SUMMARY:

• Bringing over fifteen years of production support experience ranging from project management, process improvement, system development/enhancements
• User and client support, business analysis, testing, reporting. Insuring that support of business needs and goals are obtained and fulfilled. Driven to achieve company and personal success.

PROFESSIONAL EXPERIENCE:

Confidential - Woodland Hills, CA

Sr. Business Analyst

Responsibilities:

• Manage multiple projects requiring system enhancements, user interfacing systems, business compliance and process improvements
• Create and maintain Business Requirement documentation, dashboards, test plans and traceability matrix
• Coordinate, track and report on User Acceptance Testing (UAT) testing among business stakeholders and IT vendor resources
• Conduct project meetings with stakeholders and supporting departments

Confidential - Woodland Hills, CA

Sr. Business Analyst

Responsibilities:

• Manage multiple projects requiring system enhancements, user interfacing systems, business compliance and process improvements
• Create and maintain Business Requirement documentation, dashboards, test plans and traceability matrix
• Coordinate, track and report on User Acceptance Testing (UAT) testing among business stakeholders and IT vendor resources
• Conduct project meetings with stakeholders and supporting departments

Sr. Business Analyst

Confidential

Responsibilities:

• Managed client project in excess of $20 Million
• Captured, created and implemented detailed business requirements for system functionalities and user interfacing systems
• Conducted best practice reviews to identify areas for improvement
• Created Standard Operating Procedures, business process flows and procedure documentations
• Assess projects, decisions and process in terms of big picture and cross departmental impacts and fully understand details
• Conducted project meetings with stakeholders and supporting departments

Confidential, CA

Quality Assurance/Project Management/Subject Matter Expert

Responsibilities:

• Created and executed UAT test cases for new Pharmacy software deployment
• Performed QA of various systems and process flow
• Reviewed, analyzed and adjusted User Stories
• Provided support to various business units during testing

Confidential

Sr. Business Analyst

Responsibilities:

• Provided oversight and input for full claims migration and including, Managed Health Care and Medicare Part-D from WellPoint to Express Scripts claims adjudication systems. Working with business and IT resources to address and designate claims into correct classifications.
• Provided logistics of pharmacy claims, internal/external client reporting and extractions, database management of claims adjudication system and its inputs and outputs to various entities within the organization.
• Analyzed of claim impact related to rebates billing and price concessions.
• Ensured all existing business needs of internal and external clients continued to be addressed and achieved.

Confidential - West Hills, CA

Business System Analyst

Responsibilities:

• Gained thorough understanding of claims process related to systems processing, coordination of benefits, claims adjudication life cycle and rebates billing. Expertise and knowledge was used to communicate processes and objectives to multiple departments. Attended cross functional meetings to review business and IT documentation thereby ensuring consistency and functionality within the company and various systems.
• Created and tested User Test Cases & User Stories for new enhancements to business systems and user interfacing applications. IT coordination, enhancements, fixes, and reports related to business requirements pertaining to Managed Health Care and Medicare Part-D lines of business.
• Experience writing Business and Technical Requirements Documents (BRD, TRD, HLD), including UAT testing, user test cases, validation and impacts. To ensure system integrity, reporting and functionality was not adversely impacted.
• Created and performed tutorial overview of rebate billing system process to share and educate other business departments including: Sales, Finance, IT and any other groups as needed and impacted by rebate processing.
• Preformed system analysis to ensure data integrity.
• Applied Six-Sigma basics to address system processing and department functionalities.
• Managed business requirements, process documentation, and system application testing. Developed, coordinate and managed objectives, processes and applications to effectively meet business needs.
• Knowledge and functionality of several corporate systems, proprietary applications and software: Claim adjudication systems (ProServ, ProPBM, WGS, FACETS, etc.) and Rebate Billing adjudication system. Managed enhancements or upgrades across multiple platforms.
• Investigated and trouble-shoot job or system issues from the business perspective.
• Subject Matter Expert (SME) in business functional areas pertaining to Managed Health Care and Medicare Part D.
• Report automation, design and output.
• Performed data extraction, consolidation, administration and storage related to business billing and reports.
• New client implementations or existing client changes.

Sr. Contracts Specialist / Financial Analyst

Confidential

Responsibilities:

• Managed multimillion-dollar Managed Health Care contracts.
• Interacted with internal and external groups: Pharmaceutical Contract Manager/Analyst, Clinical/Client Managers, Finance, Information Systems, and any appropriate groups.
• Researched and analyzed billing and collection issues.
• Familiarity of contract specifications, client details, product categories, and any other aspects pertaining to the contracts.
• Developed and structured department analysis modeling, adjustment to billing procedures and secure data management.
• Involved in development, implementation, and enhancement of pharmaceutical rebate adjudication system.