BUSINESS ANALYST
• Over 20 years of business analysis, sales, management, and IT experience, 10 in virtual environments across 3 time zones.
• Project management expertise involving internal teams and external stakeholders in multiple cross-functional areas.
• Innovative business solutions to increase communications and operational efficiency, slash costs.
• Proficient at handling multiple assignments, meeting tight deadlines, and managing competing priorities.
• Proven knowledge of insurance products, sales support, staff training, claims, agent training, regulatory compliance and audits.
• Launch newly created positions, drive expectations beyond those initially set forth, require multiple positions to fill the role after promotion.
EXPERIENCE
ANTHEM INC. • Telecommute, Southern California • 10/2008 – Present
Health Insurance Plan Provider
Business Information Analyst Senior / Care Management, Operational Compliance Oversight
Perform regulatory compliance audits, develop and work Corrective Action Plans. Establish policies and procedures, create workflow processes. Prepare quick reference guides, training, lead conference calls, and coordinate operations. Collaborate with IT, Finance, Product, Operations, Legal, and outside vendors on projects. Streamlined WorkNet intranet site utilizing Stellent, Oracle, and Java. Served as Cultural and Linguistic Subject Matter Expert. Created and lead work groups for Enterprise Document Naming Conventions and Translation Best Practices. Evaluated language vendors in response to Request for Pricing for Service Level Agreements. Collaborated with Industry Collaborative Effort committees to capitalize on industry best practices.
Achievements:
• Improved Utilization Management approval case regulatory time frame compliance with DMHC and CDI in California, Colorado and Nevada by 23%.
• Improved Language Assistance Program compliance for SB853, Limited English Proficient, and Health Care Reform by 36% to enhance operational efficiency 62%.
• Slashed language vendor prices by 41% while increasing operational efficiency by 63%.
• Recognized with promotion to Senior Business Information Analyst.
• Increasing communication integrity by 27% while served on UM Rules Management Team.
ANTHEM INC. / WELLPOINT • Telecommute, Southern California • 11/2014-12/2016
Health Insurance Plan Provider.
Chief of Staff and Interim Chairperson (2 year term)
Led Working @ Anthem in a Virtual Environment (W@VE) Associate Resource Group for virtual employees across 3 time zones. Managed projects, events, budget, membership, publicity, resource and tool creation, and technical support. Managed development of Community Health Charities website widely emulated by other industries.
Achievements:
• Increased memberships by 76%, member satisfaction by 94%, and improved communication by 85%.
• Key member of Enterprise Return on Investment Scorecard Committees to develop Key Performance Indicators to evaluate ARG leader performance.
WELLPOINT DENTAL AND VISION • Camarillo, California, 40% telecommute • 5/2007 – 10/2008
Company formed by merging of Anthem Insurance Company and WellPoint Health Networks Inc.
Provider Network Analyst
Subject matter expert for Dental and Vision Provider Network reporting. Provided Geo Access, Disruption and Fee research and reports for Sale’s RFPs, Clinical Quality/Compliance Administration, Product Management and Development. Wrote Operations manual and provided on site and remote training.
Achievements:
• Promoted to Business Analyst III
Additional Experience
Auto Claims Management / Tra...
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