Meggan Walker, M.S. Msim, Pmp, Cspo, Csm Email & Phone Number

Columbia, Maryland, United States

Nebraska, United States

Lead product and system analysis for finance and enrollment work-streams under the Medicare Advantage 65+ portfolio. Overall, the analysis includes current and future state business processes/systems, vendors, and large amounts of data to develop functional and technical requirements, acceptance criteria, design solutions, and perform the testing/implementation of technology solutions. Create procedures to improve existing systems, assess internal & external hardware/software needs, and recommend IT-related best practices.• Serve as an SME in advising on Medicare Advantage and BCBSNE migration from a third party to be housed and integrated internally.• Collaborate with Wipro (a SaaS based Medicare Advantage solution vendor) and internal stakeholders to migrate from a previous vendor.• Assist developers on the initial configuration and development, membership conversion data mapping file, integrations (ex. provider, broker, agent, 834 eligibility data feed, lockbox & CMS transactions), and QA & UAT testing.• Engage daily with stakeholders to ensure timelines are met and removing blockers.• Ensure downstream vendor applications (ex. HRP, SAP, & Axiom) are prepared for the intake of the Medicare Advantage product line of business.• Create a gap analysis for discrepancies between new and legacy vendors.• Analyzed prototypes and roadmaps for a successful launch/go-live for each milestone; provide training and support to users, developers, and business operations staff.• Assist team with the setup of SSO's for the broker/agent and premium payments portal, Medicare Advantage vendor portal, and SFTP (Secure File Transfer Protocol) on inbound and outbound extracts.• Perform API development and utilize technologies including Azure Data Lake and Databricks, Microsoft SQL Server Management Studio, Azure DevOps for scrum ceremonies, and Agile/Waterfall methodologies.

Irvine, California, United States

Led all aspects of the project management lifecycle including the development of project plans, scopes, schedules, and timelines, leading project progress and status meetings, enforcing quality deliverables, managing budgets, and identifying, addressing, and resolving risks, issues, and changes in project activities.• Assumed accountability for project management, business analysis, data analysis, project quality, and departmental performance monitoring.• Drove impact assessment, engagement, and alignment, facilitated retrospectives, and followed up on actions for improvement; coached teams in the Agile delivery model.• Worked with product owners and stakeholders to prioritize feature development and enhancements based on critical paths and business needs.• Assigned project work under the Digital portfolio on three successful projects both hybrid and agile methodologies; developed Agile-related metrics and status reports.• Acted as a mentor to other IT project managers and delivered expertise, leadership, direction, and coaching as a scrum master to multiple Agile teams.• Oversaw daily scrum and other ceremonies associated with the Agile methodology; administered complex communications across a matrixed Agile Team.• Identified and resolved any issues that may have impeded project success while reducing all blockers/barriers and creating contingency plans to mitigate concerns.

Phoenix, Arizona, United States

Defined product requirements for all functional departments focused on external claims data for EDI transactions on the ERP system that included Medicare and all provider-based claims, created user story acceptance criteria to get buy-in from stakeholders, and refined those stories in collaboration with the development team via Azure DevOps.• Interacted with stakeholders to define product features and functionality for dashboards and reports regarding healthcare claims; managed product backlog and ensured it was up-to-date with a focus on priority items.• Facilitated sprint planning and data mapping while working with the development team leveraging knowledge of healthcare EDI (834, 835, 837i, 837p, etc.) claims to prioritize tasks for upcoming sprints.• Monitored sprint progress, ensured all tasks were completed on time, and that the team met its goals while gathering feedback from end users and collaborating with cross-functional teams.• Drove efficiency in projects by recommending and implementing changes to processes to ensure the integrity and quality of deliverables.• Achieved operational objectives by contributing to strategic plans and reviews; prepared action plans and project control activities.• Developed and executed product roadmaps that led the way to increased customer satisfaction during a companywide system migration of claims from the ERP system.

Phoenix, Arizona Area

SENIOR BUSINESS INTELLIGENCE DEVELOPER (2019-2021)Managed all aspects of ETL for projects associated with claims, KPIs, staffing, clinical reporting and enrollment using SQL Database, Tableau, SAS, and Salesforce. Utilized Tableau for business intelligence application, worked with developers in designing dashboards for each project, and served as a subject matter expert (SME) and consultant on internal analytics focused on the development of self-service business intelligence tools and the design of data/financial models to achieve analytic goals.• Played a key role in the completion of the “Velocity” project that supported the migration of all legacy claims data onto one platform.• Conducted complex analysis and translated claims data into meaningful and actionable information; generated and submitted reports of healthcare claims through web-based applications and analytics software tools.• Led the execution of claims data extraction, healthcare analysis, and analytical model development, as well as the development of various reports.• Assisted with the collection of EDI claims for the migration of Medicare Advantage to HRP and service the PSO department on provider requests and claims data.

Scottsdale, Arizona

Collected encounter and fee-for-service (CMS) EDI claims, as well as managed care reports, for the State of Florida and contributed to the creation and presentation of project proposals, recommendations, implementation plans, communication packages (FTP), performance measurement tools, and assisted with training materials for co-workers.• Ensured appropriate and timely collection of quantitative and qualitative claims data via the creation of data-gathering tools including questionnaires, work sampling, and financial modeling.• Coordinated claims data analysis to resolve a broad array of issues across multiple disciplines and functional areas while recognizing and applying analytic approaches to key business issues.• Led claims research on identified key business issues and efficiently analyzed the components of project work.

Scottsdale, Az

Led the analysis of pharmaceutical financial claims data and tested code using statistical tools such as SAS and Microsoft application data using SAS for professionals throughout the organization who aimed to track price discount guarantees. Introduced queries on adjudication systems for the assessment of client benefits setup and production of “what-if” and ad-hoc analyses to assist with decisions on client-specific price adjustments. • Increased margins and reduced client penalties by initiating contract reviews to secure alignment of measurement setups with client documents.• Produced data summaries and network rate trend report to management to develop pricing decisions for high-profile clients, while troubleshooting data quality issues.• Rendered support to internal Auditing and Financial departments by delivering accurate ad-hoc reporting, facilitating training, and assisting team members as needed.• Effectively maximized margins while minimizing client penalties, and initiated contract reviews to ensure guarantee measurement set-ups were in line with client documents.• Inscribed/evaluated code to analyze data using statistical tools; SAS and Microsoft applications.

Master Of Science - Ms, Information System Management

Bachelor Of Science - Bs, Marketing

Activities and Societies: Alpha Kappa Psi