Jacinta Shouse

**** ********* *** #***, **********, WA. 98225 360-***-**** adznms@r.postjobfree.com

Education and Certifications

BACHELOR OF SCIENCE 02/2014 WESTERN GOVERNORS UNIVERSITY

·Major: Business Management

·Minor: Project Management

ASSOCIATE DEGREE 06/2010 SKAGIT VALLEY COLLEGE

·Major: Business Transfer Degree

CERTIFICATION 01/2014 COMPTIA PROJECT +

·Major: Project Management

Skills & Abilities

•Significant knowledge and experience with: Facets, Salesforce, Online Enrollment, ANSI 834, CREST, Toad, Claim Vantage products, and SQL. Knowledge and experience to include User Acceptance Testing.

•Strong organization, communication, and interpersonal skills with internal and external customers. Including international teams.

Experience

PROGRAM MANAGER/BUSINESS SYSTEMS ANALYST AMAZON INC. JUNE 2019- DECEMBER 2022

·Demonstrated ability to develop detailed User Stories, that includes wireframes for the User Interface design. This includes leading deep dive sessions with the business stakeholders, and running scrum calls with the tech developers to ensure business requirements are on track and being developed to the stakeholders expectations.

·Proven analytical, and communication skills with an ability to be both clear and concise.

·Worked as the first BSA hired to a project to develop customized claim management software for Leave and Disability services. Reviewed all the requirements for all work streams to develop this product from the ground up.

·Product Owner for the claim management work stream, which includes intake, eligibility automation, and extensive work with the legal team to ensure the product met state and federal compliance.

·Product owner for two integrations between the system and vendors, building vendor relationships, and running calls between our team and the external vendors.. Including an internal integration to our PeopleSoft system and an eligibility file to an external vendor. Owned these integrations from development of requirements, design of files through current. This includes file design, defect fixes, and ongoing enhancements.

·Extensive work on OP1 planning for upcoming years, including evaluation of annual goals, assessment of impact to other work streams, technical design and feasibility, tech effort assessment, and sprint planning.

·Proven track record of developing and approving User Stories for a minimum of 3-4 months of sprint planning and work.

·Extensive experience coordinating with teams across the globe.

·Proven ability to develop trust and rapport with leaders and executives on both my internal teams and the business we support. This includes providing them with my recommendations for their future state that are accepted by leaders and business stakeholders.

·Extensive knowledge of Salesforce as the product we built was built on a Salesforce platform.

·Proven ability to facilitate system configuration and User Acceptance testing.

·Experience in supporting and responding to business trouble tickets in production support.

·Experience in writing SQL and SOQL queries to provide ad hoc reporting to the business team and research reported issues.

BUSINESS SYSTEMS ANALYST REGENCE MEDICAL GROUPS 11/2015-JUNE 2019

·Demonstrated ability to develop general and detailed functional requirements, create and perform system testing, along with the ability to report on the results of such testing, ability to facilitate and carry out system configuration decisions, ability to facilitate communication between technical and business staff with the goal of finding the best solutions to meet the business requirements of various projects.

·Proven analytical, and communication skills with an ability to be both clear and concise.

·Implementation project work to include: implementation of new vendors, annual group and individual implementation work for billing, member ID cards, AFA billing, stop loss, Auto Actions, etc.

·Extensive work in assisting business staff in writing business requirements for both core system enhancements, and new custom extensions. The work includes: working with the development team to understand the business requirements, finding solutions that meet the business needs, working with our software vendor to develop the requirements, continued development with the business as requirements are added or modified, unit testing, supporting the business with questions on new and existing functionality, and support of UAT testers.

·Extensive Facets knowledge, to include the ability to write and execute ad hoc queries for data analysis, research documented system functionality, review data dictionary, data models, and various other knowledge databases.

·Support of quarterly system upgrades, enhancement releases, and defect fixes. This includes: analysis of release documentation, unit testing, support of UAT testers, and post production checkouts.

·Production support to include: batch validation, troubleshooting, configuration decisions, and data analysis.

·Member of Facets billing and eligibility subcommittee meetings with other health plans. These teams work to identify pain points, common processes, uncommon processes, process improvement, system improvements, and system enhancements that would benefit multiple plans.

OPERATIONS REPORTING AND PERFORMANCE ANALYST/BPA REGENCE MEDICAL GROUPS 05/2014-11/2015

·Extensive work with internal customers, external clients, and outside vendors, with a focus on process improvement and creating higher levels of efficiency.

·Troubleshooting system issues and working as a resource for our administrative operations team to improve relationships with large group clients. Relationship improvements include: working with the data support team to supply ad hoc reporting at client’s requests, creating written procedures for our administrators when clients have special needs, active member of the renewal and implementation teams working to streamline setup, changes to client’s benefits, identifying trends in manual errors or system issues and reporting on solutions.

· Salesforce- planning, recommendations, and preparation of fixes and enhancements. Involved in weekly meetings to identify issues and areas for improvement, to include focus on employer experience. UAT testing for both initial stages and End to End testing.

·Windows based online enrollment system - planning, providing business requirements, preparation and implementation of system before the first group was rolled onto this platform, continued support for the improvement process, not limited to: reporting issues, working with Business Systems Services and developers to determine source of issues, User Acceptance Testing for both sprint and regression testing, creating written documentation and internal procedures

· Collaborate with business partners to include BSS and sales to identify business rule and program issues. Partner with BSS to perform analysis, implement program fixes and provide UAT testing as needed in test environments for multiple applications.

· Extensive knowledge and experience with ANSI 834 files: troubleshooting, ANSI implementation for new groups and groups transferring to this platform, UAT testing, work with BSS and management to define business requirements, establishing and creating documentation for internal procedures, extensive use of Toad running comparisons to ensure automated reports are capturing correct data.

· Involvement in multiple project teams for: UAT testing, new system implementation, trouble shooting, new process development, Work Order Requests, future enhancement opportunities, incorporation of ACA regulations into current system and processes.

· Creating and documenting new procedures for manual work and review for internal use to include: working with multiple departments to clarify possible downstream effects, testing processes to ensure they are complete, pulling reports to verify processes are being handled properly by end users, and training of end users.

MEMBERSHIP ADMINISTRATOR/ELIGIBILITY PROCESSOR REGENCE MEDICAL GROUPS 09/2008-05/2014

·Provide successful account management to 2nd largest group account with over 40,000 members to include but not limited to: processing electronic eligibility, work special requests in collaboration with Underwriting Department, new process implementation, rate and product audits, work with Account Executive for updates and communication of process changes with group.

·Work with Account Executives, Group Administrators and TPAs regarding group specific guidelines.

·Assist with research and establish written documentation for processes specific to Self-funded groups (Alternate Funding Agreements).

· Mentor and train staff with questions and/or difficult issues or accounts as needed, to include creating training modules to provide to the training team for both new hire and refresher training classes.

· Maintain heavy workload with several ongoing projects in addition to working with assigned groups. Met deadlines and exceed yearly goals set by management.

·Expert at all stages of reconciliation for group’s administrative billing and claims invoicing accurately and timely while adhering to established policies and procedures. Processes could include but not limited to: allocating funds, transferring funds, write offs, and spreadsheet reconciliation. These are multimillion dollar accounts between both claims and administrative billings.

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