Sharon L. Davis

**** ******** ******, **********, ** 15132-4702

C: 412-***-**** / E: aczhh3@r.postjobfree.com

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

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