Business Need
Reduce the time and manual effort required to review Coordination of Benefits information while improving the consistency, accuracy, and traceability of determinations.

My Role
Senior Project Program Manager and Product Owner responsible for process analysis, requirements definition, solution planning, and cross-functional delivery.

Actions

• Analyzed current-state processes, manual decision points, source systems, and requirements for different member populations.

• Defined automated review rules, book-of-record requirements, and standards for retaining COB history.

• Developed operator-facing reason codes to explain determinations and changes to member records.

• Coordinated requirements, solution design, testing, issue resolution, and implementation planning across business and technology teams.

Results
Established a stronger framework for automated, consistent, and traceable COB determinations while reducing unnecessary manual intervention.

Capabilities Demonstrated
Product Ownership • Process Automation • Business Analysis • Requirements Definition • Systems Thinking • Cross-Functional Leadership

Business Need
Improve how clinical, member, operational, and risk data were used across multiple systems to identify individuals for appropriate care management programs.

My Role
Senior Project Program Manager and Product Owner aligning clinical strategy and operational needs with data and technology delivery.

Actions

• Partnered with clinical, analytics, informatics, operations, product, data engineering, development, testing, and executive teams.

• Translated complex business, clinical, data, and operational needs into requirements, user stories, and acceptance criteria.

• Prioritized backlog items and managed functional requirements, nonfunctional requirements, system dependencies, risks, and production issues.

• Developed implementation strategies, governance materials, executive communications, and product-roadmap recommendations.

Results
Strengthened alignment among clinical strategy, member data, operational processes, and technology delivery to support more effective member identification and risk stratification.

Capabilities Demonstrated
Program Leadership • Product Strategy • Healthcare Systems • Data Integration • Backlog Governance • Stakeholder Alignment

Business Need
Integrate sanctions-screening data, system functionality, configurations, requirements, and operational processes following a major corporate acquisition.

My Role
Primary systems resource and Product Owner providing application expertise and coordinating compliance, operations, and technology stakeholders.

Actions

• Evaluated customer and transaction data, filtering rules, system configurations, and operational processes.

• Documented requirements, dependencies, potential issues, and functionality that needed to be preserved or transitioned.

• Supported regression testing, user acceptance testing, issue resolution, implementation activities, and stakeholder communications.

• Transferred application, configuration, and operational knowledge to the receiving organization.

Results
Contributed to the successful integration of critical sanctions-screening capabilities while supporting regulatory compliance and operational continuity.

Capabilities Demonstrated
Systems Integration • Product Ownership • Data Analysis • Regulatory Technology • Risk Management • Knowledge Transfer

Business Need
Transfer a U.S.-based sanctions-screening system and the supporting operations for multiple lines of business to an international team.

My Role
Systems and product resource responsible for data analysis, configuration, reporting, training, and transition support.

Actions

• Assumed responsibility for monthly reporting during the transition.

• Interviewed and trained systems analysts on the sanctions-screening application and its supporting products.

• Analyzed customer data and documented anomalies caused by differences between U.S. and international system versions.

• Configured user-interface and administrative components and transferred application and operational knowledge.

Results
Supported a successful global conversion and equipped the receiving team with the system knowledge, configurations, reporting responsibilities, and operational information required to maintain the transitioned business.

Capabilities Demonstrated
System Conversion • Change Management • Technical Training • Data Analysis • System Configuration • Global Collaboration

Business Need
Improve sanctions-screening performance and reduce unnecessary alert volumes without weakening regulatory controls or excluding sanctioned individuals and entities.

My Role
Sole Business Systems Analyst responsible for system analysis, optimization, configuration, monitoring, and testing.

Actions

• Analyzed alert volumes, customer records, transactions, system performance, and high-volume recurring records.

• Used Excel macros to automate monitoring reports and pivot tables and charts to identify trends, spikes, and anomalies.

• Configured filtering components, format files, algorithms, rules, and exceptions to improve screening efficiency.

• Reviewed applicable sanctions lists and regulatory announcements and conducted regression testing to confirm control effectiveness.

Results
Improved system stability, alert management, and operational efficiency while maintaining the effectiveness and integrity of sanctions-screening controls.

Capabilities Demonstrated
System Optimization • Data Analytics • Regulatory Compliance • Process Improvement • Technical Configuration • Testing