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Business Analysis Manager Resume Profile

TaviS

Summary

11 years of experience on business and technology projects with UnitedHealth Group over 5 years , and global consulting with Accenture's and Unisys's Fortune 500 clients over 5 years

Professional Skills

Business and IT consulting, Project Management - PMP, Program Management, Business Process and Financial Analysis, Business Requirements and Systems Analysis, JADs, Healthcare Claims Analysis, Data Analysis, Six Sigma Lean Green Belt, Executive presentation, Reporting

Technical Skills

Microsoft Excel macros, formulas, charts and pivots , Access, Power Point, Word and Visio. VBA macros with IBM Emulator interface, SQL, Oracle SQL Plus, SQL Server, Cognos, CSS, HTML, Joomla, COBOL, DB2, REXX

Healthcare Insurance

Specific

Working knowledge of UHG proprietary Clinical and Financial Cubes, Claims Adjudications Systems, Claims and Issue Routing Systems, Member Benefit and Policy Database, Provider Contract and Demographic Database, Hospital Quality and Efficiency reports and Electronic Record Management Database

Experience

confidential

Lead Business Analyst, Associate Director

  • Accomplishments span full lifecycle enterprise-scale programs from ideation to deployment using Six Sigma, RSA UHG proprietary requirements and solution analysis process , SEI CMM, SDLC waterfall and agile:
  • Program requirements management of the Healthcare Reform Administrative Simplification Phase III Operating Rules on Electronic Remittance Advice x12 835 EDI transactions and Electronic Fund Transfers, as well as Essential Health Benefits 2012-2013
  • Program requirements management of UHG's business need for an enterprise-wide medical records process and technology. 2012
  • Program requirements management of ICD-10's impact to neutrality targets to UHG's provider reimbursements, member benefits and clinical quality. 2011
  • Root cause analysis, financial modeling and solution deployment of a 6M annual savings program addressing issues related to overpayments in physical, occupational and speech therapy benefits. 2010
  • Management of the national cardiology data sharing program aimed at fostering positive discussions with providers on appropriate use of cardiac imaging and intervention, chest pain ER escalation and length of stay rates. 2010-2011
  • Ideation and production of a Hospital Clinical and Financial report providing insights on key quality and efficiency metrics for use during key hospital negotiations. 2010-2011
  • Capital approval of a 2M program to enhance current hospital contract submission and audit systems with a 3M net present value over 5 years. 2009
  • Delivery of a 2M project over an 11-month timeframe on schedule, budget and quality utilizing the agile methodology to create a provider contract audit tool that enables the integration of contracting, loading and pricing systems. 2009
  • Project management of a six sigma program following a DMADV-PMBOK methodology over a rapid 3-month timeframe aimed at improving the end-to-end hospital contracting processes and systems within 2 years. 2008
  • Delivery of a 1.4M specialized call and claim queue project over a 12-month timeframe on quality and on adjusted budget involving issue resolution to gain additional capital approval. 2007

confidential

Business Analysis Manager

Managed the expansion of the new Brazil data center, an offshore unit of the North America data center, aimed at reducing operations costs by 30 via a six sigma lean program.

confidential

Senior Team Lead

Executed and managed international projects spanning Asia, Europe, Latin America and the US, following the full systems development life cycle and the CMM software model for telecommunications, manufacturing and healthcare clients.

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