Lead Analyst at Blue Cross & Blue Shield of Rhode Island Resume Example

Hired by: Blue Cross & Blue Shield of Rhode Island (BCBSRI)

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Lead Analyst at Blue Cross & Blue Shield of Rhode Island Resume Example (Full Text Version)

Kristen Auger

Address: Seekonk, MA

Email address: hello@kickresume.com

Phone number: 555-555-555

Web: https://sk.linkedin.com/company/kickresume-com

Profile

STRATEGIC ANALYTICS | CLAIMS ANALYSIS | DATA-DRIVEN DECISION-MAKING

Analytical and results-driven professional with 10+ years experience in claims and financial analysis, performance analytics, data manipulation and payment integrity within insurance and technology environments. Proven ability to evaluate large datasets to identify precise cost-avoidance opportunities, and operational inefficiencies, ensuring compliance with contracts and coding guidelines, and regulatory standards. Skilled in creating actionable reports, dashboards, and ROI models to inform strategic decision-making and improve payment accuracy and financial transparency. Recognized for collaborating cross-functionally with provider relations, finance, operations, and leadership teams to implement solutions that enhance revenue integrity, client retention, and organizational efficiency.

Achievements

Complex Claims Analysis

Leveraged advanced financial and underwriting analytics across $300M+ in written premium and $650M+ in claims reserves, assessing pricing accuracy, claims reserve adequacy, and reinsurance strategy; earned executive recognition for supporting the structure of a $950M reinsurance program.

Data & Reporting Transparency/Efficiency

Led a data-driven claim reserving optimization project with Finance Leadership, reducing reserve close timelines by 33% while improving claims and reinsurance reporting accuracy across 100,000+ claims increasing confidence among executive leadership, the Board, and reinsurers.

Critical Retention & Revenue Generation

Instrumental in managing 40+ client relationships generating $61.8M in annual recurring revenue (ARR), obtaining $21.9M for multi-year renewals in 2023, securing contracts with three of the company’s key revenue clients.

Work Experience

06/2022, Director Business Analytics, Interactions LLC, Franklin, MA

Revenue & Data Analytics Leadership: Promoted to lead cross-functional analytics teams supporting sales & retention, pricing strategy, financial performance, and operational reporting. Delivered data-driven insights across organization to support executive decision-making, improve financial transparency, and optimize multi-million-dollar client portfolios.

Managed a 13-person cross-functional team including Deal Desk analysts and Customer Success Managers supporting Sales, Customer Success, Finance, and Operations.
Led analytics supporting $21.9M in annual recurring multi-year renewals, providing ROI, financial modeling, pricing analysis, and performance insights, expanded internationally.
Directed development of analytics tools and reporting frameworks used for quarterly business reviews, contract invoicing, and pricing evaluation.
Analyzed large operational and financial datasets to identify revenue leakage risks, cost optimization opportunities, and performance trends.
Supported analytics across 40+ enterprise clients generating $61.8M in annual recurring revenue, improved retention insights and strategic planning.
Designed and implemented an interactive web-based ROI and pricing analytics tool to support data-driven decision-making and opportunity identification.

01/2020 - 06/2022, Manager Deal Desk, Interactions LLC, Franklin, MA

Led Deal Desk Operations, supervising four direct reports and managing all ROI analysis, sales proposal support, and deal contract structuring.

Accelerated new business production ramp-up over 30% by ensuring compliance with deal process standards through consulting Executive Leadership internally and externally to represent cross-functional priorities, example client resulting in a $1.8M global expansion contract.
Developed and communicated a customer-facing ROI model articulating the company’s technology value proposition and success-based pricing strategy.
Analyzed production and sales data to identify growth opportunities, strengthen ROI, generate internal and external leads, and refine pricing strategies for maximum impact.

06/2019 - 01/2020, Business Analyst Deal Desk, Interactions LLC, Franklin, MA

Joined the company in a collaborative role, meeting the challenge of analyzing potential sales guiding and influencing key decisions by the Sales organization. Scope of work included building ROI models, consulting on projects, and sales enablement.

Secured two contracts and advanced pipeline opportunities by serving as interim Manager, supervising and coordinating the business analyst team to meet project goals.
Teamed-up to align deal desk analytics with organizational objectives, enhancing pricing and deal execution effectiveness.

01/2016 - 04/2018, Actuarial Analyst, Narragansett Bay Insurance Co, Pawtucket, RI

Instrumental in providing actuarial; support to the Vice President of Risk Management reviewing gross and net underwriting performance across $300M+ in written premium, including pricing analytics, financial planning, reinsurance reporting, reserve analysis, and predictive claims modeling.

Accelerated quarterly reserves process by 33%, partnering with Controller to streamline cross-departmental workflows, reducing completion time to 15 calendar days while ensuring data accuracy for audits.
Enhanced reserve adequacy for $650M+ claims by deploying a new Gross to Net reserving procedure for complex multilevel reinsurance program, improving liability accuracy.
Developed Claims Reporting Dashboard (KPIs) for reinsurance cost analysis, capital requirements, rate/pricing changes, and marketing strategies, enabling data-driven decisions for senior managers and executives.
Revamped Claims Cost Model to support $950M reinsurance purchase, improving predictability of company risk indicators and earning recognition from CFO and VP of Risk Management.

01/2012 - 01/2016, Risk and Pricing Analyst, Narragansett Bay Insurance Co, Pawtucket, RI

Led actuarial analysis, catastrophe claims event estimating, and supported product pricing for state entries, reporting to VP of Risk Management and teaming with senior actuary

Oversaw winter storm loss reporting on $50M+ claims from 4,000 claims during 2015's severe winter, enhancing accuracy of claims estimates
Influenced Senior Executives by adjusting claims forecasts upward based on detailed analysis of Northeast severe weather claims patterns

Education

12/2012, Bachelors of Science, Actuarial Science, Bryant University

Actuarial Exam 1 (Probability/Statistics)

Actuarial Exam 2 (Financial Mathematics)

Actuarial Exam 3 (Actuarial Statistics)

Skills

Technical & Data Tools

Advanced Microsoft Excel (Pivot Tables, Power Query, VBA) • Microsoft Access • SQL • Business Objects • Data Extraction & Querying • Reporting & Dashboard Development

Data Integrity

Claims Analysis • Claims Processing Workflows • Overpayment Detection • Cost Containment Analysis • Payment Integrity • Billing Review • Contract Reimbursement Methodologies • Policy Analysis

Analytics & Investigation

Data Analysis • Root Cause Analysis • Trend Identification • Financial Impact Analysis • Audit Support & Documentation

Business & Operational Skills

Process Improvement • Workflow Optimization • Cross-Functional Collaboration • Stakeholder Communication • Contract Interpretation • Policy Implementation

Position Overview:

As a Lead Analyst, you will guide data analysis efforts that inform key business decisions. Your role involves gathering and interpreting data, identifying trends, building reports and dashboards, and translating findings into clear, actionable recommendations. You will lead and mentor other analysts, collaborate with stakeholders across the organization, and ensure analytical work is accurate, timely, and aligned with business objectives.

Company Overview:

Blue Cross & Blue Shield of Rhode Island (BCBSRI) is a nonprofit health insurance provider and the largest health insurer in Rhode Island. Founded in 1939, the company serves more than 550,000 members, over half the state's residents, primarily through their employers. Part of a nationwide network of independent Blue Cross Blue Shield plans, BCBSRI offers a wide range of products including PPO, HMO, Medicare Advantage, Medicare Supplement, and dental plans, with a mission to improve members' health and peace of mind through access to affordable, high-quality care.

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