Vaishali Patel
@vaishalipatel2
Healthcare Business Analyst at Centene improving Omni Case Management and Power BI reporting.
United StatesWhat I'm looking for
At Centene Corporation, I’m delivering requirements for Omni Case Management enhancements and Power BI Active Directory reporting. I authored requirements and user stories for case intake, workflow routing, and business rule modernization.
For Blue Cross Blue Shield of Florida, I supported enterprise claims modernization and provider integration. I analyzed 837P/837I rejection patterns and authored corrective specifications, reducing first-pass claim rejections by 26% across 18 payer and clearinghouse channels.
At Assurant Health, I managed requirements for claims, enrollment, and benefits configuration workstreams. I facilitated JAD sessions and created process models and specifications for business process re-engineering and policy modernization.
At TriWest Healthcare Alliance, I worked on benefits and enrollment documentation modernization, including 834 enrollment and 837 claims transactions. I analyzed and tested EDI transactions and helped reduce claim rejection rates by 24% across quarterly release cycles.
Experience
Work history, roles, and key accomplishments
Engaged with Centene on the Omni Case Management Enhancement program and Power BI Active Directory Reporting Enhancement initiative. Owned requirements delivery for case management platform enhancements, reporting governance improvements, and SQL-based data validation workstreams.
Healthcare Business Analyst
Blue Cross Blue Shield of Florida
Sep 2022 - Sep 2023 (1 year)
Engaged with BlueCross BlueShield of Florida on the Enterprise Claims Modernization and Provider Integration program. Owned requirements delivery for claims platform enhancements, provider data management improvements, and enterprise system modernization.
Engaged with Assurant Health on business requirements elicitation, process re-engineering, and policy modernization workstreams. Owned requirements management, stakeholder alignment, and change communication across engineering and re-engineering of business processes.
Engaged with TriWest Healthcare on the Benefits and Enrollment Maintenance Documentation Modernization program covering 834 enrollment transaction processing, 837 institutional and professional claims analysis, and 835 remittance reconciliation for veterans healthcare beneficiary populations.
Education
Degrees, certifications, and relevant coursework
CMJ University
Bachelor of Science, Computer Science
Bachelor of Science in Computer Science from CMJ University, India, completed in 2012.
Tech stack
Software and tools used professionally
Availability
Location
United StatesAuthorized to work in
Salary expectations
Social media
Skills
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