Sharon L. Davis
**** ******** ******, **********, ** 15132-4702
C: 412-***-**** / E: ***********@*****.***
PROFESSIONAL SUMMARY
Organized and disciplined team player with the ability to excel in independent positions requiring minimal supervision and the ability to simultaneously handle multiple tasks with results.
Competent at gathering requirements for business needs, applying skills in business analysis and process improvement.
Proficient at diagnosing process improvement opportunities and developing solutions using principles of process excellence and related tools.
Effective at managing team dynamics while maintaining focus on the Voice of the Customer needs.
Analyzes data and processes to develop business-driven and cost-effective solutions which aim to provide Critical to Quality business requirements for my customer.
SKILLSET
Extensive experience in Medicaid Healthcare Operations • Agile Methodology
Medicaid contract analysis and interpretation • Lean Six Sigma Green Belt
Business Analysis • Process Improvement
Project Management Analysis (PMA) • State Regulatory Compliance – Medicaid programs
TECHNICAL SKILLS
Project Management Tools: CA Clarity PPM, MS PowerPoint, MS Excel, MS Project, Nuance
Business Analysis Tools: IBM Blueworks Live, MS Visio
Lean Six Sigma Tools: DMAIC Tools, Minitab, SigmaXL
Healthcare Databases: Cactus, CSD, CSP, Credentialer, ICIS, iStream, Navigator, NDB, Trizetto Facets
Data Analytics: Python, SQL (Fundamental-level)
Testing Tool: ClearQuest
WORK EXPERIENCE
SDLC Partners, L.P., Pittsburgh, PA 2013 – 2016
Associate Consultant
Business Analyst
Collaborated with cross-functional teams including SMEs, business analysts, developers and testers.
Created business process maps for complete process identification and As-Is and To-Be processes.
Worked in Waterfall and Agile methodologies.
Provided functional deliverables (vision document, business requirement document).
Experienced at requirements gathering, generating User Stories and User Acceptance Criteria.
Provided knowledge transfer to technology teams.
Assisted in load and functional/performance testing using manual testing methods.
Business Analyst, Quality Control
Performed quality checks on individual and group Summary of Benefit and Coverage (SBC) documentation for annual commercial benefit coverage.
Audited Document Specialists’ individual workflow procedure for accurate completion of entire SBC process.
Suggested improvement opportunities on existing SBC workflow process to create a uniform system for accuracy and tracking purposes.
Project Coordinator
Coordinated maintenance of Clarity PPM database for Capability Managers adding new or revision of existing project tasks. Performed weekly audit maintenance of Clarity PPM resource demand for project financial reporting requirements.
Assisted in reporting on project deliverables and working on overall project planning. Studied assigned programs, comprehension of client requirements and analysis toward project goals.
Assisted the Project Manager in assessing each Business Analyst’s skillset to assign project tasks to the appropriate BA. Coordinated Business Analysts with accurate and focused research efforts.
Offered necessary healthcare knowledge and managed care background to new Analysts on the team to assist in comprehending Medicare and Medicaid industries.
United Healthcare, Inc. Braddock Hills, PA 2005 – 2013
Provider Data Analyst
Managed provider contract, demographic and claims reimbursement data in specialized claims payment application.
Investigated new contract documents and amendments prior to insertion into claims payment application.
Assembled detailed provider group information with Provider Advocates for unique practices, requiring meticulous care of contractual entry, reviewed reports and updated divisional databases to ensure data integrity.
Functioned as the “Go to Person” for critical updates in support of our health plan Provider Representatives.
Monitored the company’s database, a high volume production processing area for various State Health Plans, offered recommendations on major contractual or payment updates for large medical groups; proposing the most time-effective method to make the update(s) and to ensure the medical group’s satisfaction is achieved.
Served as Team Lead for a specific line of business through extensive understanding of State regulations, requirements and compliance provisions.
Unison Health Plans, Inc. Monroeville, PA (formerly Three Rivers Health Plans, Inc.) 2000 – 2005
Provider File Project Coordinator
Three Rivers Health Plan, Inc. Monroeville, PA 1999 – 2000
Supervisor
Three Rivers Health Plan, Inc. Monroeville, PA 1997 – 1999
Credentialing Specialist
EDUCATION
University of St. Francis – 2003
Master in Business Administration (M.B.A.), Strategic Management
Duquesne University, Pittsburgh, PA
Bachelor of Arts, Media Communication (B.A.)
CERTIFICATIONS/TRAINING
Business Analysis in Agile Projects, Certificate, October 2014
Lean Six Sigma – Green Belt Certification, #A3648, January 2013
Lean Six Sigma – Yellow Belt Certification, March 2011