ZENOLA LEE
Gilbert,Arizona
Overview
18
18
years of professional experience
Work History
Business Analyst II
Centene Corporation
06.2018 - Current
- Analyze, Configure, and test complex requirements
- Perform configuration responsibilities while successfully making quality, and completion goals
- Assisting less experienced BAs that have questions or concerns
- Work well with stakeholders such as CIA, keyers and testers to interpret requirements and convert to configuration.
- Share new concepts, issues and efficiencies with the team.
- Troubleshoot claim issues in Amisys and DST while incorporating best practices
- Move Configuration Requests in Service-Now through the process to completion
- Work on implementations in whatever capacity needed
Vendor Management Project Manager
Centene Envolve Pharmacy
05.2017 - 06.2018
- Project Management – Collaborated with Envolve teams to accomplish the following in support of projects:
- Tracked deliverables and Action Items
- Documented meeting minutes
- Archived project documentation on SharePoint
- Vendor Management – Supported Vendor manager with the following items:
- Facilitated Status Calls – Managed routine status calls
- Invoice validation: Reviewed invoice and validated fees against departmental operations such as project hours, user access fees, etc.
- Auditing – Worked with vendor to gather documentation for CMS audits.
- Performance Metrics – Reviewed daily, weekly, and monthly documentation against contracted performance metrics to ensure vendor is meeting SLAs.
- Archived Vendor documentation on SharePoint
BRM, Benefits Relationship Manager
CVS Health
03.2013 - 05.2017
- Manages, coordinates and trains benefit design teams
- Submit, track and manage coding requests through Salesforce
- Gathered client intent, translate, document and clarify information to teams for coding, testing, and QA
- Coordinated Welcome Season activities required to build and support 2 major clients all Lines of Business
- Completes all requests for research, coding and testing with high quality results and timeliness using Rxclaim
- Proficient using existing tools such as AS400(Rxclaim) to answer claim processing questions
- Worked with audit teams to ensure the client passes CMS audits from a benefits perspective
Client Benefits Analyst
CVS Health
09.2011 - 03.2013
- Identify, solve complex issues to conclusion and communicate them to the leadership
- Coordinated Welcome Season activities required to build and support Six Med D clients
- Completes all requests for research, coding and testing with high quality results and timeliness
- Proficient using existing tools such as AS400(Rxclaim) to answer claim processing questions
- Mentoring and training new coders and ensuring coding instructions are submitted with proper documentation
Metrics Analyst
CVS Health
05.2010 - 09.2011
- Provides technical expertise and support for Med D adjustment processes
- Effectively leverage team resources to assign processing tasks
- Identify, solve complex issues and follow through to conclusion and communicate them to management
- Extracts claim data and leverages software tools to calculate routine adjustments
- Use existing tools such as AS400(Rxclaim) to answer data and processing questions
- Manipulate and analyze large data and database issues
- Work with advisors to support and test new automated processes that interact with EAS and other IT data
- Produces and maintains key metrics, process flows, operational procedures, and test/query library
Sr. Business Systems Analyst
Mckesson Specialty Solutions
08.2007 - 03.2009
- Lead cross-functional sessions to address business or systems issues.
- Worked with the business to identify, clarify, design and develop basic to moderately complex business reports using Business Objects.
- Used Remedy to submit track and document application issues, upgrades and resolutions.
- Demonstrated strong analytical/problem solving including gap analysis skills to resolve complex business and reporting problems.
- Documented report development and distribution flow to keep track of production reports, documentation and report samples published to Share-point.
Education
Master of Information Systems Management - undefined
University of Phoenix
Phoenix, Arizona01.2007
Bachelor - Business Management
University of Phoenix
Phoenix, Arizona01.2006
Skills
- 5 Years Project Management Experience
- Strong interpersonal, verbal, written, and communication skills
- Excellent Presentation skills, Extensive knowledge of Change Management
- Subject Matter expert in Claims Adjudication, Reporting, Coding, Testing and QA of benefit setups
- Microsoft Office Suite, AS400(Amisys), Service-Now, Sharepoint, DST Pricing, Business Objects, Golden(SQL)
Accomplishments
- A Business professional with my latest focus on Medicaid Claims Configuration.
- Received performance awards in 2014 and 2015 for a successfully Implementation of benefits
- Analyzed coding problems to fix issues with coding before they go live.
Timeline
Business Analyst II
Centene Corporation
06.2018 - Current
Vendor Management Project Manager
Centene Envolve Pharmacy
05.2017 - 06.2018
BRM, Benefits Relationship Manager
CVS Health
03.2013 - 05.2017
Client Benefits Analyst
CVS Health
09.2011 - 03.2013
Metrics Analyst
CVS Health
05.2010 - 09.2011
Sr. Business Systems Analyst
Mckesson Specialty Solutions
08.2007 - 03.2009
Master of Information Systems Management - undefined
University of Phoenix
Bachelor - Business Management
University of Phoenix
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