Professional Summary:

• I have over 18 years' experience in the healthcare industry - 14 years with Highmark
• I was a Business Analyst at Highmark from 1999 through 2004, and returned to Highmark as a contract B.A. in 2006, and again in 2008
• As a Business Analyst, I have participated in various system development projects
• I have experience gathering business requirements, communicating needs to technical staff, performing systems tests and other quality assurance activities
• I have extensive experience identifying and resolving process inefficiencies, and an expert working knowledge of Benefits, Claims, Membership, and Federal Stimulus Monitoring

Technical Skills:

SQL, Crystal Reporting, QMF, Visio Flowcharting, Word, Excel, Lotus Notes, MS Project

Technical Training:

Lotus 123, SAS, HTML Essentials, Web Design Concepts, FrontPage, COBOL

Professional Experience:

• Confidential
• Created reports using internal TFS system tracking and reporting of Action items for major project
• Implemented Server Shutdown
• Provided support for Security Access to Web Portal
• Updated Web Portal as needed
• Business intelligence Analyst
• SQL Reporting
• Provided and ran SQL reports for management

Business Analyst

• Peoplesoft Financial Security - Analysis of need of all types of access requests
• Denial and removal of access based on corporate policy
• Program updates and corrections
• Provided support via SQL reporting and Access Databases
• Update and troubleshoot Access and SQL reports
• Provide Management with Reports based on research

Stimulus Monitoring Specialist As Consultant

• With Executive Stimulus Coordinator, created methodology to quantify data derived from online financial surveys into Excel spreadsheets and created reports utilizing Vlookups
• Organized and Provided status and updates at regular staff meetings
• Assumed duties as directed by Executive Stimulus Coordinator
• Manage Monitor feedback
• Schedule, Manage, and Coordinated follow up and monitoring visits with School Districts and Intermediate Units
• Quality Control and update data
• Provide feedback to questions from Districts and Intermediate units via Stimulus Mailbox

Business Analyst As Consultant

• Production and monitoring of sectional inventory reports and financial estimates
• Monitored system defects
• Communicated with BA and Technical staff as to deliverables due
• Provided status updates to management

Business Analyst As Consultant

• Utilized HPLC Highmark Project Lifecycles tools for project development. This included requirement development, preliminary design, developing system test cases and system testing. HPLC is an internally developed project methodology to address the need for a consistent approach to project development. It is founded on project management best practices including processes and templates
• Worked on projects to enhance the Corporate Provider Repository a maintenance facility for the CPR database that houses provider information used by various applications within Highmark including claims processing
• Instrumental in getting System Access setup for new staff utilizing the SARA request form
• Communicated with security to track and ensure that access was granted in a timely manner
• Instrumental when the department migrated to Microsoft Office Outlook, documenting steps for setting up mail groups, providing guidance and researching questions/issues encountered by the staff
• Created, revised, and distributed Crystal reports to assist the department leads with their project management
• Validated Crystal Reports with SQL and attended SQL additional training during this period

Medicare Enrollment Processor

• Analyze information provided and Identify benefit eligibility for low income subsidies
• Process information changes for members and contact members for clarification
• Solidify working knowledge of enrollment business needs

Business Analyst As Consultant

• Worked directly with the Benefit Production Support department
• Researched Decision Logic Processing System DLPS for audits, and assisted with audits
• Documented meeting notes for weekly and monthly Management Meetings
• Used Crystal Reports to create performance reports based on management specifications
• Processed requests for security access using SARA system

Documentalist As

• Responsible for Documenting the Scope of Work, Project Progress, and training Documentation for the PA State Electronic Benefit Transfer EBT project
• Gathered business requirements from Vice President of DDS and Lead BA and drafted a Scope of Work for the Business Objects portion of project
• Briefed customer liaisons about project specifications and changes so that they could be accurately communicated to client
• Continually updated project timeline document so team members to track the Project Life Cycle

Business Analyst

• Used Highmark and LBMS Project Life Cycle Methodology to lead various Membership Consolidation projects
• Performed Functional and Regression testing to insure that planned database changes occurred in a timely and accurate manner
• Used Crystal Reports to revise a project tracking tool for Membership Consolidation project management team Revised tool expected to save Membership Consolidation several hundred thousand dollars
• Worked with Senior BAs to translate end user requirements into appropriate database changes
• Proactively identified and proposed solutions to process inefficiencies in project tracking system AMS
• Used Microsoft Project to create project plans

Claims Supervisor

• Led and Managed the goal attainment, claim accuracy, and government compliance of a 40 member team of claims examiners
• Created and facilitated quality improvement groups to empower workers to identify process inefficiencies and communicate them to management for resolution
• Identified and communicated system problems to Staff Services
• Arranged training for and mentored new Claims Examiners