Business Analyst

Susan Churchill

***** ****** ***** **, ********, CA 92590 Cell 520-***-**** E-mail ****************@*****.***

SUMMARY

Energetic, initiative-taking healthcare business analyst with 25+ years’ experience in the healthcare payer technology and services industry support in the areas of product marketing, product development, product management, and operations.

10+ years of payer software marketing including sales marketing, product implementation, product positioning, and product differentiation.

A resolute and self-motivated professional with proven success in all aspects of supporting the healthcare payer, provider, and third-party administrator segments.

10+ years of proven effectiveness in a remote setting in autonomous and/or collaborative positions

PROFESSIONAL PROFILE

Extensive knowledge of healthcare payer benefit and care management administration supporting multiple lines of business

Excellent project management, collaboration, and critical thinking skills with demonstrated ability to manage multiple and conflicting priority projects

Highly organized and known for versatility, adaptability, and ability to “wear many hats”

Articulate communicator who effectively interacts with clients and industry constituents, at all levels of management, with exceptional people skills

PROFESSIONAL EXPERIENCE

HCIM, Walnut Creek, CA

HCIM is a partner with health care payers and managed care organizations delivering solutions that streamline their operations, increase efficiency, and improve accuracy.

Senior Application Analyst – Plexis 2021-Present

SymKey Implementation for QC and PCM

Collaborate with internal and external client on software direction and development of SymKey

Create/Deploy Business Requirements documentation

Product Training for clients via the web or onsite

Senior Consultant – 2019-2021

Software implementation of HCIM SymKey software and reseller of the CAT (Claims Audit Tool)

Consultant for healthcare software implementations (i.e., Quantum Choice Payer Suite, HSP Payer Suite, EZ-Cap Payor Suite)

Project Manage client through implementation

Draft, edit, and finalize all incoming RFP for Claims Audit Tool

Demo preparation and presentation for the Claims Audit Tool

Senior Business Analyst/Project Manager – QC 2016-2019

Create/Deploy Business Requirements documentation

Create Training/Process/User Documentation

Create and execute Test Plans

Plexis Healthcare Systems, Inc., Ashland Oregon 2014-2016

Plexis provides multiple enterprise-wide core claims administration technology solutions for payers, provider groups, and third-party administrators.

Senior Business Analyst – QC 2015-2016

System Implementation Support encompassing; Benefits, Claims, Enrollment, Providers, Provider Contracting, EDI (ANSI X-12), Data Loading, for Claims Administration Software

Assist Clients with all aspects of software implementation

Identify gaps and create Business Requirements documentation

Provide Full Gap Analysis for new and potential clients

Support Sales with RFP responses

Proposal Specialist/Sales Support/Demo Specialist – QC 2014-2015

Created a formal RFP process to within Plexis Health Systems

Create a data library for resource materials, procedures, and standards to create efficiency in the proposal process.

Outline, Research, Respond, and formats RFP responses

Assign RFP assignments and proposal deliverables to ensure customer proposal requirements to responsible and knowledgeable support staff.

Ensure proposal requirements and format compliance are achieved

Define RFP assignments and proposal deliverables to ensure flow of customer proposal requirements to responsible co-authors

Research and architect responses to the RFP and configuration controls, including proposal requirements and format compliance are achieved

Demonstrate Plexis Quantum Choice Software suite to potential clients online or onsite

Create marketing materials, reserve, set up booth, and represent Plexis at healthcare conventions and events

Prepare QC system data for demonstrations

Continually look for improvements via automation/software, data library, and structure to enhance the RFP response standards.

Primary Provider Management Company, Corona, CA - 2012-2013

PPMC specializes in working with primary care physicians, single-specialty groups, hospital-based physicians, or multispecialty groups.

Senior Business Analyst 2012-2013

Identified system configuration and performance issues and lead implementation of new and improved processes and policies.

Document process flows and develop requirements for system improvements and enhancements.

Lead Project Management for process improvements working with multiple departments to update or reconfigure software

Subject Matter expert on Core Administrative System including Enrollment, Claims, Utilization Management, Case Management, Capitation, Provider Configuration, Fee Schedules, Benefits. Rules, Division of Financial Responsibility, Electronic Data Interfaces (ANSI X-12, Flat Files), and Document Center.

Monument Systems/HealthTrio, LLC, Tucson, AZ - 2000 – 2012

HealthTrio is a Software-as-a-Service provider for the healthcare market dedicated to building secure web-based solutions that improve experiences in value-based care, data integration, care coordination, and member and provider engagement.

Marketing Analyst/RFP Manager

Lead and respond to all incoming proposals including RFP’s and RFI’s from preparation to the final RFP submission

Collaborate across teams to write, format, review and assess a plan of action to achieve RFP submission

Draft, Outline, Research, Respond, and format all RFP responses to ensure proposal compliance to RFP requirements

Delegate RFP questions to appropriate team/staff to ensure quality RFP responses

Lead ongoing meetings for to ensure quality RFP responses and timeliness of deliverables

Create, maintain, and improve the data library content to ensure current, accurate and relevancy of materials

Proposed, researched, configured, and delivered set up of Ovidian RFP software for Monument System for the data library and automation of RFP deliverables

Support Director of Marketing with collateral, trade show, and content input

Software Product Demonstrations

Market Research /Maintenance of company partnerships

EDI Analyst

Knowledge of ANSI X-12 Healthcare EDI transactions. (837, 835, 820, 834)

Create functional specifications, use cases, test plans, and other documents required to

support the software development process

SME for Claims, EDI, Enrollment, Benefits, Fee Schedules, and multiple other areas

Train users and support staff on processing of EDI transactions

Client Service Manager

Directed the Client Services/Account Management overseeing targeted projects

Consistently following up on issues that have been passed to Developers

Maximize healthcare processing/payer software effectiveness by:

Monitoring system performance post-installation

Performing detection, isolation, reporting, tracking of defects in all software through QA

and GAP analysis.

References Available Upon Request

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