Healthcare Business Analyst
Optum
Total years of experience :14 years, 11 Months
Key job functions are as follows:
•• Working closely for improvements with stakeholders on Medicaid eligibility system owned by State of West Virginia.
• Track lead of various sub-systems of state of West Virginia comprehensive medical and social benefit system. (eRAPIDS)
• Maintained budgets from $500K to $1M in different Medicaid eligibility system enhancement projects.
• Proactively analyzing client data using Oracle DB2 and other databases to simplify for metrics analysis.
• Providing project plans, requirements, design and testing documentation for integrated eligibility system enhancement projects.
• Completed in-depth analysis for business-optimization projects, reporting tools, back-office programs and case management.
• Provided executives with analytics and decision-support tools used as the basis for reorganization, consolidation and relocation strategies.
• Partnering with developers to automate manual processes, saving time and money while decreasing errors. Credited as a primary driving force behind a 5% increase in margins for two quarters.
Cross Lanes, West Virginia
Gather business requirements and translate to functional specifications including use case documents, business requirement document(BRD) and prepare test plans/cases. Communicate and present to the client.
Understand AS-IS and TO-BE business processes and convert these requirements into technical/business specifications and perform gap analysis.
Responded to RFP/RFI/SOW, prepare Onsite Knowledge Transfer (KT) plan, SOP, Process Map, SIPOC.
Conduct workshops / focus groups with client’s risk business SME’s and closure of all mappings and signoff’s.
Tracing requirements throughout the project and verify adherence using the Requirement Traceability Matrix (RTM).
Prepared graphical depictions of project processes using Activity diagrams, Sequence diagrams, Entity Relationship Diagram (ERD), including the business workflows using MS Visio.
Perform customer/client interaction at various levels to get a better understanding of client's business process (Root Cause analysis, Business process mapping, iterative problem definition and hypothesized improvement opportunities), system's functional and technical requirements.
Create communication/escalation plan, identify opportunities for process enhancements and solutions for automation, implementation of cost optimization solutions, gather & Evaluate client recommendations
Prepared the project Work Breakdown Structure (WBS) for ease of managing and meeting team tasks and project planning. Generating and presentation of project reports using MS Project.
Traveling to client’s headquarters and remote sites ensuring and overseeing knowledge transfer from incumbents to new hires.
Huntington, West Virginia
Actively participated in system implementation planning work group for Phillips IntelliSpace Critical Care and Anesthesia (ICCA) executed in Intensive Care Unit (ICU).
Tracked medical records using 2 different EMR systems.
Facilitated the design of contingency clinical flow-sheet VistA electronic documentation in ICU.
Based on existing healthcare electronic data, predicted, analyzed and presented the financial impact of health plan initiatives using Tableau.
Increased knowledge base of complex change management techniques.
Tracked medical records using 2 different EMR systems
Analyzed labor mapping for appropriate productivity and workload capture of medical center nursing staff.
Completed functional testing for clinical information systems upgrade patch which was released nationally for Veterans Healthcare Administration.
Observed Veterans Healthcare Administration national collaborative meeting on clinical terminology field request approval team.
• Identify process breakdowns in the doctor’s office billing, collections, and cash posting processes, and implementing innovative solutions to address new issues that arise.
• Maintained Electronic Health Record Software
• Assisted in physician credentialing, license renewal, and reappointments.
• Developed comprehensive Provider Manuals
• Created robust quality goals and metrics for physician groups and health plans.
• Consulted with clients to determine their needs and priorities.
• Increased annual revenue by 40% and reduced costs by 30% through meticulous business management.
• Made practice more efficient through workflow improvements, detail-oriented process changes, and increased focus on customer satisfaction.
• Managed three projects averaging $5 million budget for each project.
• Led 3 teams consisting 10-12 people each for telecommunication deployment projects.
• Performed all project management activities including initiation, planning, executing, monitoring and controlling and closing.
• Developed and assisted in project execution plans for the required scope based on stakeholder requirements and project objectives.
• Established and implemented successfully communication plans/strategies to meet stakeholders and customer needs and expectations.
• Daily/weekly and monthly reports regarding project progress and completed deliverables.
• Led and controlled project work, on a continuous basis, by motivating and coaching the project members.
During my MBA, I assisted PhD scholars and Professors in their research activities.
Maintained archives of both computer files and hard copy materials.
Assisted professors to create a pool of journal articles for literature review.
During my undergraduate, I taught classes under the guidance of multiple professors. Assisted multiple professors in making class schedules, assignments.
Helped professors grade student`s work in addition to collect the information for lecture preparation.
Planned and delivered the quizzes to class while interacting with students in absence of professors.
Masters of Science in Healthcare Administration (Huntington, West Virginia)
MBA in Project Management & Supply Chain Management
BBA (Hons.) Marketing