Manager Management
Resume:
Elisa Robin Kuritz
Jacksonville, FL 32234
Email Address: abh4l3@r.postjobfree.com
Areas of Expertise:
Over 20 years of excellent performance in Business and Information Technology Positions
for largest Healthcare Provider in the U.S. Performed successful Systems and Business
Analysis in e Commerce applications as well as Oracle and SQL based systems to include
but not limited to an Enterprise Claims Adjudication Application (Diamond), QUEST,
Convergence, IMS, and JCL for over 10 years. Excellent experience in leading requirements
sessions (business and technical) using several methodologies. Conducted numerous
JAD/JAR sessions with business associates and IT. Excellent experience with multiple
claims adjudication systems at the Enterprise and Commercial levels for claims
adjudication and network management.
Avventa Worldwide, LLC – Business Analyst May 2010 – Oct 2010
Served as a liaison to business owners to define project charter, scope, objectives, key
stakeholders and critical milestones. Lead the process of gathering, reviewing, evaluating
and producing business requirements. Developed critical success factors and key
performance indicators for success. Successfully completed business requirements goals
and objectives
I Methods – Business Analyst Jan 2010 – March 2010
Fulfilled a short term contract for developing business requirements for new system design
and on going maintenance. Developed an understanding of company’s business processes
and database structures to successfully develop BRD. Gained a broad understanding of life
and health benefit plans and insurance riders such as critical illness, cancer, long term care
and catastrophic coverage
Payformance, Inc. Business Analyst Dec 2008 –April 2009
Utilized the Agile methodology researching, analyzing and documenting business
requirements for IT development. Successfully supported the business’s goals by
conducting JAD/JAR sessions with management and walking them through business
requirement development and acted as a liaison for IT development. The process included
but was not limited to; of developing business requirements, business process flows
(Current/Future), use cases, data value charts and UAT.
Ettain Group Sr. Business Systems Analyst
Medical Systems International April 2008 – Sept 2008
Successfully build three phases of new claims adjudication and enrollment system. Worked
a liaison between the business and IT development. Effectively gathered requirements and
developed Process Flow Diagrams, Work Flow Diagrams, Web Page design and layout and
field specifications and validation rules.
Technology Service Partners, Inc. (TSPI)
IT Contractor Blue Cross and Blue Shield of Florida Nov. 2006 Dec 2007
Senior Systems Analyst
Responsible for new system design and analysis for the Diamond system by gathering
requirements from business process owners and impacted area representatives. Acted as a
data expert for the Diamond system and multiple data repositories that house information
related to providers of medical services. Facilitated the development of new capabilities and
functionalities for Employee groups migrating to the Diamond system for processing claims
and ANSI X12 transactions and ensured HIPAA compliance.
Account Manager (Business and IT Role) Dec. 2005 Nov 2006
Responsible for recruiting and placing highly qualified IT professionals with local
corporations in need of short term contractors for project work. Established and
maintained strong business relationships, which includes my primary client, Blue Cross
and Blue Shield of Florida, Inc.
Blue Cross Blue Shield of Florida, Inc. (Enterprise Level) May 1978 May 2004
Sr. Business Consultant Jan 2004 June 2001
Responsible for consulting and contracting with Core Business Leaders for Information
Technology (IT) services and support. Consulted with IT and the Business Process Owners
for IT services and development of new capabilities. Worked within the corporate Change
Management process to ensure issues identified were addressed and new releases were
scheduled and properly tested to customer's satisfaction.
Business Director of Physician and Provider Data Mar 1999 May 2001
Provided expertise in the collection, analysis and reporting of physician related data.
Participated on a core group committee responsible for planning, design, walk thru and
testing of new capabilities. Led and participated in corporate work sessions for strategy
development. Responsible for working with IT and Operations Management to address
issues associated with new systems development.
Information Technology Marketing/Web Consultant (Business and IT
Role) Mar 1999
May 2001
Provided web training and support to appropriate areas of the company. Responsible for the
design, development, and implementation of the company’s corporate Internet and Intranet
sites. Met with key stakeholders to gain their support for the funding required to create a
demo of these two sites.
Manager, Corporate Intranet (Business and IT Role) Nov. 1997 Feb 1999
Responsible for the management and planning activities to design and develop the
corporate Intranet. Developed a cross functional committee whose charter included the
overall management, governance, re design and implementation of new web sites on the
Intranet. Facilitated all reviews, web site launches and management processes to support
future growth, integration, and consistent “look and feel” templates.
Manager, Electronic Commerce Mktg. (Business and IT Role) July 1996 –Nov 1997
Responsible for the development of a vendor relations strategy for the corporation that
facilitated the implementation of corporate strategies. Responsible for corporate
management and associated plans to implement Practice Management System vendor
support of Virtual Office. Managed a team of Marketing Consultants whose day to day
activities include marketing, vendor contracting, relationship management and market
analysis.
Business Reengineering Consultant Sep 1994 July 1996
Responsible for marketing, recruitment, contracting, communications, and ongoing
relationship management for BCBS Providers and Vendors. One of 12 employees selected by
Executive Staff to be a member of the Re engineering Leadership Team. Responsible for a
corporate effort to expeditiously reengineer our business and bring about large scale change
at an enterprise level. Lead the first pilot of Virtual Office to integrate capabilities in
Jacksonville, Florida. Managed teams of individuals to reach desired objectives and goals
related to business change and information management. The processes identified in this
effort are one half of all electronic commerce transactions.
Project Consultant, Health Care Administration Project Jun 1992 Aug 1994
Responsible for collaborating with physicians/providers to ensure HCAP objectives were met
addressing their needs and expectations. Participated on a Northeast Region Project as core
workgroup member responsible for relationship building and exploring integrated health
care delivery systems. Participated in Provider/Network Business Design Team. Created
cross walks for HIPAA AS codes to BCBSF procedure and benefit codes for multiple
systems. Worked on several ANSI transactions including ANSI 270 & 271, ANSI 276 & 277,
ANSI 835 & 837, etc. Responsible for the requirements and EDI gateway specifications.
Professional Consultants/Business Services (Bermuda)
Executive/Legal Assistant Oct 1989 May 1992
Comprehensive support responsibilities to President of Business Systems, Ltd. and various
law firms. Programmed computer spreadsheets for inventory/quality control and statistics.
Blue Cross Blue Shield of Florida, Inc. (Jacksonville, Florida)
Manager, Provider Relations (Business Role) Jun 1987 Dec 1988
Developed and approved educational and contracting materials for physician groups.
Interviewed and evaluated physicians and medical professionals for participation
qualifications and led initial team that Recruited and Contracted Health Options, Inc.
Product Development Specialist (Business Role) Sep 1986 Jun 1987
Operations Supervisor, H.I.S. Field Support Feb 1986 Sep 1986
Professional & Provider Analyst, H.I.S. May 1985 Feb 1986
Marketing Analyst, Medicare Part B Nov 1983 May 1985
Profile Analyst, Medicare Part B Dec 1980 Nov 1983
Claims Examiner, Medicare Par July 1978 Dec 1980
EDUCATION:
University of Phoenix (six classes to complete Bachelors Degree in E Business)
Certification from Learning Tree International in Internet/Intranet Design
TRAINING and System Experience:
BCBS Corporate Training: Management Development Training for Supervisor, Manager
and Director, Professional Sales Negotiations, Re engineering Training, EDI, Electronic
Commerce and Clearinghouses, Project Management, Facilitation Management, Zenger
Miller Frontline Leadership, Seven Habits of Highly Effective People, Creative Writing
Skills, Microsoft FrontPage 98, Microsoft Office, Excel, PowerPoint, Access, Visio,
Proprietary databases, Practice Management Systems (The Medical Manager, etc.),
Diamond, Quest, Legacy systems, Provider and Member Data Stores (Data Warehouses),
Sales Force CRM System, Vista, Optimal Trace Requirement Development Tool
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