Business Analyst Product Owner

Cathy J Bauer

Mount Prospect, IL *****

***********@*********.***

Nov 2023 – July 2024 Personal Sabbatical Caregiver to Family Member

FULL TRANSPARENCY FOR GAP - After being laid off from CVS Health, I took some time to care for my son who had some physical and mental health issues. He died in July 2024 and I am ready to resume my career.

May 2011 – Oct 2023 CVS Health - PBM Business Analysis – Advisor/Product Owner

Experienced Sr Business Analyst/Product Owner where I collaborated closely with hundreds of PBM (Pharmacy Benefits Management) cross-functional team members by being the Voice of the Customer to facilitate, write and implement Requirements for PBM domain including Claims Adjudication and Mail Order processing.

Worked on projects for the legacy RxClaim application/AS400 Green Screens and systems integration of numerous web/digital applications, as well as data conversions, data migrations and new client implementations.

An experienced multi-tasker managing parallel multiple projects and conflicting due dates. Completed requirements for hundreds of small, medium, large and extra-large projects, with some lasting multiple years.

Experienced in documenting process flows for current state and future state Gap Analysis.

Worked on projects for categories such as Specialty, Accumulations, STCOB- Coordination of Benefits, Prior Authorizations, Utilization Management, and Plan Administration such as Eligibility.

Supported Policy, Procedure and Process Improvement projects by diagramming, technical writing and being a Change Agent. Developed Metrics to support the Post-Implementation of Process Improvements.

Highly experienced in modernizing legacy systems or converting legacy to new systems.

Highly skilled in establishing good working relationships across all areas and levels of Leadership.

Requirements formats included Standard Requirements documents, Use Cases and User Stories. Proficient in Waterfall/SDLC, Agile - Hybrid and Scrum – writing User Stories.

Skilled in writing, establishing and monitoring KPI’s.

Highly skilled in supporting Testing:

oRegression Testing, End to End Testing, Collaboration with Testers as they write Test Schedules, Test Cases (Scenarios) and supported obtaining Data to ensure complete Testing coverage, Supporting/Presenting UAT testing results to the Client

oEntering/Tracking/Resolving defects during all types of testing during the project lifecycle

Skilled Product Owner in the tasks/ceremonies such as Product Backlog, Sprint Planning, Daily Standups, Sprint Demo, Sprint Retrospective, etc.

Skilled in problem solving and data/research analysis like SQL queries, Excel and Root Cause analysis. Have worked with relational databases such as Eligibility and Claims.

Creating user interface mockups for web/digital application projects and member portals.

Familiar with EDI processing, working with Eligibility and Claims files.

Familiar with API processing with Software.

Familiar working with TPA’s, Multi-Employers, Self-Funded in Claims, Eligibility and Benefits.

Worked with PEGA CRM.

Familiar with EDW (Enterprise Data Warehousing) concepts and project needs.

Familiar with Regulatory and Compliance rules and guidelines for Federal/State, Medicare, Medicaid – 340B, NCPDP, CMS, HIPPA, etc.

Familiar with DEVSecOps framework and ITIL methodolologies.

Familiar with MS Dynamics 365

June 2009 - May 2011 TEK Systems@CVS Health External Consultant/Sr. Business Analyst

External Consultant for TEK Systems at CVS Health implementing a Standard Requirements Process across a large department. Created SOP’s, User Guides and Training Documentation.

Worked with Client Business partners, Business Analysts, Developers and Testers to develop and integrate standard processes as well as a Change Manager for introducing and adoption of Use Case methodology for the department.

Converted to a CVS Health employee in May 2011.

Dec 2007 – May 2009 Allstate Financial Technology/ Processing Reengineering Analyst

Managed the Requirements Engineering Program which championed and implemented continuous process improvements to the standard Requirements processes across AFT.

The largest Change Management effort was to communicate and implement Use Cases throughout the organization.

oCreated training documents and User Guides, and scheduled/held training workshops for over 100 Business Analysts and other staff on Use Cases.

Mar 2004 – Dec 2007 Ajilon Consulting@Allstate Financial Technology External Consultant/Processing Reengineering Analyst

External Consultant for Ajilon Consulting at Allstate Financial Technology implementing a Standard Requirements Process across a large department.

Worked with Client Business partners, Business Analysts Developers and Testers to develop and integrate standard processes as well as a Change Manager for introducing and adoption of Use Case methodology for the department. Developed corresponding SOPs, User Guides and Training Materials.

Converted to an Allstate Financial Technology employee in Dec 2007.

1985 – 2002 CBIS/CBSI/Convergys Project Manager/Business Analyst

Started at the inception of the Cellular Industry, supporting the Cellular Billing program and processes used by many Cellular Carriers.

Supported the mainframe Program – Macro/Cell by supervising the Table Maintenance Team to implement changes for new/existing Rate Plans, Features, etc. for Billing Services.

Managed project plans, issues, risks, cost, resources and Business needs on all size IT projects.

Developed and implemented standard Requirements processes including facilitation, change management and traceability.

Technical Skills:

Skilled at planning, scheduling and facilitating meetings with the needed resources to perform productive Requirements sessions as well as requirements documentation including using tools such as:

o Rally (Requirements Management Tool)

o SharePoint (Requirements Management Tool)

o Excel

o PowerPoint

o MS Project

o Visio

o Word

o SQL Queries for research and problem solving

o Testing Support for all levels such as Regression, End to End, Positive/Negative, UAT

o Defect tracking/resolving during all levels of Testing

o RxClaim Software

o Outlook

o MS Teams

o MS Dynamics 365

Documenting Requirements in:

o Waterfall methodology: Charter, BRD, FRD and Traceability Matrix

o Agile Hybrid Methodology: Use Case format

o Scrum Methodology: User Story format and associated tasks/ceremonies

14 years in Pharmacy Benefits Management:

oClaims Adjudication such as Accumulations, STCOB, Utilization Management and Prior Authorizations

oEnrollment and Eligibility

oDrug File

oSpecialty Drugs

oFormulary Management

oBenefit Administration

oMail Order Processing

oMultiple Provider/Member Facing Portals

oPayer Processing

oProcess Diagramming: such as diagrams for As Is, To Be, and Swim lanes

oGovernmental Programs such as Medicare, Medicaid, etc

oCustomer IT Request Process Analysis and New Process improvements

Soft Skills:

Proven capabilities in managing highly evolving priorities.

Productive in a remote working environment as well as office environment.

Effective Communication skills for all levels of the organization and developing good relationships with Business and IT Stakeholders.

Proven Process transformation and continuous improvement skills.

Skilled at mentoring, coaching and training peers.

Highly effective in Conflict Resolution.

Strong analytical and problem-solving skills.

Change Management and Communication, including writing SOP’s, User Guides and Training Materials.

Continued Learning:

Villanova University (Online) Completed March 2004 Mastering Project Management Certificate

Villanova University (Online) Completed January 2004 Essentials of Project Management Certificate

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