SUMMARY:

• A highly skilled analytics professional with over 10 years of experience in the Confidential and pharmaceutical areas who has an emphasis on machine learning, biostatistics, health care data analysis, and statistical inference and is currently finishing up an online Data Science 9 - course certification program from John Hopkins School of Public Health which will be completed by April 2017.
• Excellent understanding of business requirements and gathering in a Confidential and analytics IT environment for data mangling and trained data set creation
• Plan, design, and implement data analysis study needs, reporting, analytics, and dashboard reporting for internal and external clients
• Programming: SQL, t-SQL, SAS, R programming language
• Analysis: Claims data analysis, program product research studies, population analysis, pricing and prevalence analysis, study validation (ie. chi-square, t-tests), and study correlation (ie. Odds ratio), marketing research, ANOVA, survey and sampling techniques, correlation, regression analysis, and statistical inference.
• Statistical programming: Machine learning, predictive modeling, logistic regression, decision trees
• Data: Medical, Pharmacy, and Lab claims from various sources and vendors, Gene Array Data, Program Outcomes Data, Survey Data, HEDIS data, Medicare data, Commercial data, Hospital utilization data, Marketing Data, Research data

PROFESSIONAL EXPERIENCE:

Confidential, San Diego, CA

Senior Data Analyst / Lead Tableau Developer

Responsibilities:

• Developed complex algorithms and advanced (undocumented) tableau visualization techniques that were successfully integrated into Tableau dashboard models.
• Created repeated processes for data mangling needs
• Assisted in support of tableau server testing and deployment for external client support on successful Tableau server installation.
• Streamlined SAS code to efficiently calculate case mix adjustment rates for Commercial and Medicare populations using SAS macros.
• Converted SAS code to automated SQL stored procedures to run automated process on dataset development and refresh process for tableau models.
• Enforced technical best practices and development workflow for the creation of tableau models.

Environment: Tableau 9.3, Tableau Server, SQL Server, SAS, Excel, Access

Confidential, Honolulu, HI

Analyst Lead for Business Intelligence and Analytics / Project Manager

Responsibilities:

• Built relationships across several departments while acting as the project coordinator / project manager for BHI (Business Health Intelligence) Big Data Extract project, an extract for the Confidential data warehouse used for analytics and big data across 29 plans in the US.
• Developed standardized program evaluation methodology for Confidential weight loss study.
• Developed analytical strategy for evaluating medicare stars results on yearly basis.
• Developed business and design requirements for implementation of technical deliverables while working in an Agile environment.
• Created the provider metric project using provider data and other correlative data in the enterprise.
• Developed provider data model for ODS data initiative and mapping of provider data for all source systems within the enterprise.

Environment: Microstrategy, SQL Server, SAS, Excel, Access, Informatica

Confidential, Honolulu, HI

Business Analyst

Responsibilities:

• Developed ad-hoc analysis and reports for QI group, clinicians, and CMO group based on HEDIS measurements, population data, program data, and benchmark data.
• Developed a population retrospective analysis and statistical inference report on the AMM program, an external paper and presentation which showed all of the successful correlative factors for the antidepressant medication management HEDIS rate.
• Developed reconciliation workflow process and quarterly reporting of FUH database
• Developed business requirements for new reports through collaborative requirements gathering process with clinicians and IT.
• Performed quality analysis of IT databases and various internal and external data sources.
• Developed the yearly trend analysis of CCS and Confidential Quest SMI and Confidential Commercial lines of businesses
• Developed correlation and predictive analysis for population utilization trends and program factors

Environment: SQL Server, Excel, Access

Confidential, Rancho Cordova, CA

Senior Research Analyst

Responsibilities:

• Developed the first dashboard for tracking quality assurance and data management of external and internal lab, vendor, and claims files
• Developed prevalence report of current data to project future HEDIS rates
• Developed business analysis documentation for data and reporting implementations
• Managed Arizona line of business by overseeing overall file management, handle etl processes and file conversions in SQL Server SSIS and SAS, produce ad-hoc reports to support production of rates, perform quantitative and qualitative analysis of final HEDIS rates, and manage overall maintenance and production run of Quality Spectrum software for the Arizona region.
• Developed reports, data and business analysis, and tools to analyze workflow processes, HEDIS rates, STARS measures, and provider profiling.
• Participated and performed audit of policies, procedures, data sources, and maintenance of all PHI data sources. Identified gaps in workflows and consult on making the overall HEDIS processes more efficient leading to changes in quality assurance, database utilization, and other processes.

Environment: SQL Server, Oracle, SAS, Excel, Quality Spectrum 13 and 14

Confidential, South San Francisco, CA

Confidential Analyst

Responsibilities:

• Main lead on pricing analysis for new potential clients and streamlined report process from two weeks to one week and enhanced financial reports to provide finance more information to make critical business decisions while using SAS programs to validate financial results.
• Developed, tested, and coded contract monitoring project (analysis which monitors clients clinically, operationally, and financially) and automate reports in dynamic sql to apply to all customer book of business to help client managers address relevant issues.
• Developed first claims utilization reports per product to analyze inpatient, er, office visits, AHRQ, and other utilization stats and claims data fields to show yearly financial and PMPM trends to help understand the various product lines.
• Developed best practices document to enhance sql coding and define system definitions (ie. PMPM definitions) resulting in efficient coding practices and accurate sql programming across the team.
• Used multiple data sources to help address business problems and SAS statistics to validate study design and test results resulting in robust analysis and statistically enhanced reporting.
• Identified data and system issues within analytics, Confidential economics methodologies (DMAA standards), and claims processing to help improve analysis and reporting of data leading to company savings by properly reporting client measures to meet contract guarantees.
• Developed standard code to identify participants who partake in fda alerts across book of business resulting in one day turnaround time in identifying patients.
• Identified, investigated errors, and ran correlation analysis for metrics project, a company-wide project to streamline reporting definitions.

Environment: SQL Server, SAS, Ingenix, Excel

Confidential, South San Francisco, CA

Program Analyst

Responsibilities:

• Provided business analysis for new metabolic syndrome and cancer programs by authoring business specs for IT implementation resulting in first Lifemasters product claims spec and proper guidance to implementation and claims team.
• Developed and implemented operational waterfall data for the new product implementations (cancer and metabolic syndrome) to help track and analyze new product lines on a week to week basis which provided guidance to nursing staff in dealing with patients effectively.
• Developed product control charts and dashboard to determine target operational values needed to reach PMPM savings per metric categories.
• Provided a bridge for marketing group to understand system data and IT business processes
• Identified and investigated business and data gaps in system by providing ad-hoc analysis from claims, COREdb program data, and reporting servers

Environment: SQL Server, ProClarity, SAS, Excel

Confidential, South San Francisco, CA

Lead Claims Analyst

Responsibilities:

• Streamlined and improved claims loading and implementation process by enhancing and authoring queries and stored procedures in SQL Server to support the loading, analysis, and QA of all incoming claims, pharmacy, provider, member, and lab data.
• Reviewed, tested, and ran risking and stratification disease runs for all new client implementations to assure proper identification and loading of participants into system.
• Primary lead on implementations by working with a cross-functional group to implement new clients into the system.

Environment: SQL Server, SAS, Excel