Rochelle Holt Email and Phone Number

•Responsible for configuration design, build and execution of the 2015 USPSTF Mandates for Health Care Reform product enhancements by use of Facets supplemental conversion qualifier groups, supplemental conversion rules , limit rules, service payment, service definition, service rule definition, medical utilization edits and other sub systems•Responsible for the configuration design and execution for the 2015 employer group renewals•Creating Functional and User Acceptance Test Plans and develop Test Scenarios to measure requirements and configuration•Perform claims defect analysis and resolution as assigned by way of HP Quality Center tool•Perform backend queries, generate backend data append and update jobs into Facets

•Responsible for code sets configuration in benefits, supplemental conversion tables, service payment, service definition, network ids and other sub systems•Responsible for benefit package configuration implementation and maintenance for Medicaid, Chip and Medicare state programs•Responsible for group class plan structure and member premium configuration build and maintenance•Interacted with departmental staff in response to benefit design, inquiries and resolution of benefit claim issues•Responsible for conducting functional testing of benefits and authorization requirement configuration projects•Created Functional and User Acceptance Test Plans and develop Test Scenarios to measure requirements and configuration•Conducted walkthrough sessions to ensure effective knowledge transfer to the business. •Interacted with stakeholders regarding project status and feedback on UAT results

•Expertise in Facets Product builds and benefit configuration of business rules that support employer groups and reimbursement policies•Performed Benefits design, configuration and system updates within various Facets applications•Worked with internal departments and external customers to develop project scope and requirements for Facets projects•Worked as a subject matter expert in implementation of new benefits and configuration •Assisted department with the implementation of new Facets version updates•Collaborated with internal System Test Team to review and resolve system defects•Built and maintained Premium Rates by use of Facets Premium Rate Table•Fosters business partnership with health plans and operational areas to ensure project prioritization, resolution and timeliness of project assignments •Performed complex data modeling and backend data appends into Facets•Created and executed test conditions and backend queries for project peer reviews to ensure quality and accuracy•Conducted gap analysis discovery between business requirements and system functionality.•Performed pended claims analysis and resolution •Acted as mentor to Sr. Analysts and conducted weekly mentoring sessions•Participated in relevant training programs when available or offeredPricing Configuration Analyst II •Performed Pricing design, configuration, implementation and system updates within various AMISYS subsystems•Responsible for providing leadership with build approach, documentation and implementation for provider data related to Facets conversion •Managed, triage and allocate requests in support of Health Plan Services ACM Change Request process •Performed pended claims analysis and resolution

•Performed complex Pricing design, configuration and implementation within AMISYS subsystem•Supervised, triage and allocate project assignments to Pricing and Benefits configuration analysts •Developed and Executed project designs and implementation plans •Instrumental in 2003 HIPAA Regulatory Compliance Implementation•Conveyed communication of system enhancements and configuration changes to end-users•Oversaw, developed and maintained AMISYS Pricing User Guide•Performed Pricing design, configuration and implementation within AMISYS subsystem•Configured Commercial and Medicaid Benefits in accordance to the 2003 Medicaid Provider Manual•Managed and executed AMISYS Pricing and Benefits configuration updates•Executed testing of AMISYS new releases and system upgrades•Assisted with the development of a Project Request Tool used for tracking and managing income project requests •Performed pended claims analysis and resolution

•Provided configuration support and maintenance of AMISYS Pricing Subsystem•Established and manage all associates Security Profiles with AMISYS Security Subsystem•Lead configuration analyst on corporate audit of Provider and Security Subsystems•Managed and executed AMISYS Pricing and Benefits configuration updates•Executed test conditions, configuration and implementation of AMISYS software upgrades•Supported end-users training and troubleshooting of various AMISYS subsystem•Executed and maintained provider configuration updates and implementation•Developed AMISYS and Monument provider user guides to be used as a training tool for in-house and new hires•Researched, analyzed and resolved pended claims and provider issues•Performed quality analysis and configuration of AMISYS database conversion •Configured Commercial and Medicaid Benefits in accordance to the 2003 Medicaid Provider Manual•Executed testing of AMISYS new releases and system upgrades•Assisted with the development of a project request tool used for tracking and maintain incoming project requests