SUMMARY

• Accomplished Sr. Data Analyst with extensive experience in healthcare and financial sectors
• Expert in advanced SQL query development techniques, optimizing the Health Rules Payor claims processing system for enhanced performance and reliability.
• Skilled in implementing data analysis tools and methodologies to improve KPI tracking capabilities and facilitate efficient monitoring of key performance indicators.
• Adept at collaborating with cross - functional teams to gather requirements, assess data needs, and develop tailored solutions for various business challenges.
• Proficient in Agile and Kanban methodologies for effective project management, fostering a responsive and adaptive approach to changing project requirements.
• Experienced in leading data analysis initiatives using various analytical methods, providing comprehensive insights to support data-driven decision-making.
• Well-versed in developing and implementing data conversion and migration processes, ensuring seamless transitions between systems and maintaining data quality.
• Diligent in conducting thorough testing and QA checks to confirm data accuracy and integrity, adhering to relevant regulations and standards.
• Proficient in executing User Acceptance Testing (UAT) and Unit Testing (UT) to validate system functionality and ensure alignment with end-user requirements.
• Detail-oriented in documenting data migration processes, mappings, transformations, and validation procedures, facilitating knowledge transfer and best practices.
• Proactive problem-solver with a strong commitment to resolving data integration issues and delivering high-quality solutions.
• Proficient in utilizing cutting-edge technology, such as Python, Oracle 12c, and IBM Sailfish, to streamline data processing and analysis tasks.
• Demonstrated expertise in product management, including product vision, roadmap development, and feature prioritization, aligning with organizational goals and customer needs.
• Strong ability to communicate and collaborate with stakeholders, capturing feedback and translating it into actionable product improvements and enhancements.

TECHNICAL SKILLS

Data Analysis and Reconciliation: Financial data, healthcare claims, premiums, KPI tracking

Big Data Ecosystem: Spark/Scala, Impala, IBM Netezza

Programming Languages: Python (Pandas, Numpy), R, PL/SQL

Databases: Oracle (10g, 12c), SQL Server (2008 R2, 2014), DB2

Data Visualization and Reporting: Tableau, Microsoft Power BI, Crystal Reports, Business Objects XI

ETL and Data Integration: Microsoft SSIS, ADO .NET

Healthcare IT Systems: FACETS, QNXT, EAM, Health Rules Payor, Connecture

Cloud Technologies: Google Cloud Platform Software Development Life Cycle (SDLC), Agile and Project Management

PROFESSIONAL EXPERIENCE

Confidential

Sr. Analyst

Responsibilities:

• Reconciled data from the general ledger (GL) with bank accounts on a monthly basis, ensuring accurate and consistent financial records were maintained, which contributed to the overall efficiency and accuracy of the finance department's reporting.
• Utilized Python, specifically the pandas library, for ETL (Extract, Transform, Load) processes to handle and process various file types (e.g., 820, 8200, 8206) relating to the state of Massachusetts.
• This allowed for streamlined data management and improved processing times for essential financial data.
• Conducted in-depth data analysis to verify the receipt of premiums for individual members, cross-referencing multiple sources to ensure complete and accurate payments.
• This attention to detail helped reduce discrepancies and potential financial risks.
• Employed advanced data analytics techniques to identify trends, patterns, and anomalies in financial data, providing valuable insights to facilitate informed decision-making for senior management and stakeholders.
• Prepared and generated comprehensive monthly accounting reports, highlighting key financial information, performance indicators, and trends.
• This allowed for timely identification of potential issues and opportunities, ensuring a proactive approach to financial management.
• Utilized Python and relevant libraries, such as pandas and matplotlib, for efficient data manipulation, analysis, and visualization.
• This facilitated effective communication of complex financial information to both technical and non-technical stakeholders.
• Worked within Agile and Kanban project management methodologies, ensuring adaptability and responsiveness to changing project requirements, while maintaining a focus on delivering value to the organization.
• Performed data profiling and data quality assessments on various financial datasets, identifying inconsistencies, inaccuracies, and redundancies.
• This allowed for the implementation of data quality improvement measures, resulting in more reliable and accurate financial data for analysis.
• Employed various methods of analysis, including descriptive, diagnostic, predictive, and prescriptive techniques, to provide comprehensive insights into financial data, supporting data-driven decision-making and fostering a culture of continuous improvement.
• Collaborated with the corporate accounting team to maintain data integrity, accuracy, and regulatory compliance.
• Implemented data validation techniques to ensure the precision and comprehensiveness of financial transactions, accompanied by proper documentation.
• Served as a liaison between the accounting department, GL teams, and bank representatives, resolving discrepancies promptly.
• Maintained a strong focus on data quality, ensuring consistency, accuracy, and adherence to established standards and protocols.

Confidential

Sr. Data Analyst

Responsibilities:

• Developed complex SQL queries and created comprehensive documentation for the Health Rules Payor claims processing system, significantly enhancing KPI tracking capabilities and enabling efficient monitoring of system performance.
• Utilized Oracle 12c for extracting and analyzing outbound data, supporting Mede Analytics' performance management initiatives by generating actionable insights and facilitating data-driven decision-making in alignment with organizational goals.
• Created outbound data feeds for Milliman, facilitating effective utilization and expense management through grouper identification and tracking, leading to improved financial control and resource allocation.
• Spearheaded a critical data migration project from Oracle to IBM Sailfish, guaranteeing seamless transitions and system compatibility, while minimizing disruption to business operations.
• Implemented data conversion processes and best practices, ensuring accurate and smooth data transfer between Oracle and IBM Sailfish, maintaining data quality and consistency throughout the migration process.
• Collaborated with cross-functional teams, including business analysts, developers, and stakeholders, for requirements gathering, data needs assessment, and solution development, fostering a collaborative and inclusive project environment.
• Employed Agile and Kanban methodologies in project management, providing a flexible and iterative approach to project execution, allowing for rapid adjustments to changing requirements while maintaining focus on delivering value.
• Led a team of data analysts, utilizing various methods of analysis, such as descriptive, diagnostic, predictive, and prescriptive techniques, to provide comprehensive insights into financial data and inform the planning and initiation of new projects.
• Performed thorough testing and QA checks to confirm the accuracy and integrity of migrated data, ensuring data quality and compliance with relevant regulations and standards.
• Documented data migration processes, including mappings, transformations, and validation procedures, for proper knowledge transfer, enabling future migrations to benefit from lessons learned and best practices.
• Proactively resolved data integration issues, guaranteeing successful data migration and conversion project implementations, while demonstrating strong problem-solving skills and a commitment to delivering high-quality solutions.
• Developed and maintained a comprehensive Business Glossary, integrating terms and definitions from diverse lines of business, ensuring seamless collaboration and enhanced data governance.
• Contributed to the creation of Business Case Documents for Collibra Catalog (Data Dictionary) functionality by working on use cases finalized by Collibra Architect and Business Owners, defining domains in accordance with the data model, and establishing relationships between Collibra's out-of-the-box assets and new assets to enable data lineage and traceability for all reports in scope for specific lines of business.
• Demonstrated proficiency in Health Rules Payor, Oracle 12c, and SAS

Confidential

Data Analyst/Technical Product Specialist

Responsibilities:

• Created PL/SQL stored procedures in DB2 for code enhancement and optimization in HEDIS/CAP4P/P4P projects.
• Performed analysis and implemented necessary changes to optimize code.
• Worked on Perfect Service Dashboard (PSD) project, reconciling file transfers and automating alerting for transfer failures using Emdeon and Net Cool.
• Developed and maintained Appeals and Grievances module in FACETS to resolve healthcare member concerns and complaints.
• Engaged with stakeholders to gather requirements, implement code changes, and enhance C# .NET, Tableau, and Crystal Reports technologies in applications.
• Developed data marts and reports for CMS reporting requirements, including Medicare Part C and Part D, using Oracle and Tableau.
• Created complex inbound and outbound data interfaces, integrating vendor systems with multiple source systems using Oracle and .NET.
• Assisted in legacy system migration to FACETS for large group implementation, managing data extraction and loading workflows.
• Developed operational and finance reports using Crystal Reports, Tableau, and Oracle for process improvement and strategic decision-making.
• Worked on commission, billing, and enrollment modules for CNX (Connecture) application, creating custom batches for enrollment and maintaining system requirement documents.
• Implemented workflows and listeners in Microsoft C# .NET to receive and consume data via FTP servers for inbound provider projects.
• Designed and developed custom financial reports using Microsoft Power Pivot and Power BI for data-driven decision-making.
• Analyzed, designed, and developed data mart for care coordination reporting based on New Mexico HSD requirements using SSIS and SSMS.
• Developed operational reports for turnaround time and authorizations using Microsoft Power BI and SSIS.
• Contributed to big data platform implementation, migrating data from legacy technologies to Apache Hive and designing data cubes for analytics upgrade using Spark/Scala.
• Utilized R programming and Microsoft Power BI to create a statistical model for identifying high-risk pregnant women in healthcare.
• Automated reinsurance processes for actuarial team using ADO .NET and C# .NET.

Environment: Oracle 10g, SQL Server 2008 R2, SQL Server 2014, DB2, IBM Netezza, R Programming, Python, Pandas, Numpy, Tableau, Microsoft SSIS, Microsoft SSAS, Crystal Reports 2008, Business Objects XI, Microsoft Power BI, Impala, FACETS, QNXT, EAM, etc.