SUMMARY:

• 7 years of Industry experience as Business/Data Analyst with Master Data Management (MDM) solid experience in Information Technology with expertise in data warehouse design, development, implementation and maintenance.
• Good Knowledge of HIPAA Compliance Lifecycle, HIPAA Insurance Regulations and Claims Processing.
• Understanding the full healthcare lifecycle including all payers and end to end revenue flow within the industry
• Strong knowledge of metadata organization,datacleansing,dataprofiling, anddatamodeling techniques including Star Schema and Snowflake Schema.
• 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.
• Extensive experience with the SAS programming and in data step and with various SAS Procedures in Base SAS and SAS/Stat, including thorough knowledge of SAS Macro.
• Experience with Tableau for Data Acquisition and data visualizations.
• Extensively tested severalCognosreports fordataquality,datavalues, functionality, calculations, fonts, headers & cosmetic.
• Extensive experience with Medicare/Medicaid processing as well as the Claims/Billing.
• Experience in Microstrategy and Microsoft Business Intelligence (BI) platforms including SQL Server Reporting Services (SSRS), SQL Server Integration Services (SSIS) and SQL Server Analysis Services (SSAS)
• 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 knowledge 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
• Supported the end to end implementation of QlikMart,QlikViewForecasting tool and Qlik Dashboards
• Extensive experience in Strategi c development of a Data Warehouse andin 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.
• Well versed with 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
• Have 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 experience in Java, Python, RDBMS, PL/SQL, TOAD, Oracle EBS Apps Technical, ETL (SQL Loader), Workflow Builder, BI Publisher, Tableau, DENODO - Data Virtualization..
• 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.
• 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 with 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 with the medical claims and ICD9 (HEALTH EVENTS) code that was feed to the PHR (PERSONAL HEALTH REOCRD) application
• Performed manual andautomatedtestingon web based, Client/Server anddatawarehousing applications
• 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.Business/Data Analyst

Responsibilities:

• Lead multiple project teams of technical professionals through all phases of the SDLC using technologies including Oracle, Erwin, DataStage, Data Warehousing, Websphere and Cognos.
• Lead Business Intelligence reports development efforts by working closely with Microstrategy, Teradata, and ETL team
• Designed, built and implementedrelationaldatabasesusing MS Access.
• Responsible for evaluating, configuring and testing healthcare claims payer system
• 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 knowledge sharing sessions on Business Process Modeling Notation and Healthcare Payer business for team members.
• Implemented Excel pivot tables for extraction of informative data from these databases using SAS excel plug-ins.
• Coordinate with thedataconversionteam, Trading partners, SME during the development, test, and reconciliation process and post implementation QNXT and legacy systemsdatato ensure accuracy and consistency.
• Patented the design of a diabetes risk score algorithm and interactive patient lifelinedatavisualization
• Designed Physical Data Model (PDM) using IBM Info sphere Data Architect data modeling tool and ORACLE PL/SQL.
• Created action filters, parameters and calculated sets for preparing dashboards and worksheets in Tableau.
• 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.
• Extracted data from various sources (SQL Server, Oracle, text files and excel sheets), used ETL load scripts to manipulate, concatenate and clean source data.
• Worked on EDI transaction 835 and 837 to identify key data set elements for designated record set. Interacted with Claims, Payments and Enrollment hence analyzing and documenting related business processes
• 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.
• Involved in requirement gathering phase (Provider, Claim components and HIPAA)
• Explore newdatasources and createdatadocumentations likeDataDictionary,DataProfile, Entity- RelationshipDiagram,DataFlowDiagram, etc.
• Use Birst's readydatastore sits on top of alldataand combines different sources of corporatedata.
• Loading staging tables on Teradata and further loading target tables on SQL server via DTS transformation Package.
• Created Stored Procedures, Views usingDB2database.
• 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 with the users and logged any defects, enhancements from the UAT and communicated them to the development team.
• Extracted large data sets on sales and performed complex manipulations using R/Python
• 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 with ODS and OLAP system.
• Writing Test plans as per the Business Requirements and performing Manual andAutomatedtestingof many modules
• 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.
• Conducted User Acceptance Testing, gatheird and documented User Manuals and Business Rules

Confidential Houston, TX

Sr. Business/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
• 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
• Coordinate and facilitatedatascrubbing anddataconversionfrom existing system to replacement system.
• 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 with multiple business units.
• Created Dashboard usingQlikViewand written complex queries in SQL server database.
• Presentingdatain charts, graphs and tables as well as designing and developingrelationaldatabasesfor collectingdata
• Involved in mentoring specific projects in application of the new SDLC based on the Agile Unified Process,
• Involved in backend manual,automatedtestingat different stages of the project.
• Datacleaning,datavisualization, detection of missingdataand skewness, correlation analysis using heat maps, principal component analysis and model development were performed on thedata
• Report Automation using Tableau dashboards and power BI.
• Creating Databases, Tables, Stored Procedures,DDL/DML Triggers, Views, User defineddatatypes and Indexes
• Used Date functions, String functions, Database functions to manipulate and format sourcedataas a part ofDatacleansingandDataprofiling process.
• 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 with a very water-fall-centric development team
• Wrote new COBOL programs and converted existing programs to read Oracle tables
• Create, develop and test customQlikSense apps
• Conducted meetings for the Data Modeling and Analysis and Helped with Data Mapping between the data mart and the Source Systems.
• Validated the test data in DB2 tables on Mainframes and on Teradata using SQL queries.
• Analyzedatastructures design,relationaldatabasedesign, anddatamodeling to perform enhancements and maintenance.
• Created/Reviewed data flow diagram to illustrate where data originates and how data flows within the Enterprise Data warehouse (EDW).
• Collaborated with 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.
• Designed and implemented basic SQL queries for QA Testing and Report / Data Validation.
• Used Scrum Work Pro and Microsoft Office software to perform required job functions.
• Used knowledge 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 with 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 with the QA team in designing test plans and test cases for the User Acceptance Testing.

Confidential, Atlanta, GA

Business 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
• Utilized Rational Unified Process (RUP) to configure and develop process, standards and procedures.
• Responsible for working with 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
• Created and Designed logical database schema for data warehouse (Teradata) environment to prepare for ETL
• Created a test plan and a test suite to validate the data extraction, data transformation and data load and used SQL and Microsoft Excel..
• Implemented automated COB processing of Medicare claims into Facets
• Used advanced Microsoft Excel to create pivot tables, used VLOOKUP and tableau fordata visualization
• 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 ma hours to complete via the front end software.
• Followed Unified Modeling Language (UML) methodology using ReqisitePro and Rational Rose to create/maintain: Use Cases, Activity Diagrams, Sequence Diagrams, and Collaboration Diagrams.
• Experience with 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 with QA team and UAT team to go over the various test scenarios for different types of loads in the datamarts.