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Senior Business Analyst Resume

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SUMMARY:

  • Level 1 Chartered Financial Analyst with Bachelors of Science in Finance and Economic with 10 years of experience as an analyst in industies such as mortgage, financial services and healthcare. Certified in Crystal Reports, advanced Excel, intermediate SQL, Access, Teradata, QMF and other data mining applications. Currently completing continuing education credits in Advanced Access, SQLServer 2012, and Introduction to Oracle.
  • Adept at monitoring and diagnosing data to drive financial standards, project planning, process mapping and process improvement, project management, quantitative / statistical analysis, budgeting, accounting and forecasting. Experienced in multiple integration projects including gathering business requirements from stakeholders and SMEs and translating them into technical requirements. Interviewing SMEs to document "as is" processes to identify process improvements as well as discovering gaps which can then be addressed by the systems.
  • Advanced Excel & Access skills (extensive data mining); also rapidly adapt to new technologies and possess expertise in all MS Office Suite programs, as well as a broad range of statistical and accounting software.
  • Provide strong modeling and reporting to all levels of business structure individually and through cross - functional teams.
  • Comfortable leading teams thru value added reporting and working closely with accounting, reporting, and technology departments.
  • Years of close communication and presentations to senior management

TECHNICAL SKILLS:

  • Process and Procedure Improvements
  • Process Flow Analysis
  • FP&A Analysis
  • Sales Reporting
  • Data Management
  • KPI Analysis
  • SAP Financials
  • Teradata (SQL Based)
  • QMF(SQL Based)
  • Integration Project Management
  • Variance Analysis
  • Cost Benefit Analysis
  • Gathering Business Requirements
  • Credit Risk Analysis
  • Six Sigma (RSA)
  • Financial Modeling
  • Risk Analysis
  • Budget Preparation
  • GAAP & GASB 34
  • Revenue Management
  • Financial Statement

PROFESSIONAL EXPERIENCE:

Confidential

Senior Business Analyst

  • Worked with SME's in various departments to document "as-is" process flows
  • Trained on processes, wrote P&P documents
  • Gathered requirements from corporate stakeholders, created improvements, updated P&P document
  • Assist CFO with deep dive analysis for litigation purposes
  • Build and Maintain forecast model that reprices all facility claims to the CMS DRG Case pricing and compare to contracted rates
  • Track hospital contracts for Stop Loss clauses for the purposes of forecasting and reporting on possible hi dollar claims to Corporate and senior management on a daily and quarterly basis.
  • Lead for all reporting and correct payments on Pilot Shared Risk Program between IPA and Hospital., apx $20M/year
  • Responsible for all distribution resulting from the shared savings of the pilot program.
  • Prepare Monthly Capitation payments for specialists paid in a pool distribution.
  • Lead Specialty Capitation Deduct Reporting for Specialists who are paid capitation as well as leading and documenting the automation process for this task.
  • Instruct Data Architect on the needs and layout for the respective repository of the specialty capitation payments, the cap deduct detail file, and the Pilot Program of Shared Risk.
  • Direct and train new analysts in departmental duties, location and names of files in the data warehouse, and review all analysis before it is sent on to requestor.
  • Ad-hoc PMPM requested by contracting and/or senior management for professional services
  • Build and Maintain Annual Bonus Forecast Model and then process bonus' once a year after benchmarks have been determined by corporate or Medicare.
  • Worked closely with Network Development on current contract analysis
  • Devolved models of standard industry pricing vs. company pricing for use in negotiation of facility and professional new contracts

Confidential

Senior Business Analyst

  • Lead Communications Partner representing rebates to Company's top client with $100,000,000 and up revenue billing/month.
  • Extensive data mining and deep dives into variances within rebate reporting, pricing, and reimbursement to the client.
  • Creating business requirements as a SME, reviewing "as is" process flows and inputting into Visio
  • Liaison Clinical Pharmacists, Account Managers, Contracting, and IT to insure this specific client had correct rules (step edits, ect) setup with rebate and adjudication systems applicable to each group plan, line of business (Commercial, Medicare, Medicaid), Preferred or Non Preferred status each month.
  • Created multiple monthly and quarterly reports to be used both internally and by the client to identify revenue trends, volume trends, pricing and reimbursement by individual drug, manufacturer, line of business, and drug group. These reports were also used to identify possible errors within system rule setups and correct within manufacturer contract guidelines so the client and company did not lose out on any earned revenue.
  • Communicated clear action plan to client after errors were identified; lead internal communications with IT, Rebate Revenue System, and Rebate Payable teams to correct internal errors, reverse and re-invoice manufacturers properly.

Confidential

Senior Business Analyst

  • Lead on project team charged with creating an implementation plan and schedule for $22M ERP system.
  • Interview, and document "as-is" process flows from SME's in Visio.
  • Interviewed business partners, gathering and documenting current business process from "order to cash' thru service delivery and also all associated financial functions" ‘flows using Six Sigma methodology (Heavy use in Excel and Visio).
  • Communication liaison for program team charged with creating an implementation plan and schedule for a MDM (master data warehouse).
  • Intensive requirements documentation to assist IT in building out all needed aspects of both infrastructure and integration points within the two systems so they can run in a parallel environment.
  • Experienced in multiple integration projects including gathering business requirements from stakeholders and SMEs and translating them into technical requirements. Interviewing SMEs to identify process improvements as well as discovering gaps which can then be addressed by the systems.
  • Worked closely with project managers to coordinate meetings and presentations to Corporate Sponsors in PowerPoint and other project leads to insure individual phases stayed on budget and timeline.

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