Business Analyst Project Management

MELISSA K. ROBINSON

**** ******** ***., ******, ** 60076 773-***-**** *********@*****.***

Business Analyst with 18 years of experience – Skilled in leading teams of diverse backgrounds to make solid business decisions based on analysis of short-term and long-term business needs. Analytical abilities, as well as excellent interpersonal, oral and written communication skills.

10 years of project management experience – Skilled in leading teams of diverse backgrounds to make solid business decisions based on analysis of short-term and long-term business needs. Managed projects and implement technology standards department- wide, reducing redundancy by 30%.

Extensive background in healthcare – Experience in explaining complicated health care plans, conflict resolution, benefits and compensation, records management, policies development and legal compliance. The ability to deal with ambiguous and complex problems and business situations.

Demonstrated success in negotiating win-win compromises – Developing teambuilding programs and writing Standard Operating Procedures (SOP). Problem solver that can mediate and communicate persuasively to all levels of leadership. Self-starter who is detail oriented, operates with limited supervision and enjoys a challenging environment. TECHNICAL SKILLS

Microsoft Applications

SharePoint Applications

Quantum Leap (QL) System

Lotus Notes

AS400 System (RxClaim)

PROFESSIONAL EXPERIENCE

OPTUMRX — Schaumburg, IL

Pharmacy care services company part of UnitedHealth Group; provides prescription drug services to individuals and health plans. Aims to lower costs, improve medication access, and enhance health outcomes through integrated pharmacy care solutions. Senior Business Analyst 2014 to Present

Analyzing healthcare and pharmacy data to identify trends, optimize operations, and support strategic decision-making. Collaborating with cross-functional teams to improve drug pricing, benefit designs, and member outcomes while ensuring compliance and cost efficiency.

Key Results:

Serving as a liaison between clients/vendors and OptumRx to ensure eligibility requirements for all pharmacy eligibility setups are accurate, complete, and in accordance with designated plan design.

Maintaining, loading and troubleshooting complex client eligibility files by researching and resolving discrepancies with client data to ensure timely and accurate updates to the online claims system.

Developing formatting, analyzing and maintaining internal and client eligibility reports.

Handling a variety of file layouts, including standard formats and customized eligibility file mappings.

Leading the successful implementation of both existing and new clients across a range of sizes and complexities.

Ensuring all fields within client files are accurate and in accordance with National Council of Prescription Drug (NCPDP) standards.

Maintaining and strengthening a collaborative environment that encourages open, constructive communication across the department.

Exercising strong judgment to make effective operational decisions in a dynamic, fast-paced setting. CVS/CAREMARK — Northbrook, IL

Delivers an Unmatched Breadth of Health Care Capabilities combining retail, Medicaid, Medicare and PBM services. Senior Consultant Enrollment Analyst 2006 to 2014 Project managed the successful implementation of existing and new Health Plan clients of various sizes. Conducted external meetings to obtain client business needs and interact with internal operational and technical staff to ensure the proper administration of client requirements are met. Continuously looked to improve system processes and called upon to work on special project teams aimed at improvements.

MELISSA ROBINSON Phone: 773-***-**** ■ Page 2

Key Results:

Managed and maintained a client list of over a million active lives.

Worked with internal and external partners on analyzing client eligibility data and reporting.

Led big projects in developing system enhancements and process improvements that reduced the amount of time for internal testing by 25%.

Created, leveraged and implemented plans for updating and developing new enhancements to existing learning solutions.

Continued to foster a teamwork environment conducive to positive dialogue across the department.

Provided models, best practices and work ethics across the team.

Conducted training programs and mentor team members for an observed increase in performance.

Made sound operational decisions in a fast-paced environment.

Performed analyses to make business recommendations to improve the integrity of the eligibility data.

Analyzed custom test plans to assure client expectations are met by the defined account structure.

Implemented processes and procedures for employee tools and cross department utilization, which lead to a 20% decrease in enrollment errors.

Worked with IT directly on all custom, standard mapping and testing new file layouts. HEWITT — Lincolnshire, IL

World’s leading HR consulting and outsourcing company. Benefits Administration 2003 to 2006

Independently managed a large complex client. Consulted client on best practices and managed change control processes. Provided complete and accurate responses for participant and processing related issues that were escalated to senior client contacts. Key Results:

Handled only client escalated issues, executive benefits administration and labor escalations.

Drove continuous improvement and efficiency across client team by conducting research/projects and review workflow/case management documentations to investigate and resolve employee issues.

Performed trend analysis and identified root causes to enhance the efficiency of the system configuration

Navigated among several applications/tools in a Windows based system through a series of databases to access the appropriate information/data to fully counsel participants

Aligned within an integrated team to administer benefits across multiple client teams

Consulted with customers to analyze business requirements and convert requirements into product and service solutions TARGET — Niles, IL

One of the largest US retailers, serving millions of customers weekly with over 1,900 stores nationwide. Sales Associate 2002-2003

Met customer deadlines while provided outstanding customer service. Established rapport along with utilizing a deep subject matter expertise with each customer in mind.

Key Results:

Provided fast, fun and friendly service to guests by responding quickly to their needs, questions or issues, plus ring up transactions and handle other responsibilities.

Guest Service Team Lead.

Kept the Target brand experience consistent, positive and welcoming for guests and fellow team members. EDUCATION

AMERICAN SCHOOL — Lansing, IL

High School Diploma

Overall GPA: 3.25

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