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Objective Summary

Experienced Analyst, specializing in healthcare, with a solid
background managing and delivering IT solutions in combination with process improvement.  Talented facilitator with advanced communication, presentation, and technical skills, including programming and analytics.   Highly motivated, seeking an opportunity to improve  healthcare through utilization of technology.

Work History

20162017

UHG/Apex Systems Contract

Business/Report Analyst

Led core team in conversion/migration of metrics and analytics. 

  •  Developed template for gathering relevant report requirements from internal and external sources.
  • Utilized Microsoft Excel to cross reference report requirements, ensuring accuracy and efficacy.
  • Converted reports from various formats to Tableau and Cognos.
  • Created outlier pivot tables and reports in Excel, to accompany Tableau and Cognos dashboards.
20132015

3M/QSI Contract

System Implementation Analyst

Successfully installed, implemented, integrated, programmed, tested and trained the 3M suite of software specializing in healthcare coding, auditing and electronic medical records.

  • Managed entire project throughout SDLC.
  • Coordinated and conducted all meetings.
  • Directed system integration, testing and process improvement.
  • Programmed client-specific modifications.
  • Provided all training, including client specific training materials.
  • Coordinated integration with peripheral system vendors, including interfaces and data exchange.
  • Created client specific reports, provided training and resource materials.
  • Introduced internal and external implementation tools such as spreadsheets, queries/reports, forms and templates.
  • Developed standard project plan template, including best practice tips.
  • Established issue resolution QA committee.
20122012

CH Mack

Business Analyst/Project Manager

Serving as subject matter expert, led software vendor initial negotiation and implementation of innovative healthcare management software application.

  • Directed all internal and external meetings as well as all correspondence.
  • Developed a strategic implementation plan as well as a standard SDLC set of templates, such as SOW, BRD, and FRD.
  • Fostered process improvement initiative during implementation by incorporating standard care management workflow templates.
  • Created customer configuration reference manuals.
  • Introduced "How-To" and "Help" tips for users within the application.
  • Established a standard set of reports utilizing Tableau.
20092012

Carewise Health

Business/Report Analyst

Systems Analyst for a large managed care provider.  Expanded responsibilities included applications management, data analysis, operational and clinical analytics, process improvement, implementation of principal business software, interface and file management

  • Managed all agency software applications.
  • Directed implementation of principal business application..
  • Engineered ETL automation for EDI HIPAA files, including: 270/271, 278, 834/835 and 837.
  • Developed SQL data merge/update load event scripts to ensure data integrity and accuracy.
  • Integrated multiple databases to introduce a standard set of Operational (ROI, cost saving, productivity, projection, etc.) and clinical metrics (HEDIS, outcomes, trend analysis, etc.).
  • Coordinated multiple data quality and process improvement initiatives.
20072008

Humana, Inc.

Data Analyst

Provided data analysis, reporting analytics and process improvement related to healthcare claims, provider contracts and partnerships for a major health insurance company.

  • Re-engineered Provider Services Call Center database to streamline process and capture data.
  • Introduced Provider Services Call Center metrics utilized by executives to monitor trends and identify critical issues, in an effort to improve partnership satisfaction.
  • Created healthcare claims dashboard specifically related to providers and provider issues, such as number of claims submitted, total dollar amount, total average reimbursement rate compared to contract rate, diagnosis and resulting procedures, etc. as well as trends.
  • Streamlined contract loading process by enhancing the associated database, adding data integrity logic during entry and implementing automated routine error reports.
  • Initiated, designed and developed" Provider Portfolio" by integrating data (claims, contracts and call center) into a single document, including metrics and highlight of critical issues.
  • Developed reports reference guide, detailing logic.
  • Conducted MS Excel pivot table and pivot chart training for Provider Service executives, enabling them to fully customize and better utilize analytics/reports.
19962001

Charleston County

Accountant III/Business Analyst

Managed the IT needs of Charleston County Department of Alcohol and Other Drug Abuse Services.  Also managed Accounting, Transcription and Medical Records Departments

  • Managed IT, medical records and accounting departments
  • Salvaged software implementation, ultimately delivered ahead of schedule and under budget.
  • Developed agency metrics dashboard utilized by Operations (financial), QA/Clinical Outcomes (clinical) as well as satisfy County, State and Federal government reporting requirements.
  • Reengineered manual insurance claim filing process by utilizing SQL and ETL, exponentially increasing productivity and revenue while minimizing error rate and processing time.
  • Designed, developed and implemented MS Access databases to address critical operational needs, i.e. transcription process automation, increasing productivity 800 percent.
  • Established SOP manual for Accounting, Medical Records and Transcription departments.
  • Provided all IT trainings, including manuals.

Education

19901994

BS Computer Information Technology

Western Kentucky University
  • Tentative enrollment with anticipated completion 2021.