Anne "Nikki" Wilson
Saint Charles,MO
Summary
Accomplished Business Analyst with a proven track record specializing in business process improvement and strategic negotiation in a fast paced environment. Demonstrated success in developing impactful business solutions and nurturing provider relationships to enhance compliance and operational efficiency. Known for exceptional time management skills and effective cross-cultural communication, contributing significantly to project success and organizational growth.
Overview
12
12
years of professional experience
Work History
Business Analyst III
Centene - Oklahoma Complete Health
Saint Charles, MO
10.2022 - 08.2024
- Conducted market research to identify potential opportunities for new product development.
- Reviewed customer claims, identified discrepancies and determined appropriate course of action.
- Conducted investigations to gather evidence in support of claims resolution.
- Identified and resolved network problems in a timely manner.
- Performed gap analysis to identify areas of improvement and proposed solutions to meet business requirements.
- Reviewed and processed credentialing applications to ensure accuracy, completeness, and compliance with all accreditation standards.
- Developed and implemented procedures for contract administration.
- Reviewed solicitations, contracts and other legal documents in order to ensure compliance with applicable laws and regulations.
- Negotiated terms and conditions of contracts on behalf of the company.
- Prepared detailed reports related to contracting activities including cost analysis, performance reviews, and project status updates.
Quality Specialist
Ascension - Dell Children's Hospital
Saint Charles, MO
07.2022 - 10.2022
- Conducted internal audits to ensure compliance with quality standards and procedures.
- Collaborated with vendors in order to meet NCQA adequacy.
- Established communication goals with clients and developed corresponding action plans.
- Created and implemented communication management strategy, delivering updates as needed.
- Collaborated with cross-functional teams to identify opportunities for continuous improvement, streamlining processes across departments.
- Reviewed medical records to ensure accuracy and completeness of data according to HEDIS specifications.
- Developed and maintained detailed knowledge of all HEDIS measures and protocols.
- Assisted in the development of a comprehensive tracking system for monitoring data collection activities related to HEDIS measures.
Contract Negotiator
Centene Corporation
Clayton, MO
08.2017 - 06.2022
- Negotiated terms and conditions of contracts with external vendors, suppliers and customers.
- Developed effective strategies for negotiating contracts in a cost-effective manner.
- Resolved disputes between contracting parties through mediations or negotiations.
- Prioritized and organized tasks to efficiently accomplish service goals.
- Collaborated closely with team members and cross-functional partners to achieve project objectives and meet deadlines.
- Resolved any discrepancies between contract requirements and actual performance or services rendered.
- Coordinated with internal departments to ensure timely delivery of products or services according to contracted specifications.
- Ensured all SOP documentation was up-to-date by regularly reviewing policies and procedures.
- Monitored contractor performance to ensure compliance with contractual obligations.
- Prepared drafts of internal audit procedures based on departmental policies and procedures.
Human Resources Specialist
Centene Corporation
Clayton, MO
09.2012 - 08.2017
- Created training materials for new hires and provided orientation sessions.
- Assisted in developing effective performance review processes for employees.
- Set goals and expectations for direct reports using performance review process, holding staff accountable.
- Developed, implemented, and managed the annual performance and goal review process for all employees.
- Conducted needs assessments to identify areas of improvement for employee development.
- Evaluated effectiveness of existing training programs by collecting feedback from participants.
- Analyzed user requirements and developed test plans, cases and scripts for UAT testing using Workday database.
- Collaborated with developers to resolve any technical issues encountered during UAT testing.
Education
MBA - Business Administration
Lindenwood University
Saint Charles, MO05-2011
Bachelor of Arts - English
Lindenwood University
Saint Charles, MO05-2006
Skills
- Business process improvement
- Business solutions development
- Gap analysis
- Cost-benefit analysis
- Time Management Expertise
- Strategic Negotiation Skills
- Effective Cross-Cultural Communication
- Compliance Management
- Provider Relationship Management
Timeline
Business Analyst III
Centene - Oklahoma Complete Health
10.2022 - 08.2024
Quality Specialist
Ascension - Dell Children's Hospital
07.2022 - 10.2022
Contract Negotiator
Centene Corporation
08.2017 - 06.2022
Human Resources Specialist
Centene Corporation
09.2012 - 08.2017
MBA - Business Administration
Lindenwood University
Bachelor of Arts - English
Lindenwood University
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