Summary

Articulate, detail-oriented, and technically adept business analyst with 16 years of rapid advance through operations, systems analysis, and business analysis areas in both hands-on and supervisory roles. Proven ability to increase productivity and efficiency by assessing business needs to streamline and automate operations. Effective in leading business owners, project teams and IT developers through Systems Development Life Cycle SDLC to enhance existing business processes and implement strategies for new business process improvements. Demonstrated track record of solving moderate to complex business problems. Consistent history of serving as highly effective cross-departmental liaison to business owners and IT staff.

Areas of Expertise:

• Business and Process Analysis
• Leading JAD Sessions
• Eliciting Requirements
• Developing Requirement Specifications
• Managing Software Development Projects
• Developing Use Cases
• Liaison to Business Technical Teams
• Workflow and Process Modeling

Technical skills:

Proficient in using MS Word, Excel, Access, PowerPoint, Outlook, VISIO, MS Project, SharePoint, Alfresco, Quality Center, MicroStrategy, and Lotus Notes

Professional Experience

Confidential

Business Analyst III

• Responsible for supporting the Business Intelligence/Extract, Transform, and Load BI/ETL Program which includes multiple online Medicare Dashboards and Part B Analytics Reports PBAR that are utilized by the Centers for Medicare Medicaid Services CMS .
• Create and update Requirement Documents, System Design Documents and Standard Operating Procedures as required to satisfy the needs of the client and CMMI compliance.
• Develop test cases with traceability to functional requirements and perform testing of system enhancements within MicroStrategy.
• Interface with developers to resolve issues and coordinate testing activities.
• Perform data validation for quarterly data refreshes.
• Peer review system and project documentation.
• Utilize Alfresco to manage project documentation.

Key Achievements:

• Successfully implemented Shared Systems Harmonization SSH project that relocated or removed tables and/or columns in the Integrated Data Repository IDR allowing MicroStrategy BI reports and the Extract, Transfer, and Load ETL processes to run more efficiently.
• Created validation and documentation procedures for Part B Analytics Reports PBAR quarterly data refresh.

Confidential

Business Analyst - Consultant

• Responsible for business and functional support of the Medicare Advantage Prescription Drug System MARx , Consolidated Renal Operations in a Web-Enabled Network CROWNWeb and Medicare Provider Enrollment, Chain, and Ownership System PECOS that are utilized by the Centers for Medicare Medicaid Services CMS .
• Created specifications, use cases and system documentation as required to satisfy the needs of the client and CMMI compliance.
• Worked in collaboration with project team members to analyze and evaluate current business processes, suggest improvements and participate in design of new systems or modifications of existing systems.
• Responsible for leading JAD sessions.
• Performed peer reviews of system and project documentation.
• Interfaced and supported developers and testers throughout the Systems Development Life Cycle SDLC .
• Utilized SharePoint, DOORS and Quality Center to manage project documentation.

Key Achievements:

• Redesign and Modernization Project for the Marx system to improve business processing, accuracy, usability, timeliness and transaction success rate.
• Successfully implemented an online survey within CROWNWeb to be utilized by a nationwide network of medical facilities.

Confidential

Lead / Senior Business Analyst

• Promoted to lead development and enhancement of mainframe and web systems to support company initiatives, operational needs and regulatory compliance within the Enrollment/Billing Department.
• Responsible for supervising and coordinating efforts of Business Analysts.
• Served as liaison between the Enrollment/Billing Department and IT Department.
• Responsible for comprehensive SDLC projects from leading work groups defining project scope, objectives, use cases and requirements to functional specifications, to development, user acceptance testing, and implementation.
• Proactively identified areas to automate and streamline departmental workflows, operations, and functions to increase efficiency and reduce operating costs.
• Managed projects successful implementation by developing and updating project plans.
• Interfaced and collaborated with business owners to develop workflow and process models.
• Developed test cases with traceability to functional requirements.
• Tested software enhancements for accuracy and risk assessment coordinated user acceptance testing and tracked system defects.
• Performed GAP and Risk Analysis of existing system, business rules, process flows, user administration, and requirements and evaluated benefits of new system.
• Responsible for tracking and prioritizing outstanding projects, tasks and system problems, ensuring timely resolution and deadlines were met.
• Queried mainframe by writing scripts to produce ad hoc reports for management and business users.

Key Achievements:

• Substantially increased processing and inquiry efficiency by redesigning business software applications used for enrollment and customer service.
• Created new applications and systems that enabled the Group Services, Member Services and Sales Departments to support new product line.
• Successfully implemented web based enrollment system and online member self-service application.
• Significantly reduced cost of storing and retrieving processed documents by developing and rolling out department-wide electronic imaging process.
• Increased departmental efficiency and reduced operational costs by automating customer renewal process.
• Participated in project to integrate previously incompatible enrollment and billing systems by providing technical support, gap analysis and report development that allowed successful migration of membership from legacy to new platform.
• Enhanced tracking efficiency and enabled faster and more accurate data analysis by developing Access databases. Examples include: electronic eligibility processing, IT tasks and projects, member appeals and departmental correspondence.

Business Analyst

Confidential

• Promoted within six months to provide both technical and business support to enrollment and billing department, member call center, and healthcare provider call center.
• Organized and participated in work groups to define scope and objectives for system enhancements.
• Gathered requirements, wrote specifications and tested software enhancements for risk assessment.
• Aided in evaluating departmental needs and automating previously manual or time-consuming processes.
• Developed Excel spreadsheets, Access databases, and systems optimizations to increase productivity.
• Worked closely with end users to troubleshoot issues reported within the mainframe and web applications.
• Responsible for tracking and prioritizing system enhancements and fixes to meet departmental needs.
• Developed and provided reports for Senior Management.

Confidential

• Promoted twice in consecutive years to supervise cross-functional team of 12 technical and customer support professionals handling mainframe system support and analysis, electronic enrollment, Medicaid enrollment and billing, Life Insurance enrollment and internal hotlines to support sales team.
• Queried the mainframe to identify and resolve Membership enrollment, eligibility and billing issues.

Confidential

• Based on demonstrated technical and customer support ability, tasked to transition to business/technical role, using business experience to pinpoint areas for improvement throughout the Enrollment/Billing department.
• Provided technical support and guidance for Medicaid Coordinators.

Confidential

• Promoted to manage enrollment, reconciliation and collections of premiums for tri-state Medicaid region.
• Assigned and oversaw work of Medicaid Coordinators, providing technical support and guidance.
• Wrote scripts to create ad hock reports for extracting data from mainframe.

Confidential

• Promoted within one year of hire to coordinate billing and enrollment for MD and VA Medicaid.
• Interfaced with sales team and government contacts to resolve enrollment issues with customer accounts.