Description
Professional Summary Dynamic and motivated IT Senior Business Analyst with experience in client relations, team management, healthcare IT infrastructure and clinical data exchange. and Key Accomplishments Senior Business Analyst with strong healthcare analytic, design and implementation skills. Supported BlueCross BlueShield of South Carolina's TRICARE (military healthcare insurance) contract. Also acted as company liaison to the international Standards Developing Organization (SDO) Health Level Seven. Became recognized as an industry leader and contributor was then elected by peers to act as a co-chair to the organization and became instrumental in drafting an upcoming US Regulation for Attachments. Expansive healthcare and analysis knowledge including process workflows business and technical requirements healthcare claims pricing structures/updates testing and budgeting. Achieved and maintained the 95% service level agreement (SLA) for planning and budget. * Successfully identified system improvements for claims processing moving from batch to on-line processing. Led a team that developed business use cases for the move from fee-for-service to value based care payments. * Led teams in evaluating new technological trends and how they could be applied to solve business challenges. Examples include extracting data from a clinical electronic health records for HEDIS measure calculation on two HEDIS measures colorectal cancer screening and controlling blood pressure investigating integration of data lakes blockchain and master patient index into BlueCross BlueShield systems * Increased healthcare payer membership for Health Level Seven (HL7) by 10% while serving on HL7's membership committee. * Earned the Workgroup for Electronic Data Interchange (WEDI) Award of Merit 2 years in a row for educating the health care industry on electronic claims attachments.
Work Experience
| COMPANY | POSITION HELD | DATES WORKED |
|---|---|---|
| Blue Cross Blue Shield Of South Carolina | Senior Business Analyst Client Manager | 12/2002 - 12/2017 |
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