Business professional with strong background in analysis and supervision. Skilled in data interpretation, process improvement, and stakeholder communication. Focused on team collaboration and delivering impactful results. Reliable and adaptable to changing needs, with expertise in project management, critical thinking, and problem-solving.
Overview
14
14
years of professional experience
Work History
Enterprise Business Analyst
Blue Cross Blue Shield
05.2022 - Current
Elicit, document and track requirements for changes to business processes, policies, information, and information systems for intermediate-level business problems.
Analyze business needs for strategic initiatives that impact multiple business domains and applications; collaborate with cross-functional stakeholders to define, develop and communicate scope and requirements.
Ensure creation of and adherence to requirements approach and management plan in alignment with an overall project plan.
Collaborate with project teams to adhere to solution scope and maintain requirements traceability.
Manage requirements change request process and documentation throughout project lifecycle.
Use industry standard analysis techniques such as data flow modeling, use-case analysis, workflow analysis, business process mapping, functional decomposition analysis/or financial ROI modeling for initiatives that are at an intermediate level.
Support business relationships by documenting business issues, determining project needs, and supporting training as needed.
Supervisor of Pharmacy Network Support (Configuration Services Department)
MedImpact Healthcare Systems, Inc.
10.2020 - 05.2022
Supervises assigned group of Configuration Specialists and/or Analysts in the development, implementation, and maintenance of client-specific benefit designs focused on meeting the client’s satisfaction in the areas of Service Delivery, Performance Expectations, Claims Adjudication Accuracy, and Growth in Membership and Profitability.
Provides day-to-day leadership and direction to provide exceptional service to clients, including administering policies, business processes, quality standards, measurement criteria, and daily task management of benefit change requests.
Ensures that deliverables are on time, within budget, and meet the quality levels expected by MedImpact’s internal and external customers.
Develops and maintains solid business relationships with region’s clients. Ensures that Configuration Services, on behalf of MedImpact, is meeting service agreement requirements.
Monitors client service continuum including proactive and reactive components. Resolve escalated issues, while ensuring ongoing issues are resolved expeditiously.
Analyzes training needs, make recommendations and develop training programs, required training lessons, instructional materials, mentoring and technical coaching in order to improve client service delivery.
Lead Configuration Analyst
MedImpact Healthcare Systems, Inc.
07.2018 - 10.2020
Delegate task
Help manage team under the direction of Configuration Supervisor
Utilize project planning, prioritizing, and organizational skills to ensure timely deliverables, high levels of quality, and efficient use of resources to achieve claims adjudication accuracy
Acquire a thorough understanding of MedImpact system logic for claims adjudication, system constraints, conflicting benefit logic configurations, benefit coding table designs
Customer Service Representative
MedImpact Healthcare Systems, Inc.
12.2014 - 07.2018
Answer calls and respond to emails
Research required information using available resources
Complete call logs
Performed data entry for customer information
Provided policy and service information
Handled online orders and credit card transactions
Managed client records
Certified Nurse Assistant (CNA)
Glacier Hills Senior Living Community
07.2013 - 02.2015
Taking vitals (blood-pressure, pulse, temperature, and respiration).
Recording intake and output, height, and weight.
Helping patients with ADLs (activities of daily living) for which they need assistance, such as bathing, combing hair, brushing teeth, shaving, putting on stockings and/or slippers, dressing, ambulation, and toileting.
Helping patients with equipment for their treatment as well as helping patients to move, transfer from bed to chair, or transporting them to other departments.
Observing the patient and surroundings assists the nurse to assess the progress of the patient as well as any needs the patient might have for medical intervention.
Ensuring that the patient is comfortable is also ensuring they are properly cared for. This includes such tasks as keeping the bed dry and comfortable, ensuring the patient's tray table and call mechanism is within reach
2-1-1 Call Specialist
Huron Valley Ambulance
06.2013 - 12.2014
Answer phones, making accurate referrals to appropriate community agencies, programs and services
Researching and following up on cases according to established protocols.
Appropriate triage and follow up for physician offices, health care agencies and insurance plans.
Pharmacy Technician
CVS Pharmacy
08.2012 - 07.2013
Receive written prescription or refill requests and verify that information is complete and accurate. Maintain proper storage and security conditions for drugs.
Answer telephones, responding to questions or requests. Fill bottles with prescribed medications and type and affix labels.
Assist customers by answering questions, locating items or referring them to the pharmacist for medication information.
Price and file prescriptions that have been filled.
Resident Care Assistant
Sanctuary at St. Joseph's Village
01.2011 - 08.2012
Taking vitals (blood-pressure, pulse, temperature, and respiration).
Recording intake and output, height, and weight.
Helping patients with ADLs (activities of daily living) for which they need assistance, such as bathing, combing hair, brushing teeth, shaving, putting on stockings and/or slippers, dressing, ambulation, and toileting.
Helping patients with equipment for their treatment as well as helping patients to move, transfer from bed to chair, or transporting them to other departments.
Observing the patient and surroundings assists the nurse to assess the progress of the patient as well as any needs the patient might have for medical intervention.
Ensuring that the patient is comfortable is also ensuring they are properly cared for. This includes such tasks as keeping the bed dry and comfortable, ensuring the patient's tray table and call mechanism is within reach
Education
Bachelor of Science - Public Health
South University Savannah
GA
06-2019
MBA - Business Administration
Walden University
Minneapolis, MN
08-2020
Skills
Team collaboration
Microsoft Office Suite
Project management
Business process improvement
Operations management
Requirements analysis
Data and analytics
Timeline
Enterprise Business Analyst
Blue Cross Blue Shield
05.2022 - Current
Supervisor of Pharmacy Network Support (Configuration Services Department)
Business System Analyst at Blue Cross Blue Cross Blue Shield of Tennessee (Facets Billing)Business System Analyst at Blue Cross Blue Cross Blue Shield of Tennessee (Facets Billing)
Medicare Appeals & Grievances Coordinator at Florida Blue - Blue Cross Blue Shield Of FloridaMedicare Appeals & Grievances Coordinator at Florida Blue - Blue Cross Blue Shield Of Florida
Customer Service Representative at Florida Blue - Blue Cross Blue Shield Of FloridaCustomer Service Representative at Florida Blue - Blue Cross Blue Shield Of Florida