Project Manager / Business Analyst

Business Analyst

Career Summary

My professional experience within Healthcare IT Infrastructure, Government Health Solutions and Life Sciences Operations over the last 18 years has provided many challenging opportunities that have fostered growth and innovation while developing strategic solutions for complex stakeholder needs. In keeping with this growth, I am currently pursuing the ITIL v3 Foundation certification.

Core Competencies

Microsoft Office Suite

Project scope management

ITIL, Agile and Waterfall methodologies

Gather, analyze, document and communicate business and technical requirements and software designs

Developer code review and analysis

Manual and automated UAT and regression testing

Process Improvement

End user training development and delivery

Liaison between business, vendors and technical teams

SDLC project deliverables and phase management

Work Experience

Hewlett Packard Enterprise - Contract; Indianapolis, IN February 2015 – November 2016

Senior Business Analyst – Indiana Medicaid

Gather, analyze, develop and communicate project scope, Visio process flows and requirements for EDI, claims, enrollment, data maintenance, web portal and financial change requests across all Medicaid populations within a mixed ITIL, Agile and Waterfall environment. Collaborate with systems developers, architects and business units to design enterprise level software solutions and validate that those solutions align with the approved requirements. Provide subject matter expertise as the liaison between the business, vendors and technical teams. Coordinate vendor end to end and UAT / model testing including developing testing strategies, use cases, test cases and post implementation regression test plans.

Analyzed numerous HIP 2.0 projects that extended low cost health coverage to managed care members who would otherwise be without or receiving inadequate care. The continued initiatives have returned more decision making to the members with incentives for completing annual preventative services and therefore fostering more positive patient outcomes.

Implementation of the Fast Track Credit Card project reduced member enrollment times to as low as 5 business days by interfacing with FACTS.

Expanding coverage, HIP Employer Link allows Medicaid qualified employees and their eligible family members who are receiving affordable employer sponsored insurance to receive secondary coverage for Medicaid approved services along with monthly premium and out of pocket expense reimbursement. The initiative improves the member’s confidence in their care while reducing personal financial burden.

BCBS of North Carolina - Contract; Durham, NC September 2014 – January 2015

Remote Project Manager

Human Resource management of 70 remote analysts. Large scale inventory reduction initiatives including monitoring user training to ensure that analysts provide high quality output in accordance with account and departmental KPIs. Ensure that project deliverables are met.

Analyze business and system processes to identify and improve latencies within the health insurance claims lifecycle

Utilize process improvement to promote project excellence

Common Ground Healthcare Coop - Contract; Brookfield, WI August 2014 – January 2015

Remote Part-time Audit Analyst

Monitoring of health claims processing quality through data analysis and auditing. Perform root cause analysis of errors and fall-out of automated processing reports. Communicate audit findings to affected business units in order to determine collaborative solutions. Develop and promote adherence to policies and procedures.

Non-profit organization providing preventative care while reducing annual costs and providing improved services for members, regardless of income

Define meaningful metrics that measure the success of the department’s strategic initiatives

Dell Inc.; Plano, TX October 2012 – September 2013

Remote BPO Manager – Kaiser Permanente

Human resource and allocation management of 50+ remote analysts and team leads. Serve as the liaison between the client and Services team. Lead onshore and offshore healthcare benefits UAT testing and system configuration efforts. Analyze large data sets using Excel and Access. Perform root cause analysis, defect tracking and resolution development.

Monitored audit results and provided guidance and training to ensure that project output remained within the established service level agreement thresholds

Improved SharePoint cross-departmental workflows, streamlining the issue routing process and reducing the turnaround time

Analyzed the system process hierarchy to identify and eliminate unnecessary auto-suspense steps, therefore significantly increasing auto-adjudication rates and reducing inventory

Dell Inc.; Plano, TX January 2010 – October 2012

Remote BPO Project Manager – Community Health Plan of WA

Human resource and allocation management of 35+ remote research analysts and team leads. Onshore and offshore post system migration inventory metrics dashboard reporting. Data analysis and mining using SQL queries and Access Macros. Lead UAT testing initiatives. Collaborate with the configuration team to develop requirements that support software enhancements. Manage and validate provider data loads and related defect tracking. Mentor staff to provide an actionable career development path.

Lead a team of driven research analysts within a demanding environment resulting in the reduction of a multi-million dollar penalty laden health claims inventory backlog

Restored stakeholder confidence by creating an environment where consistently exceeding KPIs and SLAs was commonplace

Motivate staff and increased morale through positive focused training and incentivized production goals

Dell Inc.; Plano, TX August 2009 – December 2009

Remote & Onsite Benefits Analyst Trainer

Deliver training content via eLearning and classroom settings. Develop policies, procedures and training materials. Conduct requirements analysis and provide recommendations to support continual service improvement.

Reduce classroom time by 60+% allowing staff to provide fast meaningful contributions

Provide a hands on experience that delivers a well prepared and self-reliant team with a thorough understanding of system functionality

Deliver training in an easy to understand format for end users at varying levels of experience

Additional experience available upon request

Education & Training

Villanova University; Villanova, PA

Area of Study: ITIL v3 Foundation

Currently pursuing Axelos ITIL Foundation Certification

Indiana University Purdue University Indianapolis; Indianapolis, IN

Ivy Tech Community College; Indianapolis, IN

Area of Study: Computer Science

2 years of completed coursework

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