SUMMARY:

• Proven ability to successfully complete projects on time
• Played an integral role to collect, normalize, transform and integrate data
• Proven ability to perform data analysis, data governance, data conversion and cleansing
• Experience in data modeling, logical and physical design, and data mapping
• Ability to adhere to the SDLC Full life cycle experience in data analysis, business analysis, systems analysis, design, user liaison, functional requirements, scope, gathering requirements, development, written documentation, and user training
• Extensive experience working with internal and external clients, vendors, all levels of management, customers, and technical staff
• Excellent Leadership, interpersonal and communicational skills
• Performed data analysis for clients to optimize results and usage of their databases, systems, and reports
• Documented systems and wrote training manuals, user manuals, and procedural instructions
• Excelled at teaching clients with patience, understanding, and careful listening
• Proven ability to create processes and procedures used to maximize departmental efficiencies
• Team leader capable of motivating staff
• Ability to get on with all levels of people to build and maintain strong relationships
• Superb communication skills: technical and non - technical audiences
• Ability to gain results through others
• Able to continuously meet targets and expectations
• Experience working in a fast-paced Agile environment using JIRA and Confluence
• Experience working in an Agile environment with onshore and offshore teams
• Experience writing use case and user stories in JIRA

PROFESSIONAL EXPERIENCE:

Confidential

Documentation Specialist/Business Analyst

Responsibilities:

• Created policies and procedures for the Funding and Recovery department at Confidential
• Gathered information from the subject matter experts to assist in the development of the policies and procedures
• Coordinated the reviews with the subject matter experts until policies and procedures were finalized
• Generated reports on a weekly basis relating to claims identified as overpayments

Confidential

Business Analyst

Responsibilities:

• Working in collaboration with the stakeholders on writing functional requirements as it relates to Complia Health application
• Created gap analysis used to identify current state vs future state using requirements as a baseline
• Created workflow processes that demonstrated each step of the requirements within the entire process
• Worked as a Business analyst in a hybrid environment of Waterfall/Agile

Confidential

Business Analyst

Responsibilities:

• Working in collaboration with the Product partners on writing functional requirements as it relates to Project Welcome\Chase Connect
• Created use cases that identified the workflow based on the requirements
• Created workflow processes that demonstrated each step of the requirements within the entire process
• Coordinated Visual Quality Assurance reviews with the UI Designer and the Developer Managed the visual defects to ensure of the corrections
• Created and tested functional test cases
• Worked and participated in SCRUM calls and assigned each JIRA to a specific developer
• Managed meeting minutes relating the SCRUM calls
• Worked as the only Business analyst in a complete Agile environment, 2-week SPRINTs with a team in Chicago and offshore
• Responsible for coordinating a demo at the end of every SPRINT
• Played a role as a UAT tester, identifying all the defects in JIRA
• Coordinated defect resolution with the Development and UI Designer teams

Confidential

Data Governance Business Analyst

Responsibilities:

• Working in collaboration with the Data Governance team in development and oversight of governance processes to support Regulatory Affairs division
• Works with business owners to define and establish data quality rules and ensures strict adherence to set data quality standards
• Promotes adoption of data governance best practices across various lines of business
• Prepares detailed reports for the data governance leadership team, analyzing data for potential risk and issues
• Monitors adoption of and adherence to set data quality standards
• Guides users through data governance concepts, explaining the benefits of data governance policies and procedures within the context of the user's needs
• Coordinates the creation, reporting, compile and preparation of enterprise data quality metrics
• Working in collaboration to support the Enterprise data model, Data Governance and Data Quality frameworks to ensure compliance with enterprise and regulatory guidelines
• Collaborate with business, IT to ensure complete definition, lineage and documentation for critical data and metrics
• Collaborate with IT to implement monitoring of information, from granular level to completed calculation
• Works closely with business units to ensure that business activities are aligned to the enterprise data strategy
• Check on monitoring on a regular basis; triage any monitoring issues to determine likely cause

Confidential

Data Transformation Analyst

Responsibilities:

• Converting data from an excel format into a macro spreadsheet that will be used to upload the data into a database
• Strong knowledge of Excel, MS word, Visio tool and other MS office application

Confidential

Project Manager/Business Analyst

Responsibilities:

• Working as a project manager in an Agile environment
• Scheduling meetings with the project team to ensure that deliverables were being met as per the project schedule
• Facilitates meetings with the project sponsor and project team
• Created Standard Operating Procedures (SOP) for capturing phone and email inquires
• Created process documentation for a Confidential Management project
• Ensured that the deliverable outcomes were delivered as expected
• Assist the project team by responding to inquiries or questions
• Resolve issues and removed roadblocks
• Created Request for Information (RFI) to be used in the selection of an IT consultant
• Strong knowledge of Excel, MS word, and other MS office application

Confidential, Illinois

Business Analyst

Responsibilities:

• Worked with the business, Compliance and Regulatory attorneys to gather and develop customize business requirements for Information and Document management to be used in completing FDA applications
• Analyzed and documented the business requirements for the Information and Document management systems
• Reviewed and communicated requirements with the stakeholders
• Created VISIO workflow diagrams, functional hierarchy diagrams and logical data model diagrams
• Created workflow documents that demonstrates the request and response of information proposed by the FDA
• Created business definitions and metadata for the data identified in the logical data model
• Created ‘mock’ views of the GUI interface for the proposed systems
• Strong knowledge of Excel, MS word, Visio tool and other MS office application
• Experience in gathering Data business model and reporting requirements
• Demonstrate experience in data mapping with expertise in leading business function requirement and converting data into one source system to another
• Created data lineage diagrams that identified the data source and how it moves throughout the data lifecycle, thus resulting in the data target
• Created data mappings between two business data models to depict the data integration tasks needed to transform the data from source to target

Confidential

Business Analyst

Responsibilities:

• Worked with the business stakeholders to gather and develop customize business requirements for a GUI interface into a product of SAP, known as Employee Central
• Created functional and user test cases based on business requirements
• Played an integral role on working with the business partner, Confidential on various aspects of the project relating to established and the implementation of a back office and call center
• Reviewed and made necessary recommendations to the Standard Operating Procedures SOP’s needed to train employees for the global customer service and call center located in India
• Monitored project scope and identifying risks as potential problems
• Escalating promptly any issues that may influence operations
• Managing client expectations by ensuring the delivery of the highest quality service
• Established process controls to be identified in Standard Operating Procedures used by the global customer service and call center located in India

Confidential, Deerfield, Illinois

Business Analyst

Responsibilities:

• Worked with the business stakeholders to gather and develop customized business requirements for an environmental health and safety application
• Created test cases based on business requirements
• Played an integral role to on working with the business teams collecting data
• Created and documents processes and procedures
• Created VISIO diagrams that illustrates the swim lanes used to aid the workflow processes
• Created Standard Operating Procedures (SOP) as it relates to the different user environments within the application
• Attended the JAD session with Baxter and the Enablon (vendor) to discuss business requirements and functionality of the business requirements

Confidential, Deerfield, Illinois

Business Analyst

Responsibilities:

• Worked with the business stakeholders to develop and customize two SharePoint 2010 environments, Global and Standard Operating Procedures (SOP) and Work in Progress (WIP)
• Created VISIO diagrams that illustrates the swim lanes used to aid the workflow processes
• Created specialty working groups within SharePoint 2010 that allows special users access to document libraries
• Played an integral role to collect, normalize and transform within the Confidential inventories into a single comprehensive list of IT systems, applications and hardware
• Created and document10s processes and procedures
• Gathered and documented business stakeholder’s requirements for Global and WIP SharePoint site
• Conveyed business requirements to IT Developers and Corporate Compliance
• Played a role in ensuring that business requirements were within the Corporate Compliance guidelines
• Experience using SharePoint as a collaboration tool - a plus
• Experience configuring out-of-the-box SharePoint Web-parts to enhance a SharePoint collaboration site - a plus
• Gather IT Infrastructure and Application inventory data information from Key contacts at Confidential and integrate that data into the existing Confidential system inventory
• Identified the 105 new devices/ servers to be added to the Confidential inventories Confidential
• Played an integral role to, collect, normalize, transform and integrate within Confidential inventories into a single comprehensive list of IT systems, including meta-data and key contact information
• Use the process (as) established by these activities as the basis for consolidating similar data from other sources and affiliates
• Use and update the gathered information to promote the retiring/decommissioning of Legacy Systems from Confidential inventory
• Distribution reports to IT customers (key stakeholders) based on identified requirements
• Participation in the planning, writing, execution, documentation of the retirement/decommission plans and reports
• Placed in Technical Proficiencies
• Strong knowledge of Excel, MS word, Visio tool and other MS office application

Confidential

Sr Data/Business Analyst

Responsibilities:

• Played an integral role to establish preliminary Data Governance guidelines
• Created white papers pertaining to Data Governance at Confidential Played an important role in assisting CEC on identifying key data used to establish metrics on the Free Application for Confidential (FAFSA)
• Established processes and procedures as it pertains to the measurement of data collected on FAFSA
• Worked with the business stakeholders to develop and customize Data Governance SharePoint 2010 environment
• Granted access to members or groups that needed to review governance data
• Worked closely with the Sr Director on gathering requirements for the Data Governance SharePoint site
• Led team of business unit stakeholders, solution architects and data to establish data requirements for BI Reporting
• Facilitated meetings with various stakeholders to obtain a clearer view of the functional business requirements and to ensure that the data is modeled correctly
• Facilitated communications to various stakeholders to ensure that the data was modeled correctly and met the functional requirements
• Analyzed data from various source systems to identify metadata reuse and data lineage

Confidential, Mettawa, Illinois

Enterprise Information Data/Business Analyst

Responsibilities:

• Supports the Enterprise data model, Data Governance and Data Quality frameworks to ensure compliance with enterprise and regulatory guidelines
• Facilitates the delivery of required enterprise data definitions, business glossary and business rules
• Works closely with business units to ensure that business activities are aligned to the enterprise data strategy
• Ensures that appropriate data access controls, data quality controls and remediation plans are compliant with defined company standards
• Partners with Technology to identify required data sources and data lineage
• Defines processes and controls to set data standards and maintain data integrity
• Manages and develops a team of specialists in support of Data Management governance responsibilities
• Reviewed data from various databases and recommended the proper use of the data at an enterprise level
• Completed data analysis via review of multiple spreadsheets as a methodology to data cleansing and identified data to ensure that the quality of the data met the standards
• Performed data gap analysis
• Demonstrated success leading and mentoring cross functional teams at an international level
• Responsible for creating the team’s site in SharePoint (Documentation within folders and files)
• Created ad-hoc Cognos Reports based on the entities and attributes within the Data Model
• Capturing and maintaining metadata and data-linage for data warehouse and reporting components
• Established procedures to verify data integrity, quality and consistent metrics
• Data architecture, prototype development, updates to data models, including physical and logical to meet new and changing business requirements
• Key participant in JAD Session as a ‘contributor’ for the Confidential program
• Created and managed the SharePoint repository for business intelligence and data governance
• Established procedures and communications for identifying risks and mitigation Led team to provide documentation and training for new Conceptual Data Model (CDM) coordinated meetings with different levels of management to review the business process improvements
• Coordinated and facilitated training documentation and sessions for the Data & Service Modeling Group
• Coordinated and facilitated the training sessions with the various teams within Data & Service Modeling
• Proven experience of working with business partners’/data modelers/architects/developers/QA in building consensus, socializing data solutions/designs
• Created PowerPoint as visual presentations of the process and how it relates to other processes
• Strong knowledge of Excel, MS word, Visio tool and other MS office application
• Experience in gathering Data business model and reporting requirements
• Demonstrated experience in data mapping with expertise in leading business function requirements and converting data into one source system to another
• Created data mappings between two business data models to depict the data integration tasks needed to transform the data from source to target
• Created data lineage diagrams that identified the data source and how it moves throughout the data lifecycle, thus resulting in the data target

Confidential, Chicago, Illinois

Enterprise Information Data/Business Analyst

Responsibilities:

• Improving information quality by establishing information and data names, business rules, data integrity rules at an Enterprise level as it relates to the Confidential Meta data Repository
• Responsible for working business and technical areas on gathering requirements to be used within the Confidential Meta data Repository
• Gathered functional business requirements from the business owners/end-users and all other necessary stakeholders Presenting the requirements to all the stakeholders
• Create and present gap analysis
• Created metrics for Blue Care Connection Wellness Programs to be used internally and externally
• Providing accessible information and resources for employees, members, providers, and clients
• Able to work within a cross-functional team internally and external clients
• Performing research on where data is stored and how it is used Provide procedural documentation on how the business owners can retrieve data
• Develop charts and PowerPoint as visual presentations that will aid the business owners in understanding where their data flow
• Created the Standard Operating Procedures (SOP) relating to how to resolve ‘helpdesk’ tickets
• Work in collaboration with IT areas on acquisition of meta data, specifically for Blue Care Connection
• Responsible for documenting business rules that supports the IT requirements as it relates to the Meta data for their application
• Worked in collaboration with the data modelers in developing definitions for the Enterprise Logical Data Model, ELDM for the Enterprise
• Created data lineage diagrams that identified the data source and how it moves throughout the data lifecycle, thus resulting in the data target
• Subject Matter Expert (SME) knowledge for the development and implementation of Data Governance policies and procedures
• Participated in the development and implementation of identifying the business and technical stewards for the Data Governance program
• Developed definitions for Enterprise code sets
• Provided gap analysis
• Responsible for the development of the Managed Meta Data Environment Help Desk
• Responsible for the development of the submission on requests for the usage of the Confidential
• Responsible for the research and analysis on requests that are submitted to the ‘HIVE’
• Working as a liaison between the internal business communities, i e IT, Health Care Management
• Maintain excellent communication on expectations, deliverables and outcomes
• Created and maintain the Confidential mailbox to be utilized for inquiries about the Confidential
• Created and maintain the Confidential Helpdesk to be utilized by the Confidential team to help triage issues about the Confidential
• Worked as a Data Governance Analyst as the corporate liaison Lead information stewards from various roles and guided the development of data policy and implementation at an enterprise level
• Responsible for the analysis, maintenance and monitoring of all the data being shared
• Strong knowledge of Excel, MS word, Visio tool and other MS office application
• Experience in gathering Data business model and reporting requirements
• Demonstrated experience in data mapping and data modeling and expertise in leading business function requirements and converting data into one source system to another
• Proven experience of working with business partners’/data modelers/architects/developers/QA in building consensus, socializing data solutions/designs

Senior Technical Business Specialist

• Experience in developing data and presenting to internal clients
• Leading the Illinois Full Service Units (FSU) and Health Care Management teams on new and/or changed processes relating to claim payments
• Health Champion participant
• Knowledge of Blue-Chip Claim adjudication procedures and processes
• Knowledge of CPT and ICD-9 (converting to ICD-10) coding protocol
• Inspiring the FSU is to accommodate workflow changes as requested by Confidential Includes, but is not limited to claims payment, provider-processing rules, professional and institutional
• Coordinated and communicated information as it relates to the Corporate Records Retention policy for the Full-Service Units
• Conducted meetings on a yearly basis to review and discuss the
• Corporate Records Retention policies and procedures
• Strong Health Insurance knowledge
• Intense knowledge in the HealthCare industry
• Responsible for monitoring and researching State and Federal Legislation as it relates to Blue Chip
• Providing an impact analysis based on new State and Federal Legislation and Blue Chip
• Provide impact analysis on claims payment methodologies requested by the Confidential Provider Area
• Support Quality Improvements (QI) for all HCSC products
• Work with QI/FSU towards NCQA compliance/accreditation
• Responsible for the review of Department of Insurance (DOI) inquiries for HMO Responsible for the coordination of the Prompt Pay Claims
• Work in collaboration with SSD Learning and Development and Health Care Management on new and existing training documents
• Credible representation at Managed Care, QI and Member Appeals, Rights and Responsibilities, Policy and Procedure and Magellan committees
• SSD representation on the SSD Diversity Committee
• Responsible for monitoring State and Federal Legislation as it relates to Blue Chip logic changes
• Responsible for providing written and verbal communication to the FSU and Confidential regarding processing changes that affect the Divisions
• Resolve and respond to daily problems and issues (trouble shoot)
• Create and provide effective written and verbal communications to all the necessary departments
• Coordinated the initial role out of SOX-Sarbanes Oxley Audit to the Illinois FSU Annually coordination of the HEDIS-Health Plan Employer Data and Information Audit with the respective SSD Management
• Knowledge of insurance and industry terminology
• Provided leadership on various projects that required SSD representation
• Background on network management strategies
• Project Management Lite:
• Facilitate monthly workgroup committee meetings and conference calls between the Full-Service Units and Health Care Management to identify issues that negatively impact the current workflow processes
• Create and maintain the Project Issues Log and follow-up all issues to ensure timely resolutions are achieved

Technical Business Specialist II/Blue Chip Technical Support Area

• Responsible for regression testing for Blue Chip enhancements relative to Confidential
• Implemented the HIPAA 278 referral transactions
• Provided ongoing support to the Full-Service Units regarding KI00 issues
• Coordinated and implemented meeting with external vendors that will be submitted authorizations to our application
• Provided leadership and consulting regarding implementations affecting Blue Chip sub-systems
• Worked with McKesson on file formatting to receive electronic data for the medical management application, MEDecision
• Built client relationships with vendor, McKesson
• Monitored electronic files from McKesson to ensure data maintained its integrity with no outages
• Held monthly meetings with McKesson to uphold expectations of data
• Participated in the troubleshooting with vendor management if problems arose
• Took part in regression testing to ensure receipt of file from McKesson didn’t obtain negative effects on other applications used within healthcare management

Intake Service Representative/Customer Care Call Center

• Provided excellent customer service to various high-performance employer groups
• Provided exemplary and quality customer service to members and providers
• Created pre-certifications in MEDecision for members that were having inpatient or outpatient surgeries
• Worked with Management on various projects relative to the staffing model