SUMMARY

Energetic team player with over 15 years of experience in the insurance, financial services and banking, and IT consulting industries. The past seven years at Blue Cross and Blue Shield of Illinois managing cross-functional teams accountable for delivering on business projects. Demonstrated track record of success in developing information strategies and solutions, business analysis, operations, sales, and product management to create and adapt strategies and products to satisfy client's needs in changing environments. In-depth knowledge and background in Healthcare Insurance, Treasury and Cash Management Operations, Products, Sales and Sales Management. Perform well under pressure, able to handle multiple tasks with excellent organizational, time management and superior computer, verbal and written communication skills.

PROFESSIONAL EXPERIENCE

Confidential

Senior Business Solutions Consultant

Responsibilities

Achievements

• Mentored and trained 8 Business Analysts to accurately capture requirements, develop process flows, mockups and document system requirements for MAPD, MMAI, ICP, LTSS and TANIF
• Delivered business and technical solutions on time by collaborating with the business and prototyping teams
• Developed information strategy and implementation roadmaps for Government Programs and ACA Quality Reporting
• Solved business and technical issues by developing prototypes and ad-hoc technical solution
• Developed NCQA HEDIS Quality Reporting strategy for the Public Exchanges by defining and developing a standard enterprise solution
• Worked closely with third-party vendors to exchange data e.g. CMS, Lab, Rx, immunization, etc. to meet ACA mandates
• Ensured Medicare claims are being coded accurately by Providers to ensure appropriate risk score are assigned to members

Lead/Senior Business Analyst

Confidential

Achievements

• Documented current and future state Actuarial and Financial reporting business processes and the system data flows
• Elicited and documented the MLR Rebate requirements based on the Health and Human Services HHS mandate
• Developed system and nonfunctional requirements, mockups screens, use cases, content specs, state diagrams, activity diagrams and process flows to support interim solution
• Identified, calculated, and documented the future state requirements for forecasting and rebating the monies according to the Final Rule published by the HHS
• Elicited and captured the data classification categories for both Actuarial and Financial rep orting needs

Confidential

Responsibilities

• Elicited and documented ANSI 5010 business and system requirements and the exception handling and reporting process
• Developed Operational Metrics and Dashboard for measuring and monitoring the conversion process
• Assisted the Solutions Architect with the development of logical designs of the solution

Confidential

Responsibilities

Achievements

• Captured functional and nonfunctional requirement, Business Rules and system requirements in IBM Rational Requisite Web
• Assisted the Solutions Architect with the development of the solution
• Provided weekly requirements status reports
• Mentored other business analysts in the program

Confidential

Responsibilities

Achievements

• Documented requirements for Role-Base Access Control RBAC
• Developed standers for Group ID and User ID in both environments, including databases and other applications
• Worked on developing a process for de-provisioning users based on the HR termination file that was produced daily
• Captured requirements for Distributed Environment UNIX LDAP Integration Windows Integration Domain

Senior Business Analyst

Confidential

Achievements

• Elicited and documented business requirements for external Rx data integration project
• Facilitated meeting with internal users to develop business needs and requirements
• Defined and validated functional, nonfunctional and system requirements and maintained Requirements Traceability
• Worked closely with the Solutions Architect to assist in developing the software solution
• Provided recommendations to address and resolve business issues
• Completed project status reports, cost estimation reports and weekly status reports

Confidential

Assistant Vice President, Business Analyst/Technical Presales Support/Product Development

Achievements

• Assisted Treasury Management Sales Representatives train new commercial customers, close new deals and provide presales support for customized products, cash management reporting and account receivables services.
• Effectively established both quality and performance standards across the Treasury Management department with a 27 improvement in productivity and 21 improvement in quality by utilizing Six Sigma methodology.
• Successfully led Remote Deposit Capture and automated Bill Pay implementation, Service Quality, Treasury Management restructuring, new customer automated implementation, and Vault cash inventory reduction project.
• Maintained vendor relationship and tested and navigated through product updates or system changes that may impact the customers.
• Worked closely with our primary systems third-party systems vendor to improve performance, quality and functionality of the applications.