TECHNICAL SKILLS:

Office Software: MS Office suite, Mac OS, Warden, CME, GCRM, Windows (95 - current), Coats, SharePoint, Confluence, MS Teams

Data Analysis Tools: SQL, Toad, Excel, Access, SPSS, Power BI, and Jaspersoft

Database Software: IKA systems, SQL, Oracle

Problem Solving: Process development and implementation

Trouble Shooting: Analysis, development and implementation

Troubleshooting: Hardware / electronics / software / data integrity, Excellent interpersonal communication, Project Coordination / Program Evaluation

Teaching: class room, team-building, group instruction

PROFESSIONAL EXPERIENCE:

Business Analyst

Confidential, Austin, Texas

Responsibilities:

• Created, developed, and maintained monthly metrics for operational meetings for the VP of operations.
• Developed, implemented and maintained scheduled reports for operations and ESCO lines of business.
• Ran ad-hok reports for operations across several lines of business as needed.
• Create and maintain overpayment database for claims department.
• Oversaw delegation oversight monitoring of third party vision and dental claims, sent monthly timeliness reporting and analysis of claims to network management and senior leadership.
• Managed performance and productivity at the department and employee level for the claims and call center operations.
• Responsible for implementing and keeping up with guidance from CMS for Confidential, CDAG, and Operational Determination Regulations (ODR) for part C and D reporting.
• Created part C and D universe tables for Confidential, CDAG, and ODR reporting.
• Identified discrepancies, risk and root cause for business development and improvement.
• Ensured data integrity is maintained throughout the reporting lifecycle.
• Prepared and implemented reconciliation workflows and work instructions for reporting and analytics.
• Automated manual reporting and analysis of business implications and trends using software such as access and Power BI.

Care Navigation Service Coordinator

Confidential, Austin, Texas

Responsibilities:

• Using defined “trigger events” initiate outbound communication to patient/family caregivers and/or other concerned parties to facilitate the coordination of care for patients assigned to the Care Navigation unit.
• Receive inbound calls from patients, caregivers and health care team and resolve non-clinical issues (barriers to care) regarding the patient. Escalate calls to clinical Care Navigation staff when key phrases indicative of a medical problem were spoken by the patient.
• Collaborates with clinical staff and other members of the patient’s health care team to assist in the development of an individual plan of care to facilitate an immediate action plan to meet the patient’s current needs.
• Communicates and coordinates with patient and appropriate members of patient’s health care team in developing, executing and reviewing results of care coordination efforts.
• Collects, reviews and employs all pertinent information available from but not limited to FMC clinical systems, care management notes, vendor information, geographic mapping software, direct communication patient, physician or other members of health care team.
• Reports to clinical staff, the discovery of unreported medical or social conditions or changes at home that may lead to adverse outcomes and ensures that these are referred to appropriate sources for attention.
• Maintains and updates the appropriate software/tracking logs of patients in the Care Navigation Program to manage and record required information and data.
• Evaluates program processes and makes recommendations to management that will improve the effectiveness and efficiency of the program.
• Maintains the integrity of Protected Health Information (PHI).
• Complies with all departmental required data collection and auditing activities, participates in quality improvement activities and participates in project-based work.
• Maintains current knowledge of the departmental program software and the Company’s clinical information systems.

Client Technical Analyst

Confidential, Austin, Texas

Responsibilities:

• Analyze Dealership data using Sequel and In-house data management tools to create Client reports for product improvement and implementation documents.
• Developed client customer improvement and kept constant communication for client to DMI integration.
• Held Client meetings pertaining to Product improvement and development
• Knowledge of Dealership DMS processes for CDK (ADP), Reynolds & Reynolds, and other third-party databases collection.
• Using In-house data research utilities performed and studied data quality analytics on dealership data for, Vehicle sales, service, and inventory.
• Used BDE and DRE rules to manipulate data for client needs on exported data
• Created client “health” reports showing dealer enrollment status charts, data extraction and exporting charts, reports showing special and common causes with sales projections using yearly collected yearly data.
• Trouble-shoot data connections for data quality issues for clients such as; Jaguar Land Rover USA, GM, and Everycarlisted.
• Updated in house support tools such as SharePoint, and confluence. To keep the DMI knowledgebase up-to-date.
• Worked with clients to utilize the In-housed developed data collection and utilization tools; Dealer-Portal, InfoIQ, and ICAP.
• Trained new employees on the data quality analysis process at DMI.
• Created new employee training documents concerning client needs and DMI to client processes for new employees

Program Administrator

Confidential, Austin, Texas

Responsibilities:

• Held Client meetings to discuss client data integration with sales values for marketing trends for Lenovo and IBM
• Created Analytical and market reports for Lenovo and IBM, using word, Excel and Access processed data
• Created programs that calculate the money that business partners will receive using company software utilities
• Create queries in Microsoft Access to determine if company software is pulling information from tables properly
• Run and check weekly, biweekly, and monthly reports to ensure that pending payments for programs are correct
• Write and edit standard operating business procedures
• Market research for changes to company websites and company software
• Upload and download sales and marketing data for quality analysis
• Checked reports generated for accuracy
• Train new employees on policies and procedures

Human Resources Admin / Recruiter/ Analyst

Confidential, Austin, Texas

Responsibilities:

• Market research for new clients in the tech, health and manufacturing markets
• Analytic reports using Excel to demonstrate Market trends in Tech, Medical and Manufacturing companies in and moving to Austin
• Implemented and Managed employee benefits for over 200 temp employees
• Developed and updated the employee handbook, company policies and procedures.
• Maintained and updated employment records, including certifications, background checks, and drug screens
• Processed payroll, including payroll deductions, payroll checks, directed deposit
• Kept all records in accordance with employment and HR law
• Conducted new hire orientation
• In charge of recruiting qualified candidates for client accounts

Tort Data Analyst

Confidential, Austin, Texas

Responsibilities:

• Researched civil litigation for settlement owed to Texas Medicaid
• Market research on civil litigation and Medicaid benefits
• Processed civil litigation concerning settlement for services rendered in a Medicaid claim
• Created and developed Payment plans and methods for Medicaid reimbursement
• Processed and filed Civil litigation suites involving Texas Medicaid

Billing Data Analyst

Confidential, Austin, Texas

Responsibilities:

• Managed client limited medical benefits and applied client payments
• Analyzed data and compiled reports for clients using Excel and Access
• Analytical reports showing enrollment, payout and cost stats to clients
• Quality control analysis using excel to review claims processed data from tables
• Verified employment and medical benefit status with employers
• Coordinated credit card charges and negotiated payment schedules for individual credit accounts
• Gained expertise in the policies and procedures of major and limited medical insurance plans