Sr Business Analyst - Advisor
• Sr Business Analyst/IT Advisor-collaborated with PBM project teams to facilitate, write and implement requirements for Claims Adjudication/all other satellite applications • Worked on projects for the RxClaim application and integration of numerous web applications.• An experienced multi tasker managing parallel multiple projects. Wrote requirements for small to extra-large projects, with some lasting multiple years. Worked on projects including Accumulations, STCOB- Coordination of Benefits, Prior Authorizations, MEP (Multi-Employer Benefit Plans) and Plan Administration such as Eligibility and Plan Benefits setups. Managed a multi-year project that successfully merged 3 systems into an Enterprise-wide Eligibility system for the RxClaim Adjudication system.• Highly skilled in establishing effective working relationships across all IT and Business areas and levels of Leadership. • Requirements formats included Standard Requirements documents/Use Cases/User Stories. Proficient in Waterfall/SDLC, Agile/Scrum – writing User Stories, participating/managing the associated tasks/ceremonies such as Product Backlog, Sprint Planning, Daily Standups, Sprint Demos. • Worked on projects that were integrations with TPA (Third Party Vendors) performing gap analysis. With vendors such as SalesForce and Rally I had to clearly understanding contract specifications/constraints, work closely with vendors to diagram the current/future states and determine how to integrate into existing applications. Coordinated/resolved problems & constraints against contract specifications, managing the relationship with the TPA. • Managed projects for clients such as Aetna and Anthem.• Skilled in problem solving and research analysis techniques like SQL queries.• Involved in creating UI mockups for web applications/member portals. • Projects for Member Plan Benefits creation and implementations. • Familiar with Regulatory Federal/State guidelines, NCPDP, Medicare, Medicaid 340B, etc.