.jpeg&q=70)
Lance Baylor
Goodlettsville,TN
Summary
Experienced motivated QNXT Subject Matter Expert (SME)/Business Analyst with technical expertise and business acumen necessary to translate business requirements and objectives into scalable, highly resilient, and successful system solutions.
Overview
12
12
years of professional experience
Work History
Business Analyst Supervisor
Cigna
Nashville, TN
08.2021 - Current
- Manage 18 QNXT Configuration and Claims testers and 3 Tech Leads
- Design and testing of QNXT configuration for Medicare Advantage Benefit Plan administration across multiple regions throughout the United States.
- Supported and collaborated with configuration and infrastructure partners on design and development of implementation features.
- Facilitated and elicited actionable requirements documentation to enable successful implementation.
- Analyzed technical and business needs and documented requirements to translate into functional, non-functional and technical specifications.
- Onboarded new employees with training and new hire documentation.
- Cross-trained existing employees to maximize team agility and performance.
- Evaluated employees' strengths and assigned tasks based upon experience and training.
- Evaluated data sets from multiple test implementations to determine and account for standard variance in test results.
Lead Business Systems Analyst
Cigna
Nashville, TN
08.2013 - 08.2021
- Created and maintained standard operating procedures governing system functions and features for QNXT.
- Identified needed business improvements and determined appropriate systems required to implement solutions.
- Gathered, reviewed and reported on findings.
- Resolved malfunctions with systems and programs through troubleshooting.
- Collected, defined and analyzed business requirements.
- Monitored User Acceptance Tester's results by evaluating test case scenarios, expected results, and outcomes for configuration changes in QNXT.
- Consolidated business rules for system enhancements.
- Implemented user acceptance testing with focus on documenting defects, identifying bottlenecks and executing test cases.
- Monitored resolution of bugs, tested fixes and helped developers tackle ongoing problems by providing QA perspective.
Operations Manager
Cigna
Baltimore, MD
01.2011 - 08.2013
- Managed 65 Claims Examiners to administer Medicare Advantage benefits in QNXT.
- Trained and managed employees on proper protocols associated with Medicare Claims payment methodologies within QNXT.
- Managed claims adjudication system migration from MHC to QNXT.
- Managed QNXT configuration research and resolution unit within claims.
- HPA Robotics vendor relations management for claims.
- Trained QNXT modules across multiple departments.
- Delivered business strategy and developed systems and procedures to improve auto adjudication rates.
- Boosted team member productivity by enhancing performance monitoring and instituting motivational approaches.
Education
Bachelor of Science - Social Work
The University of Tennessee - Knoxville
Knoxville, TNAssociate of Science - Psychology
Nashville State Community College
Nashville, TN05.2020
Skills
- QNXT Claims and Benefits SME
- QNXT Configuration and Claims Trainer
- QNXT Contract Configuration SME
- SQL Server Management Studios
- Data Analytics
- User Acceptance Testing (UAT)
- Quality Assurance (QA)
- Business Operations
Accomplishments
- Successful migration from EZCAP to QNXT in 2008
- Successful migration from MCH to QNXT in 2013
Timeline
Business Analyst Supervisor
Cigna
08.2021 - Current
Lead Business Systems Analyst
Cigna
08.2013 - 08.2021
Operations Manager
Cigna
01.2011 - 08.2013
Bachelor of Science - Social Work
The University of Tennessee - Knoxville
Associate of Science - Psychology
Nashville State Community College
Similar Profiles
Rudee FriarRudee Friar
Customer Service Representative at CignaCustomer Service Representative at Cigna
Tiffany LovatoTiffany Lovato
Customer Service Advocate at CignaCustomer Service Advocate at Cigna
Luis GilLuis Gil
Customer Service Representative at CignaCustomer Service Representative at Cigna
TIA WHITETIA WHITE
Senior Enrollment / Medical Billing Specialist at CignaSenior Enrollment / Medical Billing Specialist at Cigna
Jenny PedreroJenny Pedrero
Babysitter at Christy RichardsonBabysitter at Christy Richardson