Business Analyst Quality Assurance
Resume:
**** ****** ***** **, ******, US, ***** • ***.**@*******.*** •
TANIA JOHNSON
PROFESSIONAL SUMMARY
Experienced Leader with over 18 years of experience in risk management, Medicaid, health care, enrollment, UAT, and quality assurance, skilled in process improvement and data validation. Demonstrates strong leadership and project management capabilities, enhancing team performance and operational efficiency. Committed to leveraging analytical skills and business acumen to drive strategic initiatives and optimize business operations. EMPLOYMENT HISTORY
SR BUSINESS ANALYST, RISK ADJUSTMENT AND QUALITY MANAGEMENT Apr 2022 - Present Optum United Health Group Remote
QNXT BENEFIT CONFIGURATION ANALYST Sep 2021 - Apr 2022 Community Health Choice Houston, Texas
LEAD BENEFIT CONFIGURATION AUDITOR May 2021 - Sep 2021 Prospect Medical Systems Remote
Develop comprehensive test scripts and guides for seamless UAT and CAT processes. Oversee software support and user access, ensuring smooth operations and user satisfaction. Conducted thorough data validations for infrastructure releases, ensuring accuracy and reliability in reporting and software enhancements.
Streamlined the creation of test scripts and user guides, significantly improving the efficiency of UAT processes and reducing onboarding time for testers.
Developed comprehensive release notifications and CAT summaries, enhancing communication among stakeholders and facilitating smoother transitions during updates.
Analyze and update benefit configurations for insurance accuracy and compliance. Test and validate claims payments, ensuring precise processing. Monitor regulatory changes to maintain adherence to state and federal guidelines. Evaluate application updates for potential business process impacts. Conduct system acceptance tests to ensure enhancements align with requirements. Conducted thorough testing of benefit configuration accumulators, ensuring precise claims payments and enhancing overall system reliability.
Supervised and trained benefit configuration team, enhancing efficiency and skill levels. Led audits and presentations, improving report accuracy and team communication. Configured and tested benefit changes for insurance plans, ensuring compliance. Developed audit metrics using Visio, PowerPoint, and Excel, optimizing performance tracking. Managed resource allocation, achieving measurable improvements in workload management. Led benefit configuration audits, identifying discrepancies that enhanced compliance and improved operational efficiency. Analyzed team performance metrics to develop targeted training programs, resulting in marked gains in staff proficiency and productivity.
BUSINESS OPERATIONS ELIGIBILITY MANAGER Nov 2007 - Feb 2021 Texas Children’s Health Plan Bellaire, Texas
EDUCATION
TEXAS REAL ESTATE AGENT 2024 - Dec 2025
Houston Community College Houston,Texas
MASTER'S INFORMATION SYSTEMS, DATABASE DESIGN CONCENTRATION Sep 2018 Southern New Hampshire Community College
BACHELOR'S BUSINESS MANAGEMENT Dec 2013
LeTourneau University
SKILLS
Leadership (Expert), Business Analysis (Experienced), Product Management (Experienced), Problem Solving (Expert), Process Improvement (Expert), Configuration(Expert), Analytics (Experienced), Critical Thinking (Expert), Project Management (Skillful), Data Validation (Skillful), SQL (Beginner), Business Operations (Expert), Team Management (Expert), Risk Management (Expert), Quality Management (Skillful). ADDITIONAL INFORMATION
BOARD OF ADVISORS AND COMMITTEE MEMBER
Gathering Outreach Community Services
Mission: To inspire and enrich the lives of children, teens, and adults by building relationships, providing resources, and creating outlets that strengthen community togetherness and enhance the quality of life for all. Managed Medicaid enrollment, improving accuracy and efficiency. Led cross-functional teams, ensuring timely project delivery. Resolved compliance issues, enhancing regulatory adherence. Automated tasks, boosting productivity and reducing errors. Facilitated training, elevating team skills and performance. Facilitated training sessions for team development, enhancing skills and boosting morale, which contributed to a more engaged and productive workforce.
Streamlined Medicaid enrollment processes, achieving substantial improvements in accuracy and efficiency for the organization.
Conducted comprehensive root cause analyses, developing corrective action plans that effectively mitigated future compliance risks.
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