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Healthcare Business Analyst Resume Samples
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6-10 years of experience
Analyzed and collected national account benefit benefit package information regarding subscriber liability and covered services such as cost-share and visit or dollar maximums on a ICD- 9 code level of detail and built requirements using custom applications such as Benefit Explainer and Benefit Editor
- Performed ongoing quality assurance to ensure accuracy and consistency of output in the system
- Acted as project team member on [company name] Blue Shield of Michigan’s initiative to combine a local and national claims processing system into one single platform
- Conducted user acceptance testing and data validation of web applications used to present benefit information
- Loaded and maintained Health Care Certificates and Riders in Document Database
- Wrote and entered SQL language in Benefits at a glance (BAAGS) chart templates
- Generated reports and performed data validation in SMART ([company name] Blue Shield Custom App.)
- Implemented and maintained account benefit updates in system as part of National Health Care Reform mandates.
0-5 years of experience
Worked closely with IT personnel and business partners to identify and maximize opportunities to improve products services and program business processes.
- Reviewed, analyzed and created detailed documentation of business systems and user needs, including workflow, program functions and steps required to develop or modify application programs.
- Assisted in developing and maintaining business & financial reports and IT work/databases which was required to support the various lines of business and specific projects.
- Consulted with IT Personnel to determine business, functional and technical requirements for specified applications.
- Developed effective reporting tools for the business unit and completed existing projects from original concept through final implementation
- Organized chart-holding facilities and assisted in training staff. Assisted various projects from start to finish through the SDLC process.
- Participated in Code Reviews, System Testing and UAT followed by production verification, post production testing and support
- Performed internal & external reporting, cash management, cost reduction & efficiency
0-5 years of experience
- Gathered and documented existing client processes and data using Microsoft Excel in order to perform gap analysis between client’s system and McKesson’s system in order to access client’s readiness.
- Identified specifications for billing and accounts receivable requirements, performed gap analysis and presented information to technical team to identify system requirements.
- Facilitated strategic meetings between Perot technical team and hospital administrators resulting in identifying key differences in clinical systems.
- Created and designed SharePoint website to be used as project data repository for project.
- Created new processes/procedures/guidelines to leverage data.
- Trained all new associates which were on-boarding on how to use SharePoint website.
0-5 years of experience
Was the resident subject matter expert for all health-related projects. Trained as business analyst using e-
[company name]. Awarded more than $1M by DARPA over 3 consecutive years to develop a
healthcare modeling application. Won Cleveland Clinic bid to develop EMR.
- Developed algorithm for healthcare simulation model.
- Gathered functional, business and technical requirements using individual and group meetings.
- Documented system functional and technical requirements.
0-5 years of experience
Managed Data Aggregation project for BCBSIL medical groups keeping project on schedule and on budget
- Jr. Project Manager for IMH, HEDIS and CCM projects
- Developed project proposal for BCBSIL HIE project to increase company revenue and capabilities
- Developed website and marketing materials for company and client outreach
- Developed operational processes for increase company organization, productivity and performance
0-5 years of experience
- Researched, defined and analyzed changes to both state and federal laws affecting the Medicaid Management Information System (MMIS) for Texas Medicaid account.
- Served as a project management analyst on multiple initiatives involving maintenance and systems changes for HIPAA implementation.
- Researched and gathered detailed requirements and translated it into proposed systems system enhancements.
- Completed system documentation, researched system requirements, participated in system testing and verification for HIPAA implementation.
0-5 years of experience
Served as business analyst implementing McKesson Healthcare software.
- Gathered and documented existing client processes and data in order to perform gap analysis between client’s system and McKesson’s system in order to access client’s readiness.
- Identified specifications for billing and accounts receivable requirements, performed gap analysis and presented information to technical team to identify system requirements.
- Facilitated strategic meetings between Perot technical team and hospital administrators resulting in identifying key differences in clinical systems.
- Defined, designed and created initial specifications for SharePoint website to be used as project data repository for project.
- Created and designed custom webpages on SharePoint to maximize storage on SharePoint website.
- Created new processes/procedures/guidelines to leverage data.
- Trained all new associates on SharePoint website.
- Completed Perot’s Project Management class. Utilized Project Management Institute (PMI) methodology.
6-10 years of experience
Analyzes Medicare business processes and translates to business requirements for users within Medicare Operations.
- Works closely with business users to define requirements, prioritize issues, and address production support issues.
- Coordinates and facilitates work sessions with Medicare Operations users and IT development to define projects’ scope and requirements and manage project expectations.
- Acts as liaison between the users and the IT development team to determine and deliver the most effective solution for development and implementation including preparing detailed business requirements documents.
- Develops implementation and testing plans and assists in coordinating testing.
- Performs user acceptance testing to ensure system integrity before release to production
- Participates in driving the success of the software design, implementation, testing, production deployment and post-production phases of the Medicare tool.
0-5 years of experience
- Served as the Applications developer developing the solutions agreed upon by Business.
- Performed Vulnerability Analysis and Deep Dive analysis of the application to find out vulnerable areas and to strengthen them by offering solutions.
- Provided post implementation support and performed root cause analysis and fixed post implementation issues.
- Participated in IT Audits and made sure all the project artifacts were available whenever required to produce them.
0-5 years of experience
- Reported to and worked directly with the CIO.
- Researched the progression of the national Beacon Project, in regards to the adoption of Health Information Exchanges for San Diego and Riverside County area medical facilities.
- Assessed how Planned Parenthood Southwest could benefit in partnering with this program.
0-5 years of experience
Develop business process models for projects and demonstrations at the Centers for Medicare and
Medicaid (CMS) using business process model notation and enterprise architecture
- Facilitate and lead project meetings with various CMS stakeholders to elicit project information and resolve project issues
- Analyze government furnished information to develop business artifacts, models, and interaction
- Create business process detailed description documents for projects under the Affordable Care
- Prepare and track projects through weekly reports and deliverables
- Collaborate with client to develop Standard Operating Procedures for CMS IT Systems Inventory
0-5 years of experience
Participates in the analysis of existing business process and systems to recommend process and system enhancements to improve business performance and maximize the effectiveness of available technology.
- Participates in the design and implementation of new systems initiatives.
- Performs business support responsibilities, including production monitoring, file maintenance, and ad-hoc reporting.
- Provides ongoing internal and external customer support for system questions and problems.
- Analyzes and researches system problems, coordinating with the necessary parties to track them to resolution.
- Develops or assists in the development of user documentation and training.
0-5 years of experience
Responsible for implementing payers onto the Health Care Exchange (HIX) for the Affordable Care Act.
- Document requirements, system analysis and project documentation such as BRD, Business Process Mapping and functional workflows
- Facilitate communication between clients, consultant teams, and solution developers
- Strong working knowledge of the 820, 835 & 834 EDI Healthcare files and Transactions
0-5 years of experience
Lead the analysis process from concept to development for clinical applications. Act as the subject matter expert post-development.
- Gather, assess, and interpret business need and translate into written system requirements. Organize and facilitate meetings with key internal stakeholders.
- Author and champion system requirement documents in order to solicit approval.
- Conduct focus group meetings with external senior managers.
- Subject matter expert for Computerized Physician Order Entry and Zynx
0-5 years of experience
- Gather and document functional requirements for the integration of a $5 million dollar long term care EMR system.
- Communicate with the business owners to identify clinical and operational reporting metric requirements.
- Collaborate with stakeholders and IT teams to align ETL transformation rules with Cognos reporting.
- Data Mapping to integrate vendor external systems with a major insurance company.
- Experience with the Waterfall systems development life cycle model.
- Experience with Primavera (financial management solution tool).
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Healthcare Business Analyst
Last edited by: Gabriela Barcenas, CPRW, Content Writer II -
Gabriela Barcenas
CPRW, Content Writer IIGabriela is a Certified Professional Resume Writer (CPRW) and career adviser. With 10 years of digital media experience and five years of resume writing expertise, her publication history includes fashion, education, travel, social justice, equitable design and career advice.
