Bellingham, Washington, United States
Accomplished Business Analyst and Supervisor, skilled in achieving operational efficiency and increasing revenue in the health insurance industry. Skilled in process documentation and improvement, Six Sigma's HIKE methodology and staff/inventory management. Experienced with project management and collaboration with business end users. Experience in running a team of 12-32 people. Capable of monitoring and using positive/negative discipline to ensure productivity benchmarks are achieved. Experience in creating benchmarks, tracking statistical data and refining workflow processes. Expert problem solver in cooperative team-driven structures or independent analysis.
* Create and maintain a repository of workflow and process models for assigned business value streams, with iterative Agile updates. * Provide oversight of contractor workflow modeling resources. * Lead analysis of existing business processes for innovation opportunities using Business Process Management, Lean and Six Sigma techniques. * Facilitate business process documentation onsites for 20-50 stakeholders, subject matter experts and developers. * Provide clear, consistent status reporting.
* Created and maintained a repository of process models for assigned business value streams. * Managed the work for 3-10 Analysts and contractors. * Led analysis of existing business processes for innovation opportunities using Business Process Management, Lean and Six Sigma techniques. * Partnered with Polaris Business Architect team to ensure future state business process models were aligned to business capabilities and overall strategic goals. * Conducted workshops, process/requirements walkthroughs, stakeholder alignment sessions and demonstrations to large groups of audiences. * Served in a trusted advisor role to business process owners. * Mentored and trained business stakeholders in key Business Process Management concepts.
• Document process maps and workflow for all departments in support of transitioning from proprietary core policy/claim administration system to InsPro Technologies. Includes 17 distinct departments, all core responsibilities for 300+ employees. Trained four other Business Analysts on Sterling process documentation methodology. • Facilitate process improvement in targeted departments to address key business issues, using Six Sigma HIKE methodology. Targets include: Customer Service, HR Employee Onboarding, Credentialing as well as a cross-division initiative for Integrated Coordinated Member Care. • Identify process bottlenecks, implement new processes and polices and develop metrics to evaluate effectiveness of specific solutions. Use Voice of the Customer / FACT (Fulfillment, Accuracy, Cycle Time, Treatment) evaluations to turn broad needs into specific, actionable, measurable targets. • Gather and translate technical requirements from business end users to IT. Includes defining scope, researching alternatives, working with IT on solution and developing test plans with the business to ensure user acceptance.
• Worked as a subject matter expert and interim Project Manager on the Sterling/Windsor Integration projects for Provider/Network Services. Responsible for analyzing, implementing and supporting the transition of provider records between claim, contract management and document imaging systems. • Responsible for the System Analyst Team and all department Work Orders for system configuration, upgrades and enhancements. • Responsible for the Audit Team and department auditing of claims for 100+ staff. Auditing refinements in 2010 tripled the number of audited claims. • Responsible for creating the Intake Team to handle all department correspondence. Created inventory tracking, classified work, drafted guidelines and trained staff. • Responsible for hiring, firing and managing 20-32 direct report staff.
• Responsible for hiring, firing and managing 12-32 direct report staff. • Subject matter expertise in Medicare claims processing with emphasis in provider identification, validation and provider file configuration. • Created and refined productivity measures for two teams, with 98% average accuracy and 99% department turnaround over expectation of 95%. • Implemented NPI in 2007 and innovated process improvements in 2008 with $198,000 savings in 2009.
Learned how to maintain high functioning under pressure during 100 hour work weeks.