SUMMARY:

• More than 12 years of hands on experience in the Healthcare Industry.
• Strong knowledge of Health care terminology, with an excellent skill of analyzing complex datasets, and report writing.
• Experience with different analytical and visualization tools such as Tableau, Minitab, SAS, SQL, SQL Power Architect and Microsoft products.
• Have excellent analytical, problem solving, communication and interpersonal skills with ability to interact with people at all levels and can work as part of a team or independently
• Devoted and a quick learner with capability to master and implement new technologies
• Possess in - depth knowledge of concepts and principles of business metrics, effective requirement gathering/proper documentation along with analytical techniques / tools, including their application in executing effective data management and reporting with an eye for details.
• Proven track record of effectiveness to multitask in a fiercely competitive, stressful, and fast-paced environment.

TECHNICAL SKILL:

Tools: Tableau, Microsoft SQL Server, SAS, Minitab, MS Access, Excel, Word, PowerPoint, Teradata SQL Assistant, SQL Power Architect

EXPERIENCE:

Confidential

Senior Business Intelligence Developer

Responsibilities:

• Develop Tableau dashboards for various healthcare metrics
• Automate standard reports using SAS or/and Tableau
• Perform monthly ETL process.
• Generate multiple monthly and ad-hoc reports.
• Perform data analysis for various healthcare measures.
• Participate in patient safety and quality team huddle.
• Perform data validation using different tools such as SAS, Minitab and SQL server.
• Perform report proofing.
• Participate in requirement gathering for new Dashboards need.
• Create workflow and documentation for future use

Confidential

Business/System Analyst/ Consultant

Responsibilities:

• Provided information technology support for the Civil Division of the U.S. Department of Justice.
• Analyzed business objectives of the stakeholder and develops solutions to their business issues
• Translated business requirements to System/Functional requirements.
• Analyzed and define processes of business, for both “To-Be” and “As-Is” states.
• Created test plans, create test Cases, and Issuing SRs upon detection of defects and collecting the Test Metrics.
• Performed application testing on aggressive sprint
• Performed regression testing, developing a traceability matrix to establish mapping between requirements, Test Cases and defects.
• Utilized MS Word, Excel, PowerPoint, SharePoint, and VersionOne products to document functional and system requirements, use cases, and the high-level design for projects that span multiple application systems.
• Actively involved in Positive and Negative testing to ensure the process being fully tested, including additional scenarios that may not be covered in test plans.
• Managed schedule to meet project timelines and delivery dates.
• Responded to client inquires involving application questions.
• Worked with the Program Developer on system application implementation, tests end user processes to ensure critical defects were found, documented within SharePoint and retested to ensure system readiness.
• Managed competing priorities to complete task by scheduled deadlines on the project.

Confidential, Rockville, MD

Lead Business Analyst/informatics specialist

Responsibilities:

• Produced Data Mining activity for Medicare risk adjustment project by translating clinical metrics and develop systemic dataset to help the accuracy of diagnosis capture/documentation improvement.
• Work with Clinical Documentation Information specialists to develop data mining metrics.
• Gather appropriate requirement from leadership/business partners (Medical Group) to execute Goals/projects
• Supported in Risk Adjustment data submission by developing statistical program to generate systemic dataset
• Evaluate eligibility status for risk adjusted members Medicare/Affordable care Act members
• Performed SOX check list and monitor risk adjustment data submission accuracy
• Follow up on the goals to make sure deliverables are met
• Perform effective documentation/workflow for future reference
• Extracted data from various data sources using Sybase (ODBC), Oracle SQL Developer, Teradata (Clarity), SAS.
• Provided status update/trend to prove our Data Mining effort
• Perform analysis based on HEDIS measurement/requirement
• Processed ad-hoc Analysis based on both internal and external claims data
• Performed quality assurance on risk adjustment data submission and produce supplemental file when needed to remove or add information after IT submitted data to CMS

Confidential, Rockville, MD

Sr. Business Analyst

Responsibilities:

• Produce utilization for non-participating providers and analyze the financial benefit if contracted
• Analyze Network Adequacy for Medicaid, Medicare and Commercial members
• Produce Network Utilization and analyze financial impact during rate increase
• Provide Rate comparisons between vendors for better contractual agreement
• Develop Plug-and-Play models for contract managers during rate negotiation
• Perform claim audit and identify any configuration errors
• Maintained complex database, compile report, and perform data analysis for various groups.
• Designed and prepared trend analyses of RX prescribing patterns and provide drug utilization.
• Coordinated reports and analyzed for other regional customers, including member eligibility and fraud control.
• Data Source used are; Business Objects, Sybase (Infomaker), Teradata (Clarity), Point System, MCPS, Med-Impact and more.

Confidential, Rockville, MD

Sr. Business Data Analyst

Responsibilities:

• Maintained complex database, compile report, and perform data analysis for various groups.
• Extracted data from various data sources using Sybase (ODBC), Teradata (Clarity), Health Connect and more.
• Developed and compiled reports in support of programs like Provider Coding assessment, Medical Record quality team, Medicare Refresh program, Yellow Card database and more.
• Maintained complex database, compile report, and perform data analysis for various groups.
• Developed and compiled reports in support of programs like Provider Coding assessment, Medical Record quality team, Medicare Refresh program, Yellow Card database and more.
• Extracted, compiled, and performed data analysis from various sources including but not limited to the pharmacy, lab, radiology and encounter system to support management for financial, quality, and budgetary purposes.
• Also developed and compiled reports to support various initiatives, for example Drug conversions, formulary/non-formulary management, Weight loss, Smoking Cessation and more

Confidential, Reston, VA

Pharmacy Data Analyst

Responsibilities:

• Extracted, compiled, and performed data analysis from various sources including but not limited to the pharmacy, lab, radiology and encounter system to support management for financial, quality, and budgetary purposes.
• Also developed and compiled reports to support various initiatives, for example Drug conversions, formulary/non-formulary management, Weight loss, Smoking Cessation and more.
• Designed and prepared trend analyses of RX prescribing patterns and provide drug utilization.
• Coordinated reports and analyzed for other regional customers, including member eligibility and fraud control.
• Data Source used are; Business Objects, Sybase (Infomaker), Teradata (Clarity), Point System, MCPS, Med-Impact and more

Confidential, Oakland, CA

Pharmacy Internal Auditor

Responsibilities:

• Audited Cost of goods sold (COGS pricing) for nationwide pharmacies.
• Correspond with various groups like, pharmacy informatics, catalog groups, pharmacy warehouses and other associated departments for better system management and solutions when system errors found.
• Developed SAS programs for both Fraud/compliance and Pricing department in bettering monthly as well as annual reporting system
• Supported the department with statistical analysis for any ad hoc request.
• Performed surprise Physical audit every month.

Confidential, Oakland, CA

Pharmacy Tech/Project coordinator

Responsibilities:

• Maintained Par-level effectively
• Reduced cost by controlling orders efficiency
• Established a system for the nurses to order
• As a pharmacy Technician I also worked in regular pharmacy line by taking (Inputting) new/refill prescription from members, dispensing prescription medications for members
• Trained new pharmacy staff