EDITH H.

HEYLIGER
404-992-7071 edith.hey23@gmail.com SUMMARY Results-oriented Senior Business Analyst with a solid background and proven track record in all aspects of management reporting, data collection and analysis. Proven strengths include using technical reporting tools for data collection and analysis. Solid investigative and research ability that provides solutions for client issues. Utilization Analysis Quality Analysis Time Management Financial Reporting Ad-hoc Reporting Communication Skills EXPERIENCE KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC., Atlanta, GA 1995-2011 Environment: fast paced, high pressure, changing environment with 2000+ employees serving 248,000 members Decision Support Services Analyst (2010-2011) Accountable for the monthly extraction and cleaning of utilization data from EPIC (electronic medical record source systems) for use in Avega Alliance medical cost application. (Alliance). Verified data accuracy, reconciled and accounted for variances between medical source systems and Alliance helping to reduce reporting cycle from 45 to 30 days on monthly basis. Reduced backlog of missing data in Alliance by identifying, researching, correcting and evaluating data trends in utilization volumes which resulted in reduction of errors by 68%. Provided monthly statistical reports such as, Full Time Equivalent (FTE), member count, brokerage commission, square footage, for allocating overhead to appropriate departments within a given medical facility for Alliance. Analytical Resource Senior Analyst (2006-2010) Supported the Kaiser-Georgia organization in reporting and analytical resources Charged with analysis, facilitation, and presentation of utilization and financial reports for senior and mid-level managers, marketing account executives and external employer groups. Managed delivery of Healthcare Effectiveness Data & Information Set (HEDIS) measures for the National Committee Quality Assurance (NCQA) submission for national ranking of health plan organizations. In addition, provided quality measure analysis for medical work groups to improve care delivery and disease management in which Kaiser-Georgia consistently receive top rankings annually among other health plan organizations. Demonstrated highly effective communication skills with all levels of staff to ensure information gathered and feedback of analysis were sufficient and accurate.
Negotiated project deliverables, consistency met deadlines while managing multiple priorities and maintaining excellent internal and external customer service relationships.

Project Management Attention to Detail Team Oriented

EDITH H. HEYLIGER

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Senior Health Plan Data Analyst (1998-2006) Consolidated data in a cross functional environment from multiple data sources (i.e. membership, claims/encounters, pharmacy, lab, radiology) to create ad hoc reports to support large group proposals. Led the design and development of standardized reports on utilization and pricing data for marketing presentations to clients, such as, Clayton County, Federal Government, Southern Company. Produced and reported monthly detailed cost statements and invoices for self funded and other product segments. Management Reporting Analyst II (1997-1998) Conducted statistical analysis and reporting of customer satisfaction surveys using regional database. Collaborated with IT department in developing survey data structures that maintained efficient and reliable patients/members and provider details for KP Health Plan of North Carolina (KPNC). Served as liaison between survey vendor, KPNC and IT department to select new vendor from one of five proposals to conduct the NC regions surveys. Data Quality Analyst (1995-1997) Led membership data quality (DQ) clean-up initiative which entailed investigating DQ problems, working with IT to correct system deficiencies and overseeing the work of temporary Data Entry clerks. Developed and tested end user profiles for access to membership database. Facilitated Membership Data Integrity team that reviewed and prioritized critical membership database issues. Provided training on processes and procedures for using the Membership database system. Worked on committee to establish security guidelines for system access. Other Professional Experience Instructor of Economics East Tennessee State University Master of Arts in Economics, Bowling Green State University, Bowling Green, OH Bachelor of Science in Economics, Fayetteville State University, Fayetteville, NC COMPUTER SKILLS Proficiency: SAS Enterprise Guide, Cognos Impromptu, Advanced Excel, Paradox, SQL, Crystal/Business Objects, Microsoft Access HEALTHCARE SYSTEMS Epic Clarity, Epic Ambulatory, Tapestry, Radiant, MHC, PIMS (Pharmacy System) PROFESSIONAL DEVELOPMENT & TRAINING Project Management, Time Management, SAS Education