Julie
Business
Systems Analyst |
Summary
of Skills and Qualifications
Ø More than twelve years
experience acting as a liaison between end users, IT staff, and management to
design systems that meet the needs of multiple stakeholders
Ø More than ten years experience
analyzing and formulating systems requirements, and communicating requirements
and best practices in software design to programming and management staff
Ø More than ten years
experience reviewing and testing software, including work with QA to create
test scripts
Ø Experience providing
end-user orientation and training
Ø Exceptional oral and
written communication skills; self motivated and directed
Ø Outstanding
organizational and interpersonal skills; experience working in team-oriented,
collaborative environments
Ø Experienced user of
industry-standard software, including (but not limited to): Microsoft Word,
PowerPoint, Excel and Visio, Enterprise Manager, Query Analyzer, AS400, SQL,
Oracle, Toad
Ø Skills matrix:
|
Skills |
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Ø
Writing specifications |
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Ø
Business Analysis & Development |
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Ø
Excellent interpersonal skills |
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Ø
Client Relations |
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Ø
Needs assessment |
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Ø
Writing test scripts |
|
Ø
Product testing |
|
Ø
User-acceptance testing |
|
Ø
Querying (SQL) |
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Ø
Project management |
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Ø
Visio |
|
Ø
Microsoft Project |
Professional
Experience
|
RXAmerica, Team Lead Business Systems Analyst |
3/2006–Present |
Ø
Distribute
reports and file requests from customers to the development team for scope,
analysis and development.
Ø
Lead
in all MMA (Medicare Part D) projects, including PDE (Pharmacy Drug Event) for
RXAmerica and all external clients, quarterly reports, adhoc reporting
troubleshoots problems with the claims adjudication system. These clients include lives totaling
300,000. These projects are critical to
company operation and the success of Medicare Part D.
Ø
Created
departmental reporting and specification guidelines that are currently in use.
Ø
Liaison
between customers (internal and external) and developers.
Ø
Worked
with all members of RXAmerica to obtain the requirements, business rules, and
specifications for reports and files.
Ø
Responsible
for all work load estimation and distribution as well as deadline negotiation
Ø
Used
Toad and SQL to extract data from Oracle
for reporting and data extraction.
Ø
Used
EspressReport writer to create
reports for internal and external customers.
Ø
Organized
and scheduled departmental training to enhance team skills.
|
Educators Mutual, Business Systems Analyst |
8/2005–2/2006 |
Ø
Successfully
researched and implemented Medicare Part D
Ø
Lead
in analysis, planning, design, and deployment of a web-based
Ø
Used
SQL Enterprise to query data and build data transformation packages for
importing and analyzing data.
Ø
Maintained
compliance with federal requirements under critical deadlines.
Ø
Used
SQL Enterprise to query data and built Data Transformation Packages to import
many incoming Medicare files.
Ø
Created
systems models, specifications, diagrams and charts to provide direction to
system programmers.
Ø
Provided
end-user orientation and training for all modified and new systems.
Ø
Reviewed,
tested, and verified the accuracy of new and changed programs prior to
deploying them in the production environment.
|
XanGo, Business Systems Analyst |
1/2005–8/2005 |
Ø
Researched,
collaborated with the commissions departments their workflows and procedures
and documented a technical and business specification requirements for their
processes; i.e. distributor payments, Japanese commissions, international
payout methods of commissions, currency conversions, RMA processes, check
printing, back office distributor tools and reporting.
Ø
Obtained
business requirements and composed detailed system design documents, using UML
charts and diagrams indicating the various steps involved.
Ø
Researched
‘Bottomline’ as the going forward solution for check printing and local
currency conversion for payment of commissions for distributors.
Ø
Collaborated
with the QA department to create test scripts.
Ø
Key
liaison between business and information technology during requirements
definition and change request and user acceptance phase of development
|
Magellan Behavioral
Health, Business Systems Analyst |
8/2000–1/2005 |
Ø
Lead
Analyst / Project Manager to automate a five million member feed from
Ø
Wrote
specifications, design and development plans, using the development life cycle
for a Utilitization Management System to keep current with Federal regulations,
HIPAA and Sarbanes Oxley, while maintaining daily operations.
Ø
Lead Analyst / Project Manager for a web-based automated
authorization tool for therapists and physicians which was compliant with
company business and federal rules.
Ø
Worked
closely with developers to translate business needs to create applications with
the functional specifications needed by the business.
Ø
Proficient
in writing queries and analyze data on the As400, Access, and Excel.
Ø
Propose
the best alternatives if between development cycles.
Ø
Construct
User Acceptance test scenarios. Once the release is tested and accepted I
educated the Training Department in all new functionality of applications.
Ø
Wrote
detailed test plans to ensure accuracy of software.
|
Educators Mutual
Insurance Association,
Configuration Analyst |
4/1998–8/2000 |
Ø
Custom
designed the intelligence of the system based on the plan design of the client.
Analysis of end users current workflow and configuration of the existing
client’s structure. If it was determined that there was a significant enough of
a difference, an entirely new hierarchy would be created from general to very
specific details of the plan document.
Ø
Analyzed
new clients requirements to determine how the plan should be set up within the
current system while maintaining all benefits, pricing, which are translated
into claims payment based on the client documentation, state regulations,
provider contracts, etc.
Ø
Worked
directly with front-end staff to research and resolve difficult claims. From this analysis, reengineered manual
workflows into automation to eliminate errors.
Ø
Instrumental
in data conversion to for an upgraded system.
|
First Health, Business Analyst |
12/1996–4/1998 |
Ø
Analyst
for the implementation of Kaiser Permeate business health benefits.
Ø
Analyzed
hundreds of Maryland State Mandates and other states in order to create benefit
packages.
Ø
Performed
business requirements gathering and writing from various levels of the
organization.
Ø
Quality
Assured claims to insure that they paid correctly.
Ø
Conducted
business analysis and configuration of Claims and Membership Sub-Systems.
Designed test plan, test scenarios, test cases and test scripts.
Ø
Performed
User Acceptance and Integration testing.
|
First Health, PPO Coordinator |
7/1994–12/1996 |
Ø
Pricing
of Provider and Hospital aspect of claims payments. First Health, as a TPA,
administrates all different types of plans. I handled over fifty diverse plans
at a time.
Ø
The
client would provide the pricing requirements for the discounted PPO rate. This
required extensive rapport with the Marketing, Clients, and Internal Front Line
Operations. I would configure the system and maintain, which required
prioritization, and the ability to work with more than one project at a time.
Ø
Extensive
experience with ASA tables, HIAA, MDR, RVRVS, to establish the UCR to determine
an allowed amount for the particular procedure. I would ensure correct claims
payment by doing extensive Quality Assurance.
Ø
Exclusively
responsible for translating information into First Health standard format to
facilitate rapid comprehension by Benefits Examiners as well as any other First
Health employees who may be required to access this information.
Education
|
|
|
Ø
Completed
coursework in computer information systems.
Ø
Oracle
programming and forms
Ø
Advanced
SQL
Ø
Project
Management I and II
Ø
Management
Training