Creating and managing features in the Jira application to support the needs of the digital experience and journey within the Consumer Transparency tools.Leveraging agile methodologies and process to support the delivery of Minimal Viable Products.Participating in various working sessions to groom and prioritize features and User stories for releases. Collaborating with vendor partners for design efforts within the Cost Transparency Tool user interface.Develop materials for presentations of enhancements and updates of the Consumer Transparency tools to BCBS Plans and stakeholdersFacilitates User story grooming sessions for testing and developmentReport out production defects on consumer tools to internal and stakeholders in defect meetings.Create a journey map of the member digital experience by utilization for improvements.Utilize Jira align for program board reviews and release planning, ranking features accordingly for deployment Prioritizing features according to job sizing and the complexity of work across all impacted areas.

 Eliciting actual needs of Stakeholders that involves investigating and clarifying their expressed desires in order to determine underlying issues and causes. Produce clear and concise Functional Specification Requirement, Risks’ and Gap documents so that existing systems can be modified or new systems built that meet the Business needs of the Stakeholders. Produce formal Risks’ and Gap documents to determine whether business requirements are being met for our Stakeholders. Lead Enrollment resource in scoping sessions for SRTS and BRD’s in all releases, determining resources, LOE’s for deliverables towards implementation.  Produced and modified the designed the functionality of the benefit inquiry application (iService) through requirements and Standard Operating procedures for client satisfaction or at the client request.  Transitioned application functionality onto new application platform, trained and mentored new employees on the team.  Lead Enrollment resource in proactively establishing a standard operating process when identifying technical only SRTS, recommendations on rating priorities and other activities in submitting SRTS to Team Track Change Control from various departments. Includes various Benefit scripts to use when servicing Provider/member or non-member inquiries

Conduct root cause analysis on system issues and fixes derived from enrollment and billing. Report Analysis to the Reliability committee for to assign IT resources and resolution.Lead and outline new Projects and UAT initiatives, accountable for assigned departmental deliverables and completion datesDefine business and functional requirements, test plans, test cases and test scriptsExtract data from data warehouse tables to create reports for departmental reconciliation processesCreate current and future Visio process flows for departmental documentationLead Billing and Enrollment User Acceptance Testing (UAT) for projects, implementations, system fixes and enhancements.Review technical specifications to ensure department business requirements are adequately reflected in technical planning documents and projects

Identify and communicate business needs to support regulatory requirements for Healthcare Reform regulation within the context of the 2014 Operating Model.Creating Visio process flows and desk level procedures to capture the new Exchange business for the use of testing and training. Establish a framework for process assessment, transformation and continual change management.Conduct interviews to extract process knowledge from membership, billing and enrollment stakeholders to translate into process maps and detailed training materials that capture step-by-step activities required by each team and role to complete each process. Design and document workflows, make recommendations that will positively impact operational effectiveness for the Exchange markets.Creation of an Exchange member on-boarding/welcome packet to support enrollment and fulfillment.Share Best Practices and work to develop junior team members in process improvement skills.Participated in business scenarios and gaps documentation sessions with NASCO to capture system enhancements for the Exchange program.Partner with the User Acceptance Testing team (UAT) for projects, implementations, system fixes and enhancements.Create the BRD and TRD’s, collaborate with business and IT leaders to ensure the delivery of high quality business requirements.Create, deliver and execute initiatives that improve implementation during open enrollment.Support and implement initiatives related to mandates: Health Care Reform, Minimum Standards, and mandated ID card changes.

Provided consultative services to a range of healthcare professionals on company’s payment processes, system requirements and other related issues. Involved in the implementation of a custom web-based benefits management and claims payer system within all lines of business in the healthcare industry. Performed gap analysis and closed gaps in current and future application enhancements.Testing of claims to insure products was configured correctlyRun SQL queries in access for each product.Researched and resolved systems configuration questions from the internal project teams and the client.Became a Subject Matter Expert in the finance, benefit building and code limitations functional areas.Used Sales Force to write customer work orders for system errors. Worked with software engineers on the creation of technical specifications and system upgrades. Created use-case scenarios to support application enhancements.Analyzed the clients’ requirements to specify user interface design, field level functionality and mapping documentation within the software design life cycle (SDLC). Configured auto lockbox file feeds into application environment to process cash receipts batches.Defined and documented requirements to assist in the development of software specification.

Managed new business and renewals for key accounts. Initiated and managed project timelines and regular internal & external status calls with participating teams. Completed business readiness checks on structured lines of business.Orchestrated all activities required to properly install businesses on to all UHG systems. Collected and interpreted data for loading and traceability purposes. Collaborated with strategic account executives, account managers and underwriting to provide effective benefit consultation for plan revisions, managed care strategies, product development, policy and procedures changes, legislative change and claim cost control. Served as a Benefit Configuration Expert.