Summary
Overview
Work History
Education
Skills
Certification
Work Availability
Quote
Timeline
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Steven Gilbert

Steven Gilbert

Sr Application Analyst
Maricopa,AZ

Summary

I have over 20 years of experience working in Tech Support and Healthcare Analytics. Thus having a background in web support, tech support, healthcare, data analytics and customer service, makes me adaptable in any environment. My background helps me to possess the skills to be a valuable asset to your company.

Overview

19
19
years of professional experience
1
1
Certification

Work History

Senior Application Analyst

Cognizant
Mesa, AZ
12.2021 - Current
  • Manage hot fix process and communications between development, shareholders and the client
  • Adhere to SLG/SLA guidelines
  • Resolved issues with in SLA/SLG guidelines at 98%
  • Assist product support team in meeting the Customer Satisfaction Survey at 100%
  • Meet with product support team daily for new assignments and updates
  • Provide product support for QNXT, via Azure, and SQL
  • Attend weekly maintenance and client support meetings
  • Attend weekly meeting with shareholders
  • Provide training and guidance on the hot fix process
  • Maintain the maintenance log work with development and product management on maintenance issues
  • Troubleshoot,Submit defect error report documentation to maintenance team, QA test and resolve.
  • Collaborated with business owners, vendors and other team members to evaluate and recommend solutions to complex problems and requests.

Network Relations Analyst

CVS Health
Tempe, AZ
03.2020 - 06.2020
  • Establish/maintain and align contracted provider demographic data and negotiated reimbursement arrangements across provider systems
  • Review new and existing contract reimbursement arrangements for compliance with standards and determine most appropriate system input methodology that facilitates accurate and consistent claim adjudication
  • Maintain cooperative working relationships with internal Aetna contacts
  • Analyze, identify and report on significant changes to network configuration and market information
  • Support and assist with operational activities that may include, but are not limited to, database management, and contract coordination
  • Submit weekly network status reports to the network and development director and manager
  • Extract information from provider systems to meet business reporting needs
  • Performs credentialing support activities as needed
  • Educates providers as needed to ensure compliance with contract policies and parameters, plan design, compensation process, technology, policies, and procedures
  • May collaborate cross-functionally on the implementation of large provider systems, to manage cost drivers and execute specific cost initiatives to support business objectives and to identify trends and enlist assistance in problem resolution
  • Provide guidance and training to less experienced team members
  • Verify provider credentialing
  • Assure that provider information is aligned via QNXT
  • Build database and report in QNXT and SQL

Network Development Analyst

Mercy Care, CVS Health
, Tempe AZ
08.2018 - 01.2020
  • Builds, loads and maintains standard contracts, agreements, amendments and/or fee schedules, tables in contract management systems
  • Ensure that signature and delegation activities are complete per required timeframes
  • Partners with internal constituents and provides information to ensure contract compliance adherence to company policies and procedures including contracting guidelines, clinical and payment policy information, coding requirements, and other required policies/procedures
  • Implement SAS to build reports and track opportunities in network coverage
  • Sends, receives, processes and documents and triages provider contracts and agreements and ensures all paperwork is received, complete and accurate
  • Sends agreement to providers
  • Partners cross-functionally to ensure the credentialing process is complete
  • Requests appropriate analyses (financial, legal, business language reviews) as appropriate
  • Maintains contract and agreement files and file management systems and spreadsheets and single point of contact for questions related to the same as well as special projects, internal audit, core, provider service organization and other functional areas for contract copies and information
  • Provide weekly network data reports using Tableau and SQL
  • Assisted in analytical implementation of building a provider network for DDD
  • Verify provider credentialing
  • Assure that provider information is aligned via QNXT

Web Support Application Analyst

Endurance
, Tempe AZ
07.2018 - 08.2019
  • Resolved tickets within SLA 98.6%
  • Resolved escalation ticket 100% SLA
  • Attend weekly meeting with stakeholder
  • Document, Test and Maintain Web Applications including C-panel, Coldfusion, Java, Perl, SQL, HTML
  • Provide root cause analysis to resolve system or application issues
  • Coordinate with ITS Client Support, Help Desk, and Product Support Team to resolve clients issue
  • Build database and reporting in mySQL
  • Adhere to SLA guidelines

Provider Service Analyst

Magellan Health
Phoenix, AZ
05.2004 - 08.2018
  • Triage appeals, nurse, and doctors cases
  • Email appropriate correspondence for pending cases or expedite
  • Enter new Provider Information for verification
  • Email and update provider changes for pending cases
  • Handle Medical Doctor Peer to Peer cases via (transfer, email, or schedule)
  • Attach faxes to pending, status, and reprocessed cases
  • Handle inbound calls for new/existing authorization with the appropriate time frame
  • Submitted expedited appeals via Facets
  • Assist claims department in process claims during overflow
  • Build database and reporting in mySQL

Education

Maricopa Community Colleges - Rio Salado Community College
Tempe, AZ
01.2023 - Current

Skills

Complex problem-solving

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Certification

Google Data Analytics Certification

Work Availability

monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote

There is a powerful driving force inside every human being that, once unleashed, can make any vision, dream, or desire a reality.
Tony Robbins

Timeline

Maricopa Community Colleges - Rio Salado Community College
01.2023 - Current

Senior Application Analyst

Cognizant
12.2021 - Current

Google Data Analytics Certification

06-2021

Network Relations Analyst

CVS Health
03.2020 - 06.2020

Network Development Analyst

Mercy Care, CVS Health
08.2018 - 01.2020

Web Support Application Analyst

Endurance
07.2018 - 08.2019

Provider Service Analyst

Magellan Health
05.2004 - 08.2018

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Steven GilbertSr Application Analyst