
Operations Analyst, Care Management Systems at Excellus BCBS
Greater New York City Area

Operations Analyst, Care Management Systems at Excellus BCBS
Greater New York City Area
As an analyst I am responsible for the creation of ad hoc reports to fulfill interdepartmental needs as well providing reports for various other department groups. In this analytical role I support the medical review processes for medical necessity, clinical editing for correct medical code set auditing, and care management programs such as utilization management, case management, and disease management. My understanding of both the business requirements as well as the corresponding technical data allows me to be a much stronger analyst. I am also the primary point of support for the medical claim review team of roughly 30 staff. I’ve played an instrumental role in several interdepartmental projects – including project management, requirements gathering, project development, and user testing/validation.
Extensive knowledge of Microsoft Access databases, experience with: Lotus Notes databases,MySQL databases, Microsoft SQL databases, and Business Objects. Highly proficient in adapting current or emerging technologies for business needs or process improvement.
(Non-Profit; Insurance industry)
March 2009 — Present (9 months)
(Non-Profit; Insurance industry)
June 2007 — March 2009 (1 year 10 months)
Database support, customer care, many many other things.
(Privately Held; 11-50 employees; Real Estate industry)
December 2004 — September 2007 (2 years 10 months)
(Educational Institution; 501-1000 employees; Higher Education industry)
September 2003 — December 2004 (1 year 4 months)
B.S. , Psychology , 2007 — 2008
Psychology 2001 — 2004