Charlie Fernandez
Bronx,NY
Summary
Highly analytical Business Analyst with background in identifying business needs and determining solutions to business problems. Strong skills in data analysis, project management, and strategic planning, coupled with ability to communicate effectively with stakeholders at all levels. Proven track record of improving operational efficiency and driving growth by successfully implementing innovative strategies and process improvements.
Overview
7
7
years of professional experience
Work History
Business Analyst I
Centene
Queens, NY
01.2020 - Current
- Consistently meeting service level agreement in overseeing data integrity of member enrollment records and remittance files transmitted from the state
- Write technical requirements based on business needs for implementation by developers by collaborating with various teams and develop project plans and present them to management
- Coordinate QA testing and acceptance criteria between QA staff, developers, and stakeholder
- Analyze and document current systems and processes as well as seek innovative methods to be more efficient
- Provide timely, efficient support for the eligibility load process while coordinating with corporate departments to resolve issues that arise during the process to minimize member abrasion
- Review eligibility reports and identifies all changes to eligibility (additions, terminations, and/or contract changes) and update accounts accordingly to DHS to allow for efficient claim processing and access to care
- Effectively troubleshoots escalated and/or complex eligibility issues as well as identify recurring issues in database and present finds and offer solution to application developers
- Contribute to the success of the health plan or corporate initiatives by performing rational decision making backed by evidence of recurring evidence of data analysis
- Perform daily data analysis using excel, Ember reports and Structured Query Language
Enrollment Sales Representative
Metroplus Health Plan
Brooklyn, NY
10.2017 - 12.2019
- Record and respond to all Customer contacts and update in the tracking system
- Manage and ensure appropriate follow-up and closure for all customer contacts
- Process and resolve complaints and record given information in the system
- Provide all benefit/service-related information to members, prospective members and providers
- Perform retention efforts for all lines of business
- Handle disenrollment inquiries from members, providers and regulatory agencies
- Respond to all claim billing inquiries from providers and members
Education
Master of Science - Chemical Engineering
Manhattan College
Bronx, NYBachelor of Arts - Biochemistry
Lehman College (CUNY)
Bronx, NYSkills
- Effective Organizational Skills
- Microsoft Office Suite
- Strategic planning
- User acceptance testing
- Cost-benefit analysis
- Business process improvement
- Analytical thinking
- BI tools expertise
- Team collaboration
- Data analysis
Languages
English
Professional
Spanish
Professional
Timeline
Business Analyst I
Centene
01.2020 - Current
Enrollment Sales Representative
Metroplus Health Plan
10.2017 - 12.2019
Master of Science - Chemical Engineering
Manhattan College
Bachelor of Arts - Biochemistry
Lehman College (CUNY)
Similar Profiles
SERGINE DA SILVEIRASERGINE DA SILVEIRA
Clinical Pharmacy Technician at CenteneClinical Pharmacy Technician at Centene
Jennie ZautnerJennie Zautner
Business Analyst at CenteneBusiness Analyst at Centene
Rachel JonesRachel Jones
Pharmacy Technician Care Advocate at CentenePharmacy Technician Care Advocate at Centene
Julie ColeJulie Cole
Lead Pharmacy Technician (Appeals) at CenteneLead Pharmacy Technician (Appeals) at Centene
Casey "Kat" WebsterCasey "Kat" Webster
Sales Associate at Dollar TreeSales Associate at Dollar Tree