Sunday Myers
Columbia,SC
Summary
Highly experienced results oriented professional with 20+ Years of experience in the Health Care/Insurance industry to include managing care systems, TPA, Marketplace, Medicare, and Medicaid. Develop documents, execute, and monitor predictable, repeatable processes in the disposition of change requests, trouble tickets, software releases/fixes, enhancements, new product development, and other items. With the ability to display strong communication skills, compassion, in-tune interpersonal abilities, organizational proficiencies, problem-solving, and time-management skills.
Overview
11
11
years of professional experience
Work History
Technical Support Lead Analyst
Conexess (Cigna Healthcare)
06.2022 - 12.2022
- Conduct UAT Testing, Test Script writing for upcoming Releases
- Performed Smoke testing and analyzed system abnormalities and defect testing.
- Mentored junior team members in both technical skills and soft skills, fostering a culture of continuous learning and professional development.
UAT/QA Test Analyst-Integrated Eligibility Project
SC Department of Health and Human Services
04.2015 - 06.2022
- Analyze business and system requirements, manage development of specifications to create and execute detailed test plans, and verify bug fixes
- Implementation of Curam System from a legacy system
- Work as hybrid role of the Development and Design team that performs UAT Testing as well as some QA testing to fully test system designs
- This project is working with the Eligibility system (MEDS) performing system testing as well as some Interface testing
- (MAGI & Non-MAGI)
- Work with project management, training team, helpdesk, business analysts, policy analysts and business operations staff to develop a strategy for operational readiness
- Configure test environment and create strategy for product development and certification
- Assure test data, schedule automated/manual tests
- Approve results documentation and tracking systems updates
- Coordinate and develop test case scenario development, tests, and recommends updates to Desk Level Procedures.
- Kept scripts and test cases updated with current requirements.
- Contributed to the successful launch of several major software products by consistently meeting aggressive deadlines without compromising on quality assurance principles.
QA Test Analyst V
Insight Global (Prime Therapeutics)
11.2021 - 02.2022
- Analyzed Sample Explanation of Benefits (EOB’s) received from the Print vendor with changes based on CMS standards as part of the Annual Enrollment (AEP) changes
- Ensure that the samples match the Client approved templates
- To include the drug calculations, discounts, other health plan contributions and Medicare Extra Help adjustments
- Works closely with the Office of Eligibility, Enrollment and Member Services (EEMS) to ensure that all system, policy, procedural and operational changes are identified, documented, and communicated to stakeholders.
Healthcare Consultant
The Jacobson Group (Contracted Positions)
01.2012 - 01.2015
- Led a team of 35+ employees who handled service calls for on & Off Health Exchange Members (FFM)
- Utilized the FISS system to determine the disposition of claims with explanations, payments issued to Part A providers, verify information on file for providers and their locations
- Participated in the initial Provider Services training and now continued coaching and direction of the on/Off Exchange plans and other functions.
- Scope of several Projects included: Aided in completion of Provider Enrollment Part A applications. Accepted supervisor transferred calls along with team coaching and guidance. Also accepted Part A calls of an intermediary. Processed provider enrollment applications & assisted in the set up process for new providers.
Education
MBA - Business
Webster University
Columbia, SC01.2007
MHA - Health Administration
Webster University
Columbia, SC01.2007
Bachelor of Science - Business Administration
Limestone College
Gaffney, SC01.2005
Skills
- Software Knowledge
- Manual Testing (UAT & QA)
- Curam
- Medicaid (MMIS & MEDS)
- Business Analysis
- AS400
- Jira
- Managed Care, TPA, ASO, Blue Card, Self Funded
- PBM
- Provider Enrollment
- Licensed Nursing Home Administrator
Timeline
Technical Support Lead Analyst
Conexess (Cigna Healthcare)
06.2022 - 12.2022
QA Test Analyst V
Insight Global (Prime Therapeutics)
11.2021 - 02.2022
UAT/QA Test Analyst-Integrated Eligibility Project
SC Department of Health and Human Services
04.2015 - 06.2022
Healthcare Consultant
The Jacobson Group (Contracted Positions)
01.2012 - 01.2015
MBA - Business
Webster University
MHA - Health Administration
Webster University
Bachelor of Science - Business Administration
Limestone College
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