Systems Analyst Business

Christina Scullin

· Mobile: 206-***-**** · Email: ************@*******.*** · LinkedIn

· Offer: Two-week Notice

OBJECTIVE:

Seeking a Business Systems Analyst role where I can apply my expertise in healthcare analytics, data visualization, and project management to optimize business intelligence solutions. Passionate about leveraging SQL, Power BI, and ETL processes to enhance data-driven decision-making. Committed to partnering with cross-functional teams to improve data accuracy, compliance, and operational efficiency within the healthcare industry.

EXPERIENCE:

BUSINESS SYSTEMS ANALYST – ADVANCED ANALYTICS TEAM, POLYCLINIC - OPTUM CARE WA, 2021 – 2025

Delivered actionable insights by supporting population health and data quality analytics to drive care improvements and performance reporting. Maintained ETL pipelines for Stars and QIP dashboards, optimizing data integration for quality programs.

Developed and maintained data models and warehousing solutions to support robust business intelligence systems. Utilized a broad tech stack including MS SQL Server, T-SQL, SSIS, SSRS, Power BI, Snowflake, Visual Studio, GitHub, Active Batch, Epic Resolute, and ServiceNow to support scalable reporting solutions.

Interpreted complex clinical data including HEDIS measures, risk adjustment methodologies, and medical coding to ensure accurate reporting and compliance.

Conducted advanced analysis of membership, claims, pharmacy (Rx), and EMR data to uncover trends and led gap analyses and data submission reviews to identify integrity issues and recommend corrective actions.

Enhanced documentation standards and streamlined operational workflows while ensuring HIPAA and data governance compliance.

BUSINESS SYSTEMS ANALYST – CLAIM SYSTEMS DEVELOPMENT, Zenith-American Solutions Inc., 2018 – 2021

Built a data warehouse SQL query library for optimized reporting.

implemented system enhancements through Linux and tested program accuracy.

Resolved data issues, file format, and client implementation challenges.

Wrote design specifications, coordinated data interfaces with clients.

Designed, generated, and evaluated reports, queries, and periodic processes.

Developed training programs for emergency problem resolution.

Oversaw form production and data monitoring.

REPORT & SYSTEMS ANALYST - USFHP, Pacific Medical Center, 2016 – 2018

Reviewed contracts and set up reporting strategies and schedules.

Produced health plans and managed care reports, including DoD and IMFC.

Audited and maintained the integrity of the data in the MCA module of the IDX which then transfers to the data warehouse and is utilized for all companywide reporting.

Facilitated and Implemented contracts for provider and facility reimbursement, including capitation, sub-capitation, case rates, global rates, percentage discounts, usual and customary fee schedules, RVUs, per diems, health plan schedule and networks.

Administered Milliman Model and MARA predictive modeling systems.

Built and audited claim adjudication systems for accurate data transfer.

Managed provider reimbursement contracts and ensured compliance.

Evaluated Medicare and Tri-care payments and advised on modifications.

Monitored Medicare and Tri-care payment methodology and made recommendations for the contract modification.

Worked with the Manager of the Managed Care Operations to identify outdated contracts and vendor issues with payments. Formulating new rates, presents to clients, achieving consensus and implementing changes to IDX.

OPERATIONS ANALYST/PPO ACCOUNT MANAGER, First Choice Health Network, 2005 – 2015

Defined business requirements and led system enhancements for client, provider and claim adjudication systems.

Acted as Charter and Product Owner for the contract module.

Mapped provider categories and measured accessibility using Geo Access software in accordance with OIC compliant requirements.

Managed contract enhancements, provider discounts, and network analysis.

Generated and analyzed provider network files for operations.

Led system projects using Scrum and managed contracts, claims, and EDI.

Completed Critical Skills for writing Business Requirements through ASPE.

Generated and analyzed provider network files to support Sales and Operations, Customer Service, Enrollment, Claims, Finance, Quality and Care Management, Utilization and Network Management.

Resolved claim processing and payment issues.

Negotiated Contract Holder agreements.

Industry Experience

Consulting, Healthcare

Secret Clearence

CAC Civilian Clearance (U.S. DoD)

Functional Experience

Project Management & Stakeholder Communication

Business Systems & Data Analysis

ETL Development & Data Warehousing

Quality Assurance & Testing (Unit, Integration, Regression)

Diversity, Equity & Inclusion Initiatives

Cross-Functional Team Collaboration & Agile Facilitation

Claims Analysis & Healthcare Reimbursement (HIPAA/PHI/PII/PCI)

Compliance Monitoring & Incident Management

Process Optimization & Documentation Best Practices

Application Experience

MS SQL Server, T-SQL, SSIS, SSRS, IDX, Power BI, Optum Performance Analytics (OPA), Snowflake, Smartsheet, ServiceNow, Epic Resolute, Visual Studio, GitHub, Active Batch, Acclaim, GE Centricity, Diamond, Bridge, ISSI claim adjudication systems, Crystal Reports, Optum Geo Reports, Access, Windows Operating Systems, Microsoft Office, Word, Excel, Access, Power Point and Outlook.

Methodologies

AgilePM, ITIL, SDLC, Waterfall

Education

Eastern Washington University BSc in Technology

GPA 3.82

South Seattle College

Associate of Applied Science

Network Administration

GPA 3.82

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