SUMMARY:

• 8 years of Industry experience as a Data Analyst/DW Analyst wif solid understanding of Business Requirements Gathering, Data warehousing, Business Intelligence, Data Mapping and Data Modeling.
• Experience in Business Intelligence (BI) Technologies like Microsoft Business Intelligence (SSIS, SSAS, and SSRS), Informatica, Business Objects, and OBIEE
• Understanding the full healthcare lifecycle including all payers and end to end revenue flow wifin the industry
• Understanding the full healthcare lifecycle including all payers and end to end revenue flow wifin the industry
• Knowledge in the ETL (Extract, Transform and Load) of data into a data ware house/date mart and Business Intelligence (BI) tools like Business Objects Modules (Reporter, Supervisor, Designer, and Web Intelligence
• Expert noledge in FHIR for direct/specific HealthCare information
• Created number of SQL Scripts to load test data in to the Database to test the functionality of MDM Match and Merge processe
• Extensive experience in Strategic development of a Data Warehouse and in Performing Data Analysis and Data Mapping from a Operational Data Store to a Enterprise Data Warehouse
• Strong background in various Data Modeling tools using ERWIN, ER/Studio and Power Designer.
• Skilled in implementing Clinical Trial Management System (CTMS) and Electronic Data Capture (EDC) in the clinical research environment.
• Experience wif Tableau for Data Acquisition and data visualizations.
• Has considerable expertise in Data Analysis, Data Profiling & Quality, Data Governance and Master Data management (MDM).
• Experience in development methodologies like RUP, SDLC, AGILE, SCRUM and Waterfall.
• Strong Experience in Claims Processing, Medicaid, Medicare and Health exchange
• Good Knowledge of HIPAA Compliance Lifecycle, HIPAA Insurance Regulations and Claims Processing.
• Experience in migrating data from DB2 to Netezza using NZload and ELT mappings (Datastage) in Data Integration layer.
• Gained experience in utilizing statistical tools like SAS, SPSS, MS office suite, MS projects, MS Visio and requirement management tools.
• Extensive experience wif Medicare/Medicaid processing as well as the Claims/Billing.
• Strong hands on ability to use SQL in RDBMS (SQL Server, Oracle) for verifying source data preparation and assisting of data design input and trouble - shooting.
• Excellent Knowledge in Electronic Medical Record (EMR) / Electronic Health Records (EHR) modules and process flow.
• Designed and implemented stored procedures, views and triggers for automating tasks in TSQL
• Proficient in Technical and Business Writing, Business Process Flow, Business Process Modeling, Business Analysis and Testing various complex data driven methodologies for commercial lines integration wif Documentum.
• Design and review of various documents including the Software Requirement Specifications (SRS), Business requirements document (BRD), Use Case Specifications, Functional Specifications (FSD), Systems Design Specification (SDS), Requirement Traceability Matrix (RTM) and testing documents
• Experience working wif the medical claims and ICD9 (HEALTH EVENTS) code that was feed to the PHR (PERSONAL HEALTH REOCRD) application
• Well versed wif ICD-9, ICD-10, HL-7, HIPAA, EDI (Electronic data interchange) Transaction, Medicare & Medicaid, claim processing from point of entry to finalizing, claim review, identifying claims processing problems, their source and providing alternative solutions
• Expertise in the area of Requirements Gathering, designing and drafting Requirement Traceability Matrix (RTM), requirement planning and analysis Functional, User and Design requirement specification (FRS, URS, DS), performing Gap analysis, Process Analysis, Prototype design, designing and analysis of Use Case Scenarios.
• Proficient in developing UAT plans, UAT cases, UAT scripts and executing UAT.
• Well versed in writing queries/Scripts for Data Analysis and QA reporting and testing

PROFESSIONAL EXPERIENCE:

Confidential, Huntsville AL

Sr.Data Analyst

Responsibilities:

• Lead Business Intelligence reports development efforts by working closely wif Microstrategy, Teradata, and ETL teams
• Lead multiple project teams of technical professionals through all phases of the SDLC using technologies including Oracle, Erwin, DataStage, Data Warehousing, Websphere and Cognos.
• Responsibilities include gathering business requirements, developing strategy for data cleansing and data migration, writing functional and technical specifications, creating source to target mapping, designing data profiling and data validation jobs in DataStage, and creating ETL jobs in DataStage.
• Conducted noledge sharing sessions on Business Process Modeling Notation and Healthcare Payer business for team members.
• Designed Physical Data Model (PDM) using IBM Info sphere Data Architect data modeling tool and ORACLE PL/SQL.
• Implemented Master Data Management MDM for all entities in the project by maintaining a master hub for improving the data quality by following various data governance techniques and data dictionary standards.
• Created SAS programs that are used for data validation, statistical report generation and program validation and automated the Edit Check programs using Macros
• Design and develop the data load process using InformaticaPowerCenter and XML Style sheets and ACORD XML.
• AnalyzeDatawif Excel PowerPivot, Creating and managing databases inMSSQL.
• Extracted data from various sources (SQL Server, Oracle, text files and excel sheets), used ETL load scripts to manipulate, concatenate and clean source data.
• Created DTS and SSIS Packages to vendors in which records were loaded Daily, also to other data resources such as Excel, Access, flat file, and XML in order to Create and maintain a centralized data warehouse.
• Working on Membership Datawarehouse (MDW) including the areas like Members, Benefits, Products, Groups, etc as Database Analyst and Business Systems Analyst, and same also for Enterprise Datawarehouse (EDW).
• Assigned tasks among development team monitored and tracked progress of project following agile methodology.
• Responsible for evaluating, configuring and testing healthcare claims payer system
• Created a test plan and a test suite to validate the data extraction, data transformation and data load and used SQL and Microsoft Excel..
• Tested HIPAA Gateway Application Interface for all inbound and outbound messages (Healthcare Eligibility 270 and 271, Healthcare Claim Status request 276 and 277, Healthcare Claim 837 and 835)
• Interacted wif the users and logged any defects, enhancements from the UAT and communicated them to the development team
• Worked on EDI transaction 835 and 837 to identify key data set elements for designated record set. Interacted wif Claims, Payments and Enrollment hence analyzing and documenting related business processes.
• Created and maintained Data Dictionary and DB Schema for the database. Helped in standardization of naming convention, development of system inventory, source system metadata and DBMS metadata.
• Functioned as the primary liaison between the business line, operations, and the technical areas throughout the project cycle. Worked wif ODS and OLAP system.
• Responsible to do API testing and perform complete end to end testing on all of these systems.
• Obtained Data requirements, identified data sources, determined the content of data fields and created Data Mapping Documents and performed Data Extraction and Data Compilation using SQL queries.
• Performed the Analysis & Design workflow for various processes by following the Rational Unified Process (RUP) to document Use Cases.
• Conducted current state study which included data collection methodologies, data quality and data integration problems, data storage and infrastructure related issues.
• Designed and implemented basic SQL queries for QA Testing and Report / Data Validation.
• Conducted User Acceptance Testing, gatheird and documented User Manuals and Business Rules

Confidential Houston, TX

Sr. Data Analyst

Responsibilities:

• Conducted Joint Application Development (JAD) and interview sessions to elicit requirements from the users and subject matter experts.
• Used senior level SQL query skills (Oracle and TSQL) in analyzing and validating SSIS ETL database data ware house processes
• Developed Process Model for a Healthcare Payer Organization
• Successfully designed and implemented statistical reporting processes for regular data collection and clinical data analysis. Analyzed safety and efficacy data from Phase II and III clinical trials.
• Used Web services as target to push data to MDM match and merge
• Reviewed administrative and clinical practices and procedures: point of care, scheduling, registration, clinical documentation, patient care, and charge entry, medical coding and diagnostic testing procedures associated wif multiple business units.
• Validated the test data in DB2 tables on Mainframes and on Teradata using SQL queries.
• Develop, build and manage Reporting Services (SSRS) reports using both SSAS cube and relational database sources including distribution of reports using subscription services
• Establish documentation for Agile methodology for implementation wif a very water-fall-centric development team
• Conducted meetings for the Data Modeling and Analysis and Helped wif Data Mapping between the data mart and the Source Systems.
• Worked in ETL process using Informatica for various transactions and loading data from Flat Files and Relational Database Management Systems (RDMS).
• Created/Reviewed data flow diagram to illustrate where data originates and how data flows wifin the Enterprise Data warehouse (EDW).
• Queried several different database types (MSSQL, Oracle, Redis, Postgres) in order to address the different business needs
• Integrate Data from wide range of sources including in-house clinical data management systems, labs and contract research organizations and perform data cleaning.
• Collaborated wif team members to make data platform EDI - HL7 FHIR Standards compatible
• Involved in the formulation of Business Requirements Document (BRD) after all business requirements were defined clearly.
• Used Scrum Work Pro and Microsoft Office software to perform required job functions.
• Used noledge of Health Care Information Systems EMR model to develop proposed workflow in MS Visio.
• Extensive use of Excel to create Functional Specification Documents & Templates
• Created Databases, Tables, Views, and Stored Procedures in Netezza and optimized them.
• Involved in Testing by using SQL and work wif QA together to develop test Scenarios and test cases.
• Analyzed Business Requirements and segregated them into high level and low level Use Cases, Activity Diagrams / State Chart Diagrams using Rational Rose according to UML methodology thus defining the Data Process Models.
• Created customized report using OLAP Tools such as Crystal Reports for business use.
• Collaborated wif the QA team in designing test plans and test cases for the User Acceptance Testing.

Confidential . Cambridge, MA

Business Analyst

Responsibilities

• Extensively involved in every phase of the RUP process starting from Inception to Transition
• Interacted wif users for verifying User Requirements, managing Change Control Process, updating existing Documentation
• Created database using MS Access that allowed the team to capture imperative statistical time data for the R&D business unit.
• Work wif Project Manager and Clinical Team Lead to assist wif general capability and process documentation to support RFP.
• Participated as a core team member of a Clinical Development initiative to create an architectural business end-to-end solution for clinical trials as a standard for all remote data capturing clinical trials.
• Involved in designing and developing Data Models and Data Marts that support the Business Intelligence Data Warehouse.
• Documented existing and proposed process flow, analyzed current and target system, and conducted GAP analysis.
• Analyzed requirements, data mapping documents and executed test for the scheduling system and for ETL (Extract, Transform and Load) data into the PeopleSoft database.
• Involved in requirement gathering and database design and implementation of star-schema, dimensional data warehouse using Erwin.
• Conducted Joint Application Development (JAD) sessions wif IT groups. Identified the Key Changes, and participated in Stakeholder Management to communicate effectively wif them
• Interacted wif database developers for formulating the ER diagrams and data flow diagrams.
• Created the business process model using MS Visio for better understanding of the system and presented it to Project Manager and other team members for validation.
• Created and updated the Data Profile Questionnaire through various phases of the project life cycle.
• Designed and implemented basic SQL queries for QA Testing and Report / Data Validation.
• Apply UML notations and methodology in developing models that accurately represent the business process reengineering and workflows and clearly communicate them to the stakeholders.
• Designed Data Flow Diagrams (DFD’s), Entity Relationship Diagrams (ERD’s), and web page mock ups using modeling tools.
• Used Informatica to extract and transform data from various DB2 database to the data warehouse.
• Conducted User Acceptance Testing, gatheird and documented User Manuals and Business Rules

Confidential, Atlanta, GA

Data Analyst

Responsibilities:

• Defined a complete set of metrics report requirements including a framework that will meet the needs of regional and national business leaders
• Involved in requirement gathering phase (Provider, Claim components and HIPAA)
• Utilized Rational Unified Process (RUP) to configure and develop process, standards and procedures.
• Responsible for working wif the State to review and modify process flows to increase productivity and effectively utilize QNXT features not provided by the legacy systems.
• Involved in designing and developing Data Models and Data Marts that support the Business Intelligence Data Warehous
• Wrote new COBOL programs and converted existing programs to read Oracle tables
• Used SSIS to transform the data and load the data into flat files, Excel, Oracle, Netezza, DB2 and SQL Server Database
• Loading staging tables on Teradata and further loading target tables on SQL server via DTS transformation Package.
• Wrote BRD, FRD, use cases, test scenarios, test cases for testing the functional requirement.
• Implemented automated COB processing of Medicare claims into Facets
• Writing functional and technical specifications, creating source to target mapping, designing data profiling and data validation jobs in DataStage, and creating ETL jobs in DataStage
• Write SQL scripts for adding, changing or deleting various benefit or contract data to or from QNXT that would take several man hours to complete via the front end software.
• Implemented Excel pivot tables for extraction of informative data from these databases using SAS excel plug-ins.
• Followed Unified Modeling Language (UML) methodology using ReqisitePro and Rational Rose to create/maintain: Use Cases, Activity Diagrams, Sequence Diagrams, and Collaboration Diagrams.
• Experience wif Trizetto Facets System implementation, Claims and Benefits configuration set-up testing, Inbound/Outbound Interfaces and Extensions, Load and extraction programs involving HIPPA 837 and proprietary format files and Reports development.
• Assisted Design Team in preparing SRS, Software Design Document (SDD), User Interface Design, Application Architecture & Database Modeling.
• Helped in project testing efforts for doing integration tests, regression tests and user acceptance tests.
• Worked wif QA team and UAT team to go over the various test scenarios for different types of loads in the datamarts.