Linda Valencia

Focused Senior Business Analyst accomplished in developing SmartUM portal intelligence to improve business procedures and streamline implementation. Vast knowledge of business best practices, regulatory standards and optimal control systems. History supporting growth and driving success.

Experience:

• Analyzed existing systems and processes, identified gaps and recommended improvements.
• Developed business workflows to identify and document caregiver requirements.
• Reviewed system design specifications for completeness, accuracy, consistency, traceability and usability.
• Performed root cause analysis to determine underlying issues and complex problems.
• Documented test cases for validating system functionality against user requirements.
• Identified opportunities for automation of manual processes through technology solutions.
• Developed opportunities to improve workflow by adding and modifying processes, revamping use cases for each initiative and creating new components for each area of the Utilization Management Department.
• Delivered timely support by tracking issues and communicating resolutions to the end users.
• Identified needs of caregivers promptly and efficiently.
• Provided technical support for existing operational adhoc reporting
• Provided monthly and quarterly review and submissions of health plan reports.
• Administrator of the SmartUM referral and prior authorization portal system.