SUMMARY

• A highly analytical professional with 15 (+) years of experience in healthcare data consulting, IT support/development, and data extract, analysis and report development.
• Develops project plans with strategic business initiatives then delivers data analysis and implementing effective business solutions.
• Expertise in team leadership, business intelligence, systems implementation and integration, ETL, and data warehouse modeling.
• Experience with solid systematic diagnostic and solution experience specific to health care data management challenges.
• Merge and append data from various data sets, servers and applications.
• Collaborate with colleagues/leadership in developing and executing business roadmap.
• Translates business needs into application software.

AREAS OF EXPERTISE

• Systematically Managing Data Processing and Output to Expected Results
• Project Management
• Policy Development and Implementation
• Client/Business Requirements Produce technical specifications
• UAT Testing and Documentation
• HealthCare Data Extraction and Analysis
• Ability to manipulate large sets of data
• Ability to effectively manage and facilitate work sessions without support
• Creativity, strong problem solving, business process engineering, planning, time management and strong reporting and data analysis skills
• Team Leadership and Training
• Data investigation and error validation
• Root Cause Analysis and Solution development
• Facilitate optimal internal communications by serving as liaison between services organization and product development, product management, and technical teams.

TECHNICAL SKILLS

• Microsoft Parallel Data Warehouse Visual Studio 2013 and 2014
• SQL Server Reporting Services(SSRS, SSIS)
• Oracle SQL Developer
• SqlDbx Database IDE
• Microsoft SQL Server Query Analyzer
• T - SQL
• Business Objects Enterprise
• Data
• MYSQL
• Hummingbird BI/Query SQL data analysis
• Microsoft Access
• Qlik Sense (like Tableau)
• Confidential data servers Production
• Stage
• UAT
• HEDIS engines.
• ConnectBridge
• DUO Mobile
• NCQA and Medicare for HEDIS/STARS/P4P accreditation coding and regulations
• CPT/ ICD-9/ICD10/ HCPCS/DRG/ LOINC/NDC SQL coding expert
• Agile and/or waterfall
• Rally
• CA Central
• Service Now and Scrum Processes to manage IT work activities.

PROFESSIONAL EXPERIENCE

Confidential

Sr.Data Analyst and Business analyst

Responsibilities:

• Business Consultant UHC transition business requirement - Identified requirements and gaps, collaborated with product/ IT team to produce appropriate changes to all applications, reporting needs and components; support the design / development, programming, maintenance, and publishing of operational reports needed for client. Worked directly defining new applications requirements and resolving issues. Application SME
• Provided data preparation for Healthcare Effectiveness Data and Information Set (HEDIS) Compliance Audit roadmap, audit submission and audit data.
• Subject Matter Expert (SME) for HEDIS report development and metric design for all categories of NCQA and CMS for NCQA/HEDIS DM Quality improvement/HEDIS Health Plan/CMS HEDIS/STARS CAHPS data requirements for accreditation. Supported Product and IT development for development of application.
• Reporting specialist for HEDIS/STARS applications and data extract from various databases. Team with IT development to QA and tested new 2017 HEDIS metrics before deployment.
• Developed Process Flow Diagram/Activity Diagrams, Test Cases, Use Cases and performed Functionality testing & Regression testing. Managed, research and resolved assigned defective tickets created.
• Worked closely with manager to analyze & understand Business requirements; gathered User, Functional and Non-Functional requirements & translated the requirements into User Stories for Scrum process using Rally
• Trained staff on HEDIS/STARS UI Application. Application SME
• Partnered with the leadership team to execute on the UHC transition team in relation to HEDIS and STARS business roadmap. Provided client engagement and support for the UHC HEDIS transition to Confidential . Customer support and collaboration.
• Medical Record data imported (healthcare records) displayed from vendor. Validated all data formatting for import.

Confidential

Senior Business Intelligence Analyst and Developer

Responsibilities:

• Develop and implement effective / strategic business solutions through research, development and analysis of data and business processes. Then presented results and solutions to leadership and client managers.
• Ability to problem solve including multiple priorities and research conflicting and/or inaccurate data.
• SQL writing of data reports/analysis and publishing to company web site relating to healthcare
• Supported the design / development, SDLC & Agile Projects, programming, maintaining and publishing of operational report and data analysis. BCBSMN and Wellmark claims, healthcare records and data extractions for report development and Subject Matter Expert. Call campaign development. ICD10 coding and Medicare risk coding
• Designed, developed and produce technical specification documents from product and client business requirements.
• Presented analysis and interpretation for operational and business review and planning to leadership team and client managers. Customer support and collaboration. Supported IT development and process.
• Ongoing data debugging and QA of data server platform tables and issues. Testing of all IT releases and updates. Data development, implementation and monitoring of data from centralized server.
• SP and ETL development and ETL and BI testing using SSIS ETL environment. Participated in to end to end testing
• Provide data analysis of outcome and functions of health care relating to disease management data driven metrics to identify gaps and implement interventions to improve results on key performance measures. Data mining and data quality monitoring. Used agile and waterfall approaches for software/ reporting development.
• Work independently and directly report to senior corporate management in matrix environment
• Supervised junior analyst for ad-hoc reporting and operational report development.
• Achieved NCQA QIP and HEDIS DM accreditation and successfully passed the onsite NCQA audits.
• HEDIS and Medicare codes development for coding, testing and debugging and reporting design
• Home Health care vendor reporting and metrics development