SUMMARY:

• Proactively communicated and collaborated with the business to analyze information needs and functional requirements and deliver artifacts as needed, such as Business Requirements Documents, Use Cases and UML modeling.
• Use case created and storyboarding to synchronize requirements with the vision plan and to accommodate all the software features
• Worked for operating support group involved in multiple projects for the claims and compliance department.
• Used complex SQL queries, Tableau to perform Data Analysis like Data Profiling, Data Quality checks to maintain the integrity of data.
• Compliance & Contract Management: Manage the Compliance staff and provide compliance expertise to the pharmacy’s core business areas: Accreditation, Quality Assurance, Management and Contracting
• Manage the day - to-day elements of the Compliance Program to help ensure the Pharmacy’s compliance with all applicable laws, regulations, and Pharmacy policies
• Proficient in programming with Base SAS, SAS Graphs, SAS Macros, SAS ODS, SAS SQL, SAS STAT, Proc Gchart, Proc Format, Proc Transpose, Proc Print, Proc SQL, Proc Report, Proc Freq, Proc Means, Proc Univariate. Experienced in producing RTF, HTML and PDF formatted files using SAS/ODS.
• Ad-hoc Programming for Clinical and Data Management Departments and also MATLAB software programming to conduct statistical analysis using t-tests, chi-square tests, ANOVA, correlation, linear regressions and medical imaging analysis.
• Proficient in using SAS/ACCESS SQL pass through facility to write queries for pulling data from oracle and Access databases.
• Excellent experience in generating reports, tables, listings, and graphs according to Statistical Analysis Plan, Standard Operating Procedures (SOPs) and departmental guidelines.
• Clinical research regulatory specific knowledge to maintain SOPs, ICH guidelines, SAE reporting and GCP auditing
• Experienced as statistical computing for MATLAB and SAS in Rutgers University, where I have carried out data analysis project works on health data for periodontitis and rheumatoid arthritis affected population, studied the correlation coefficient between these two diseases. Also, learned writing codes and data lines to process fMRI images using MATLAB.
• Master’s Thesis Project Researched the association between Periodontal disease and Rheumatoid Arthritis by incorporating passive expert system CORVID EXSYS software for clinical decision making and analysis, meant to assist physicians and hospitals with minimizing medical errors.
• Carried out project work successfully in industry sectors hospital businesses (researched and analyzed data on small scale entrepreneurship and rural poverty eradication projects sponsored by University), and hospital/healthcare organizations.
• Proficient with Advanced Microsoft Excel, Microsoft Access, Microsoft Outlook, MS Word, MS PowerPoint.

PROFESSIONAL EXPERIENCE:

Confidential,Edison, NJ

Healthcare Business &Data Analyst

• Elicited requirements using JAD sessions, interviews, document analysis, requirements workshops, surveys, site visits, business process descriptions, use cases, scenarios, business analysis
• Extensive experience with claim transactions such as 834 (Benefit and Enrollment), 835 (Billing Pay and Remittance), 837 (Submit Medical Claims), TriZetto’s Facets.
• Well versed with various types of health insurance programs such as: Medicaid, Medicare (Part A, B, C and D), PPO, HMO, and POS.
• Well versed in Health Insurance Portability and Accountability (HIPAA) standards to fetch big data, Electronic Data Interchange (EDI), HL7, TriZetto’s FACETS, EHR ICD-9 to ICD-10 transfer coding, CPT, HCPCS, LO INC, SNOMED, NCPDP 4.2, Medicare, Medicaid Insurance and HIPAA, 4010-5010 coding.
• Strong understanding of Data warehouse concepts, ETL, Star Schema, Snowflake, data modeling experience using Normalization, Business Process Analysis, Dimensional Data modeling, FACT and dimensions tables, physical and logical data modeling.
• Experienced in developing rich Interactive reports and dashboards integrating various reporting components from multiple sources and proficient in Tableau 10.x/9.x
• Extensive experience in Data Analysis using complex SQL queries, ETL, XML, Data Profiling, Data Quality, Data Validation, Enterprise Data Warehousing, Data Mart and Reporting
• Expertise in broad range of technologies such as Microsoft Project, MS Access, MS Visio, technical assessment tools, Data Warehousing concepts, web design and development.
• Expertise in using AGILE Scrum programming for creating User stories, epic, use cases, story writing, version control, and defect tracking, monitoring and all areas of the software development life cycle (SDLC).

Confidential,Newark, NJ

Compliance Analyst Assistant

• Manage credentialing for the pharmacy and handling application and audit process for accrediting bodies such as URAC, VIPPS, ACHC and The Joint Commission for retail, specialty and DME departments of the pharmacy.
• Carried out patient data mapping from PrimeRx tool to pharmacy data warehouse tool.
• Data analysis by analyzing the specification required for the Prime Rx.
• Data Governance to provide limited accessibility to pharmacy technicians, pharmacists, nurses and other customer service staffs.
• Generated daily reports for the patients prescribed specialty pharmacy drugs and delivery reports.
• Monitor changes in laws, regulations and examination trends through external regulatory services and distribute related information in a timely manner to applicable areas of the pharmacy.
• Work with the operation areas to ensure regulatory changes are implemented, policies and procedures are created or updated, and training is developed and delivered within required timeframes.
• Respond to inquiries and research questions as needed
• Perform or oversee compliance self-monitoring including sub-testing where necessary and escalate exceptions as appropriate.
• Assist in compiling reporting to the Board of Directors, sub-committees thereof, and management committees as required.
• Manage pharmacy and staff licenses and handle out-of-state (non-resident) pharmacy licenses and it’s requirements

Confidential,Princeton, NJ

Clinical SAS Analyst Intern

• Ensure high quality of encounter data by identifying, analyzing and resolving problems.
• Effectively communicate data issues to all relevant stakeholders, using SAS and SQL to clean, manipulate and organize large volumes of data into user-friendly reports.
• Developed SAS Macro programs to create ad-hoc reports
• Data Reporting for any issues and provided suggestions.
• Reduced the unit's weekly report generation time exponentially by writing a program in SAS to automate the data visualization process.
• Accumulated business requirements from various business users and translated them into business requirements document.
• Documented all the discussions, stored the requirements and tracked the changes maintaining the versions of document.
• Assisted in UAT to ensure all applications were tested for functionality and were adequately accepted by user community
• Managing the system and addressing day to day user queries