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Risk Adjustment Data Analyst Resume

Boston, MA

SUMMARY:

Experienced IT professional with a history of success in design, development, enhancement and technical support of business client/server and web - based applications throughout the full SDLC. Curious, creative, and eager to adapt to new software environments.

CORE COMPETENCIES:

Operating Systems: Windows, UNIX, Mac OS X

Languages: Unix shell scripting, Windows PowerShell, T-SQL, PL/SQL, HTML, CSS, XML, C#, Progress 4GL, Visual Basic

Databases: MS SQL Server, Oracle, MySQL, Progress, Sybase

Software: Alteryx, Tableau, SSIS, SSMS, PL/SQL Developer, TOAD, PeopleSoft, MySQL Workbench, ASP .NET, VMware, JIRA, Remedy, Excel, Microstrategy, ReportNet, Oracle Reports.

PROFESSIONAL EXPERIENCE:

Confidential, Boston, MA

Risk Adjustment Data Analyst

Responsibilities:

  • Monitor ongoing encounter data submissions and corresponding federal government agency responses files to identify and address file level discrepancies
  • Perform routine data reconciliations to ensure data submission integrity
  • Review monthly error reports, perform trend analysis, investigate critical errors and work the appropriate business areas to resolve issues
  • Assist with implementation of vendor programs regarding data file transfers, including reviewing internally received files for completeness reasonability and accuracy
  • Provide general data management and analytics to support ongoing and upcoming risk adjustment initiatives.
  • Managed software installation and upgrade of proprietary deal management software for customers
  • Managed backup and recovery SQL Server 2005, 2008R2 & 2012 database
  • Analyzed and resolved customer business issues ranging from back-end related issues, hardware environment, configuration, and core software, to resource issues.

Confidential, West Bridgewater, MA

Database Administrator

Responsibilities:

  • Database administration inclusive medical claims and membership data import to enhance the development and analysis of healthcare cost data.
  • Operational support to Managed Care Department ETL processes including data analysis using SQL

Confidential, MA

Math Teacher

Responsibilities:

  • Provided private tutoring for middle school children, utilizing strong communication skills and knowledge of diverse learning styles to effectively convey key concepts and inspire an ongoing love of learning.
  • Prepared math lesson plans and delivered lectures for advanced after-school enrichment program, tailoring instruction to meet the needs of gifted learners.

Confidential, Wellesley, MA

Programmer Analyst

Responsibilities:

  • Developed SQL queries in PeopleSoft Campus Solution database (MS-SQL Server) for ad-hoc data analysis.
  • Produced and analyzed Excel reports to track DOL and comparison groups students.

Confidential, Southborough, MA

QA Analyst/contractor

Responsibilities:

  • Designed and managed data migration process from existing database to mySQL
  • Performed testing of data, data migration audit, reconciliation and exception reporting.

Confidential, Waltham, MA

Senior Technical Support Engineer

Responsibilities:

  • Managed Tier-2 technical support to general users and technology subscription customers.
  • Assisted with troubleshooting incidents, finding solutions or workarounds on functions and usage of Empirica Trace.
  • Collaborated with customers interested in creating custom SQL queries as well as QA activity to ensure optimized and timely solutions in adherence with regulatory requirements.
  • Documented enhancements, defects, and issue resolutions in Remedy tracking tool, demonstrating excellent attention to detail.
  • Monitored the quality of resolution and satisfaction level of PF customers using development and management tool Jira.
  • Presented findings to key staff members to improve overall level of customer service.

Confidential, Waltham, MA

Senior Programmer Analyst

Responsibilities:

  • Subject matter expert and report developer on Facility Contract, claims modeling and design.
  • Developed and maintained automated Unix scripts to integrate Facility Contract data into vendor applications in accordance with HIPAA regulations.
  • Developed Progress interfaces for third party Sybase application.
  • Claims Data Warehouse (CDW) - created interfaces using Pervasive to the UB92 claims.

Confidential

Database developer

Responsibilities:

  • Designed, developed and supported business reports using Cognos Impromptu, Cognos Powerplay, Cognos ReportNet for Lottery Management System.
  • Created various reports and screen forms to handle agent accounting, cash management and draw processing.

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