Open to opportunities

TESSA HOUSTON

@tessahouston

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Experienced lead business analyst specializing in compliance and operational excellence.

United States

Message

What I'm looking for

I am seeking a role that values compliance and operational excellence, with opportunities for growth.

I am a dedicated Lead Business Analyst with a strong focus on compliance and operational excellence in the healthcare sector. With over a decade of experience, I have successfully led compliance oversight for Commercial, Marketplace, and CHIP programs, ensuring alignment with CMS and state regulations. My expertise in designing and implementing quality audit frameworks has proactively identified compliance gaps, significantly enhancing operational efficiency.

Throughout my career, I have spearheaded training initiatives on regulatory changes and audit readiness, collaborating closely with cross-functional teams to establish budget tracking tools and reporting dashboards. My role as a subject matter expert in compliance has allowed me to lead multiple successful external audits, demonstrating my commitment to maintaining the highest standards of regulatory adherence. I thrive in dynamic environments where I can leverage my analytical skills to drive improvements and foster collaboration across departments.

Experience

Work history, roles, and key accomplishments

Current

Lead Business Analyst

Current

UPMC Health Plan

Aug 2021 - Present (4 years)

Led compliance oversight for Commercial, Marketplace, and CHIP programs, ensuring alignment with CMS and state regulations. Designed and implemented a multi-layered quality audit and review framework to proactively identify and address compliance gaps.

Regulatory Affairs Audit Management Training Development Budget Management Data Analysis Stakeholder Management CHIP Programs

Business Analyst

UPMC Health Plan

Aug 2018 - Present (7 years)

Conducted workforce capacity planning and forecasting using advanced modeling and trend analysis. Contributed to internal audits and compliance readiness for CMS, PID, and SOX requirements.

Workforce Planning Forecasting Power BI Data Analysis Compliance Regulatory Requirements Workflow Automation Operations Management

Team Lead

UPMC Health Plan

May 2016 - Present (9 years 3 months)

Acted as a liaison between team members and leadership for ACA and Individual Market products. Managed cross-departmental issue resolution involving Operations, Customer Service, Premium Billing, and Grievances.

Team Leadership Customer Support Portal Testing Policy Development Project Management Reporting ACA

CHIP Enrollment Specialist

UPMC Health Plan

Nov 2012 - Present (12 years 9 months)

Managed CHIP member enrollment/disenrollment in compliance with federal and state regulations. Served as an internal resource for resolving member enrollment discrepancies.

Enrollment management Regulatory Compliance Auditing Training Data Analysis Process Improvement

Legislative & Campaign Intern

West Virginia House of Delegates

Aug 2010 - Present (15 years)

Coordinated daily office functions, scheduling, and community engagement for Delegate Barbara Fleischauer. Supported campaign activities and created press releases for local/state media.

Office Administration Scheduling Community Engagement Press Release Writing Media Relations Public Speaking Event Coordination Legislative Support Communication

Legislative Assistant

PA State Senator Lisa Boscola

Apr 2009 - Present (16 years 4 months)

Drafted press releases and coordinated communications to over 2,000 constituents. Supported daily legislative activities and fundraising efforts.

Press Release Writing Legislative Support Fundraising Public Relations Event Planning Research Policy Analysis Administrative Support

Education

Degrees, certifications, and relevant coursework

Point Park University

Master of Arts, Organizational Leadership – Health Systems Management

2012 - 2014

Completed a Master of Arts in Organizational Leadership with a specialization in Health Systems Management. This program provided advanced knowledge in leading and managing healthcare organizations.

West Virginia University

Bachelor of Arts, Multidisciplinary Studies

2006 - 2010

Earned a Bachelor of Arts in Multidisciplinary Studies with concentrations in English, Public Relations, and Leadership Studies. This interdisciplinary program provided a broad foundation in communication, critical thinking, and leadership principles.