SmartWorks, LLC is a technology solutions provider specializing in business intelligence, data analytics, custom software development, and enterprise application integration. The company focuses on delivering tailored IT solutions that enhance business performance and operational efficiency. Known for its client-centric approach and agile methodology, SmartWorks partners with organizations to understand their unique challenges and deliver innovative, scalable solutions leveraging advanced technologies. With a commitment to quality and long-term client relationships, SmartWorks helps businesses stay competitive by driving digital transformation and strategic growth.
CLIENT: Aetna | Connecticut, Unites States | Jun 2017 – Jul 2019
Senior Business Analyst, Aetna Quoting Center (AQC)
Aetna, a CVS Health company, is a leading healthcare benefits provider in the United States, offering a wide range of health insurance products and related services. Aetna serves individuals, employers, healthcare providers, and government entities with solutions including medical, dental, pharmacy, behavioral health, and disability plans. The company focuses on improving healthcare access, affordability, and quality through innovative health management programs and personalized care solutions. With a strong emphasis on preventive care and wellness, Aetna leverages data analytics and digital tools to enhance member experiences, optimize health outcomes, and drive value-based care.
Redesigned the CBAS billing system, enhancing enrollment file processing and transmission, which improved the accuracy and timeliness of member invoices and letters.
Led the refinement and grooming sessions that produced detailed user stories, improving clarity and development efficiency.
Managed the backlog in collaboration with key stakeholders, ensuring alignment with strategic goals and delivering features that enhanced user satisfaction and system functionality.
Led the adoption of Agile methodologies across projects, defining tailored processes and tools based on project specifics and goals, and developed comprehensive project artifacts, resulting in streamlined operations and enhanced team agility.
Conducted financial analysis to mitigate risks, leading to a reduction in project overruns and enhanced predictive measures for managing change in global business environments.
Directed a high-performing team, achieving around-the-clock productivity, reducing project delivery timelines by 25%, and ensuring successful rollout of new functionalities with a 30% reduction in critical defects post-launch.
Environment: MS Office Suite, Skype, AQC (Aetna Quoting Center), CCFE (Census), eProposal, RTC, RRC, CBAS (billing), ClearCase and ClearQuest.
CLIENT: Blue Cross and Blue Shield (HCSC) | Texas, United States | Jun 2015 – May 2017
Senior Business Analyst, ITG Applications and Portfolio Delivery
Blue Cross Blue Shield of Illinois, Montana, New Mexico, Oklahoma, and Texas (Health Care Service Corporation - HCSC) is the largest customer-owned health insurer in the United States. HCSC provides a wide range of health insurance products and services, including individual and family health plans, Medicare and Medicaid options, and employer group plans. The company is committed to improving healthcare access and affordability while enhancing the overall health and wellness of its members. HCSC leverages data-driven insights, innovative care models, and a vast network of healthcare providers to offer personalized, high-quality care.
Orchestrated the strategic IT direction and service delivery for new product development and eSales system enhancements, overseeing a team of over 14 professionals, achieving project deliverables through robust collaboration.
Led the redesign of the quoting and renewals (Q&R) front-end portal, significantly enhancing user experience and expanding market reach, which subsequently increased referral rates.
Managed the product backlog effectively by collaborating with the senior management, product owners, and development teams to prioritize and size requirements, which streamlined release processes and improved project outcomes.
Coordinated the planning and implementation of specific testing protocols tailored to meet quality assurance standards for end users, enhancing product reliability.
Ensured seamless stakeholder engagement throughout the SDLC, adeptly handling change requests and ensuring stringent requirement traceability, which reduced project disruptions and aligned outcomes with strategic objectives.
Articulated and clarified project goals and scope, translating complex business needs into actionable technical requirements, and developed detailed WBS to promote shared responsibility and ensure on-time achievement of project milestones.
Developed and presented detailed cost-benefit analyses and return on investment assessments for proposed IT implementations, providing a reliable basis for strategic decision-making.
Environment: MS Office Suite, Jabber, JIRA, Rally, ALM, Clarity, eSales, BlueStar and SQL Server.
CLIENT: First Care Health Plan | Texas, United States | Jan 2015 – May 2015
Business Analyst, EDI Department
FirstCare Health Plan is a Texas-based health insurance provider dedicated to offering affordable, high-quality healthcare coverage to individuals, families, and businesses. FirstCare provides a range of health insurance options, including HMO, PPO, Medicare Advantage, and Medicaid plans, tailored to meet the needs of diverse communities. The company emphasizes member-centric care, working closely with a network of healthcare providers to deliver comprehensive services and ensure optimal health outcomes.
Gathered and Prioritized customer product requirements, ensuring alignment with revenue goals and customer satisfaction.
Collaborated with vendors (UHG Optum, Megellan and Vitals) to document mapping specifications, essential for the development of various data files.
Provided EDI and system integration expertise, supporting system enhancements and SDLC standards implementation.
Environment: MS Office Suite, TFS, Axiom (Claims), HealthRules, Samanage and SQL Teradata.
CLIENT: Express Scripts Inc | Missouri, United States | Aug 2013 – Dec 2014
Business Analyst, Government Programs Division (GPD)
Express Scripts, part of Evernorth Health Services, is a leading pharmacy benefit management (PBM) company that provides comprehensive prescription benefit management services to employers, health plans, government agencies, and unions. The company focuses on making prescription medications more accessible and affordable while improving patient outcomes through data-driven solutions, advanced analytics, and innovative care models.
Managed large-scale program initiatives for business change and system implementations in the healthcare sector.
Collaborated with the business users to gather requirements and analyzed functionalities for seamless system integration.
Led technology integrations that optimized health operations, involving system design, development, and testing.
Established post-implementation feedback loops, providing continuous improvement insights to senior executives.
Environment: MS Office Suite, PEGA, Client benefit manager, Claims research tool and SQL Teradata.