FL Business System Analyst/QA Analyst Jun 08- Nov 10 Implementation of the new processing system for Benefit Enrollment files (834) along with review, design and reconfigure of the following FACETS functional areas: • Enrollment • Claim • Billing • Provider • Member Information Responsibilities: ● Participated in creating Facets data model. ● Worked on the EDI 834-file load to Facets through MMS (Membership maintenance subsystem) ● Performed Requirement Gathering by interacting with Business users and documented the requirements ● Worked with Business Users and Solution Engineers to solve the capture defects in the MMS system and to effectively solve them. ● Performed Data Mapping to map the EDI 834 data to XML. ● Performed Gap Analysis to review the existing XML XSD and make necessary changes. ● Conducted JAD Sessions, Peer Review sessions with the SMEs, Solution Engineers, developers, and Business users. ● Analyzed the scope of the project to review it with the customers for different review sessions of the application. ● Used to execute test cases for several transactions such as 837, 835, 820, 834, 277, 278, 270/271 ● Create SQL queries to read data from databases. ● Requirements Gathering & Analysis always ensured HIPAA Compliance Auditing ● Defined the maps from the existing BizTalk solution and validated it with the client for any changes. ● Performed data mapping and tracing data from system to system in order to solve a given business or system problem ● Created draft plan for resource hiring and budget optimization for 1 year CVS/Caremark Jul 07 – Jun 08 Sohaib Zaib-- Richardson, TX Business System Analyst The primary goal of the project is to extract common services such as Eligibility, Formulary, Drug Maintenance, etc. out of the disparate systems and host them independently to facilitate economy of operations, isolation of common business services from core adjudication transaction processing and externalize the data in a way that can be consumed by other external applications within the Organization. This will enable common services, tools and interfaces that can improve client experience and drive consistency regardless of which adjudication engine is used. Responsibilities: ● Involved in gathering, documenting and verifying business requirements ● Organized JAD Sessions to collect requirements from system users and prepared business requirement that provided appropriate scope of work for technical team to develop prototype and overall system. ● Performed market risk analysis and risk management like continuous time finance & asset pricing, stochastic processes & simulations, credit derivatives, structured products, documentation, value at risk, risk & return optimization. ● Worked closely with stakeholders and SME’s for requirements gathering ● Identified end to end requirements for all systems and business units that may be impacted by the project ● Assisted the Project Manager in updating the project plan and charter documents ● Involved in the full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Health Insurance Claims. Worked on HIPAA Standard/EDI standard transactions: 270, 271, 276, 277, 278, 834, 835, and 837 (P.I.D), 997 and 999 to identify key data set elements for designated record set. Interacted with Claims, Payments and Enrollment hence analyzing and documenting related business processes. ● Designed and developed Use Cases and Use Case scenarios, Activity Diagrams, Sequence Diagrams, High Level and Low Level Process Flow Diagrams, OOAD using UML and Business Process Modeling. ● Followed the RUP methodology for the entire SDLC. ● Established and maintained traceability matrix until business requirements were signed off. ● Conducted walkthrough and lead work sessions. ● Responsible for working closely with internal clients in all facets of project life cycle to deliver a useful application supporting the business need ● Using MS-Visio analyzed business requirements and process through Use Cases, Class, Sequence, and Activity diagrams, and adapted UML standards to define modularized Data Process Models. ● Ensured Use-Cases were consistent and covered all aspects of the Requirements document. ● Developed a Business Acceptance testing strategy and plan EDUCATION ● ● ● Mastering Business Analysis Certification ( Canberra, Aus) Mobile Apps in Healthcare (Course-University of Leeds, UK) Health Data Analyst Certification (George Mason University, USA) Sohaib Zaib-- Masters in Health Informatics (George Mason University, USA) ● BSC in Applied Sciences (Bluefield State College, USA) ●