Experience

Health Partners Plans

• United States
• Hospitals and Health Care
• 300 - 400 Employee

• Business Analyst

  • Aug 2013 - Present

  • Responsible for translating benefits configurations on Power MHS. Identifying if issues being assigned are valid. Configuring benefits to accommodate member's contracts. • Providing updates to business units and end-users with the identification of appropriate MHS solutions to business problems. • Demonstrate subject matter expertise of system applications • Responsible for end-to-end designs regarding new initiatives, mandates, and/or projects. Write business requirements and functional specifications outlining the initiative’s intent, purpose, existing set up, and strategy on the changes that will be performed. Created test scenarios and test plans related to the project. • Involved in the testing, deploying, and support of MHS releases and defects as it related to the ASM area. • Provided assistance to ASM team members • Lead resource for translating ICD9 to ICD10. Support production build, readiness planning, and execution. Work closely with the Project Manager and Health First to ensure all system configurations and codes are ready for the 10/1/15 go-live. • Responsible for configuring benefits for the Medicare and Healthy PA products • Identify issues with MHS configurations and provide solutions to management • Resource for the authorization mapset that will be used for the authorization/claim linkage in MHS by December 1, 2015. • Support implementation of BCMP projects. Perform solution analysis and implement solutions ensuring no downstream impacts. Ensure that stakeholders approve solutions, understand impacts, and approve testing outcomes. Keep business areas informed of project status for all components during the project lifecycle. Show less



Independence Blue Cross

• United States
• Insurance
• 700 & Above Employee

• Sr. Business Analyst

  • Dec 1995 - Aug 2013

  • Responsible for translating benefits configurations on Power MHS. Identifying if issues being assigned to the benefits work group were valid. Issues were tracked and housed in a spreadsheet to ensure that service level agreements were met. Once validation was identified, the issue was triaged to the benefit analysts. Non benefit issues were reassigned to the correct work group. • Performed analysis of contracts, benefits exceptions, medical policies, Mandates, and business requirements of other initiatives to support existing benefit set up. Propose strategy on how to make system’s changes to meet contractual needs. • Responsible for end-to-end designs regarding new initiatives, mandates, and/or projects. Write business requirements and functional specifications outlining the initiative’s intent, purpose, existing set up, and strategy on the changes that will be performed. Created test scenarios and test plans related to the project. A coding alert was written documenting changes performed. • Responsible for writing and presenting work order templates to benefits staff • Involved in the testing, deploying, and support of MHS releases and defects as it related to the Benefits area. • Provided assistance to Benefits team members Show less