SUMMARY

• Over 15+ Years experience in Business Analysis and Business Architecture in Health Services.
• Worked in information delivery providing support to end users, created new reports, maintained and answered questions on existing reports.
• The reports covered Finance, Authorizations, Claims, Provider, Membership and Patient detail as well as summary reporting including analysis of the results
• Worked for the Datawarehouse team where set up entire test environments and test cases.
• Led Error tracking meetings and was the SME (Subject matter expert for the authorizations datamart).
• Worked as lead Sr. Operations Reporting Analyst for the Disease Management/Condition Care Management Product.
• Reporting analyst from the beginning of the product's inception. Created and maintained all reports and applications.
• Created performance reports for staff, underwriting models, staffing models, RFP's, QIA's for NCQA accreditation, customer reports and many other reports analyzing processes, measuring the success of the program and identifying barriers and solutions for better business practices.

TECHNICAL SKILLS

• SQL Server
• Oracle
• Teradata
• T - SQL
• SSRS
• SSIS
• SSMS
• SSAS
• Crystal Reports
• Access
• OWB Discoverer
• UNIX
• Micro Strategy
• SAS
• Tableau
• Cognos Impromptu
• Actuate
• Sharepoint
• Ideabook
• MS Office Suite
• Classroom - C++
• COBOL
• Visual Basic
• Pascal
• Fortran
• Assembler
• BASIC

PROFESSIONAL EXPERIENCE

Confidential, Fulton, MD

DBA / Sr. Data Analyst

Responsibilities:

• Designed/Built SSIS packages to load all the data into the SQL database from flat files & Access Databases.
• Set up SQL Report Manager and created Summary Level Reports & Patient Detail Level Reports using SSRS.
• Created extracts for Tableau for reporting.
• Monitored SQL Server performance and created Indexes to improve performance.

Confidential, Glen Burnie, MD

Sr. Business Systems Analyst

Responsibilities:

• Created HEDIS reports based on gathered requirements from Senior Management using SSRS & SSIS.
• Created various reports and processes using SSRS & SSIS.
• Updated all existing SSRS reports for ICD10.
• Updated all existing SSIS processes for ICD10.
• Received, Processed and Loaded all new OPTUM HCPCS, CPT, ICD9 & RBRVS update files.
• Created Provider Reassignment processes and ran the reassignment process.
• Tested all Enhancements, Updates & Releases in MC400.
• Led the whole Open Enrollment process in the place of a retired employee who ran it for the previous 10-20 years.
• Led meetings, created data flow diagrams, created project plan, received all the data, processed all the data, checked all the data & documented the whole process to ensure everything processed and loaded accurately & smoothly.

Confidential, Hunt Valley, MD

Sr. Applications Analyst

Responsibilities:

• Created ad hoc reports based on requests from Senior Management using SQL, SSRS & Crystal Reports.
• Created, Deployed & Maintained reports in SSRS.
• Review and analyze existing reports & processes to ensure data accuracy.
• Set up a process to ensure data accuracy & integrity.
• Created stored procedures that were used by the clinical front-end application to trigger events and alerts.

Confidential, Baltimore, MD

Business Analyst III

Responsibilities:

• Analyze user requirements, procedures, and problems to improve business process.
• Write detailed description of user needs, as well as functional and technical specifications.
• Review current business process, workflow and scheduling limitations.
• Study existing information-processing systems to evaluate effectiveness and develop new system specifications to improve production or workflow as required.
• Serve as technical consultant to facilitate and participate in interactions between Business Unit Controllers and IT Developers.
• Enhance/Strengthen/Simplify reconciliation processes and fulfill other Finance initiatives objectives and migrations.

Confidential, Woodlawn, MD

Sr. Healthcare Systems Analyst

Responsibilities:

• Research and investigate key business problems through quantitative analyses of utilization and healthcare costs data.
• Design the analysis approach, write complex SQL and interpret complex data models that support a large health care program and claims processing.
• Provide and defend conclusions and recommendations to customer based on results of analysis.
• Answered questions and troubleshot Micro Strategy reports.

Confidential, Silver Spring, MD

Sr. Business Systems Analyst

Responsibilities:

• Researched and documented the Sources of Encounters data.
• In addition to Encounters data, worked extensively with Claims, Demographics, Enrollment, Census, Lab and Pharmacy data.
• Worked with clinical staff to understand all the data, gather requirements and document workflows.
• Supported data issues and questions surrounding CarePoint/Health Connect.
• Assisted the Research Department with SQL data pulls for HMORN research studies.
• Learned Teradata/Oracle differences to write, modify, error check SQL code while working with all the data.
• Ran Weekly RDW/VDW Update Meetings.

Confidential, Baltimore, MD

Business Intelligence Business Analyst

Responsibilities:

• Gather requirements using interviews, document analysis, requirements workshops, surveys, site visits, business process descriptions, use cases, scenarios, business analysis, task and workflow analysis.
• Critically evaluate information gathered from multiple sources, reconcile conflicts, decompose high-level information into details, abstract up from low-level information to a general understanding, and distinguish user requests from the underlying true needs.
• Produce ad-hoc reports from data housed in systems.
• Communicate and collaborate with external and internal customers to analyze information needs and functional requirements and deliver the following artifacts as needed: functional requirements use cases, report designs.

Confidential, Columbia, MD

Sr. Operations Reporting Analyst

Responsibilities:

• Worked closely with the Confidential Marketing Manager when creating out monthly mailings to the targeted members.
• Designed and created staffing underwriting models for finance.
• Designed and created Customer reporting packages.
• Designed and created management's operations reports.
• Designed and created performance measures/metrics reporting packages for Health Coaches and Clinical Health Associates.
• Designed and created NCQA reporting audits and QIA's
• Led workgroups and provided solutions for all data and reporting issues and questions.
• Developed error tracking and data integrity checks for all CCM data entered.
• Presented and explained all Data and Reports to Senior Management.
• Trained clinicians on understanding reporting I developed for them and explained how they can use the reports and how the data they enter impact reporting.
• Trained other reporting analysts and answered all questions concerning CCM data and reporting.

Confidential, Columbia, MD

Business Analyst

Responsibilities:

• Participated in full-life cycle software development for mid-size to complex projects by performing requirements analysis and testing using development methodology.
• Tested Programmed procedures and modules prior to rolling them out to production by setting up the test environment and creating test cases.
• Stepped through design documentation and SQL code to fix production problems.
• Led Error resolution meetings with business owners and department leads to get errors fixed in a timely manner and fix errors in the Data Warehouse to maintain a 6 sigma ratings.
• Worked on many Enhancement projects researching the problem and testing the solution.
• Monitor and run production jobs in UNIX.

Confidential, Columbia, MD

Business Analyst

Responsibilities:

• Provided support and analysis within the Analytic Services Department.
• Met with users to define and document business reporting requirements.
• Created technical specifications based on business requirements signed off on by the end user.
• Programmed technical specifications using SQL, Access & Impromptu for Fraud Investigation, Upper Management, Regional Service Centers & Finance.
• Tested Programmer/Analyst report applications prior to rolling them out to regional service centers and clients.
• Responsible for making changes (including programming changes) to existing reports using Crystal, Access, Impromptu & SQL.
• Created new reports using SQL, Access & Impromptu for Fraud Investigation, Upper Management, Regional Service Centers & Finance.
• Developed specific paid claims, authorizations, denied claims, readmission, Membership, Provider and Patient data queries to meet ad-hoc work requests for various departments and regional service centers.
• Determined the logic used by Programmers/Analysts to research results from the reports and answered questions presented by regional service centers on calculations and definitions of certain fields on such reports.
• Trained regional personnel on use of reporting software developed at National.
• Trained and assisted new employees on use of reporting software and ad-hoc work request generation.
• Managed small projects as they were delegated.