Florida Blue is part of the Blue Cross and Blue Shield Association and the largest customer-owned health insurance company in the United States.
Project overview:
Sapphire: is an integrated and modernized platform for enrollment, billing, finance, fulfillment & reporting capabilities for both Medicare Advantage and Medicare Supplemental products.
Capitation: The system that calculates and pays capitated providers both over 65 as well as under 65. I worked in the Over 65 part of it related to Sapphire.
Product Management Tool (PMT): details out the Plan & Benefit information for over 600 Plans for both Individual and Group
Summary of Benefits and Coverage (SBC): This application automates the creation of the mandatory document which is a summary of the health plan benefits and coverage.
Siebel – The Siebel CRM customized to the enrollment and sales processes of Florida Blue.
Responsibilities:
- Developed detailed test cases and test scripts.
- Executed the test cases manually from HP Quality Center to test the application for its functionality and system integration.
- Wrote extensive SQL queries to perform data analysis. One of the few with update access to the database.
- Performed data driven testing by fetching data from Excel sheets and Databases to verify the application’s behavior for different data inputs.
- Attended review meetings and performed Scenario reviews with the developers and analysts.
- Supported User Acceptance Testing (UAT) to ensure that applications are performing according to desired acceptance criteria for timely implementation of the CRs.
- Created and executed models for Capitation testing in Sapphire and verified Roster, RA and Variance reports. Worked closely with the UAT team and Users.
- Onshore point of contact for offshore resources.
