Hi, I’m
Ophelia Gibson
Avon,MA
Summary
Senior Data Analyst with over 10 years of experience in the Healthcare Industry. Experience includes but is not limited to: healthcare insurance reporting and analysis, data analysis using IBM® Cognos Analytics, SQL, SAS, Excel and, Tableau, and Quest Analytics; business requirements documentation, business needs evaluation and process and quality improvement.
Overview
23
years of professional experience
Work History
WellSense Health PlanCharlestown, MA
Data Analyst
10.2016 - Current
Job overview
- Improving efficiency by at least 10% on standard and regulatory reporting
- Develop, implement, and maintain regulatory and management reports for executives and other stakeholders critical for business and financial decision making
• Collaborate weekly with internal departments to evaluate membership impact of upcoming legislation, program changes, and provider terminations
• Monitor actual membership performance against forecast and other targets; proactively investigate and communicates explanations for variation to business owners
• Use Quest Analytics to analyze data; to discover network impact of adding or terming providers and availability standards for Provider Contracting and Credentialing Departments
• Actively participate in Data Analysis work-group as part of overall data governance team and provide feedback to be used in designing of new data warehouse - Skilled at working independently and collaboratively in a team environment.
- Worked effectively in fast-paced environments.
WellSense Health PlanCharlestown, MA
Pharmacy Benefit Analyst II
03.2008 - 10.2016
Job overview
- Gathered and documented technical and business requirements needed to support new enhancements and/or regulatory requirements for Pharmacy Benefit Manager vendor system
- Partnered with vendor to troubleshoot system issues, identify root causes and outline steps to resolve in timely manner to minimize downtime
- Managed change control requests with internal IT and vendor
- Create and manage website content using Sitcore automation software on a monthly basis
- Developed training materials and conducted internal pharmacy training of pharmacy systems
- Documented requirements for custom IBM Cognos Analytics reporting and generation
- Collaborated with clinical staff, and other professionals to develop and implement client rehabilitation programs
Tufts Health PlanWatertown, MA
Senior Client Service Representative
02.2001 - 03.2008
Job overview
- • Provided effective customer service to all internal and external customers by communicating early and engaging with team members within organization and supporting them with any issues related to health benefits plans and programs
• Resolved member and provider health benefit issues in timely manner reducing need for escalation
• Distributed communication to cross-functional teams, and internal and external stakeholders during product implementations
• Mentor and trained new hires on company policies and procedures
• Worked as liaison with other departments to assist and resolve customer issues - Cultivated impactful relationships with customers and drove business development by delivering product knowledge
Education
BOSTON UNIVERSITY, Boston, MA
Master of Science from Database Management & Business Intelligence
2018
UNIVERSITY OF MASSACHUSETTS BOSTON, Boston, MA
Certification from Project Management
2011
UNIVERSITY OF MASSACHUSETTS BOSTON, Boston, MA
Bachelor of Science from Information Technology
2005
Skills
- Team player
Relationship building
Training
SQL Server Reporting
Tableau
Quest Analytics
IBM® Cognos Analytics
SAS Business Intelligence (BI)
Data Analysis
Data Warehouse
Data Management
Report Designing
Requirements Documentation
Microsoft Office Suite
Process Improvement
Project Management
Quality Improvement
Timeline
Data Analyst
WellSense Health Plan
10.2016 - Current
Pharmacy Benefit Analyst II
WellSense Health Plan
03.2008 - 10.2016
Senior Client Service Representative
Tufts Health Plan
02.2001 - 03.2008
BOSTON UNIVERSITY
Master of Science from Database Management & Business Intelligence
UNIVERSITY OF MASSACHUSETTS BOSTON
Certification from Project Management
UNIVERSITY OF MASSACHUSETTS BOSTON
Bachelor of Science from Information Technology
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