SUMMARY:

• Highly qualified, results - driven IT professional with extensive analytic and programming background.
• Proven expertise within the Health Care and Financial Services industries.
• Able to perform system conversions, analysis, methodology development, and management.
• Creative and critical thinker with strong problem-solving skills.
• Capable of working under challenging circumstances and/or changing priorities.
• Superior interpersonal and communication skills.
• Ability to work on multiple projects simultaneously and under deadline.

TECHNICAL SKILLS:

PC Software: - MS Windows, SAS 9.3 and SAS Enterprise Guide 5.1, MS Excel, Word, Visio, Project, and Office Professional tools, Photoshop, Acrobat, Quest Central DB2 access and reporting tool.

Mainframe: - SAS-base, SAS-Procedures, SAS-Procedure SQL, SAS-Macros, DB2, SQL, COBOL I-II, OS/MVS JCL, TSO/ISPF, ENDEAVOR, CHANGEMAN, FTP, NDM, PANVALET, COMPAREX, FILEAID, STARTOOL

PROFESSIONAL EXPERIENCE:

Confidential

Finance Data Team / Healthcare Analyst

Responsibilities:

• Pharmacy Shared Risk: Developed the Provider and Member level HEPC Drug Pharmacy Shared Risk Monthly Adjustments models (EG V5.1) for the Medicaid, HARP, and Essential plan products. These adjustments are used by other Finance team members to Risk Adjust the costs of HEPC drug prescriptions within participating risk sharing hospitals in the HF network. By sharing the HEPC costs as adjusted by the model, hospitals with high costs get additional excess medical revenue based on the ratios of HEPC drug costs to revenue by hospital.
• Member Months: Generated the Member Months on demand model (EG V5.1) to be run weekly. This model collects HF member data from the HF DWH and creates up to date member, hospital and physician relationship tables for use by the Finance, Enrollment, and HF Product / Network support teams. This process is run weekly in order to stay up to date with weekly updates that are entered into the warehouse tables. Reports sent to the Enrollment team are used to correct errors (overlapping dates or gaps) found in the DWH tables.
• Lags on Demand: Produced the Claims Detail Lags on demand model (EG V5.1) run on a weekly basis. EG project utilizes SAS code, DWH tables for lookups and data pulled from claims detail (Month of Service date vs Month of Payment date), and an excel spreadsheet to define the input and output parameters needed each week. The SAS Enterprise Guide (EG) project reads in the fields for input and summarization, which product tables to use, and where to output the summary excel files for Finance Team use. These excel files are then used for verification and reporting of costs and provider services utilization within Finance by analysts using pivot tables and other external reporting methods.
• Member Risk Modeling: Assisted with the development, testing, and monthly execution of the HF CMS - HCC Risk Adjustment on demand model (EG V5.1 and SAS 9.3). This is an ongoing development project that utilizes the CMS-HCC Risk Adjustment SAS programs and macros to create HCC score variables from diagnoses recorded in claims, using coefficients from the Community, Institutional, and New Enrollee regression models. The process consists of three main program and data sources: Member data repository (Member level Demographic, Enrollment, and diagnostic summary information), Execution of the models using the HF Repository data, and the blending of the models with output reports and executive summaries.
• Ad-hoc data pulls, analyst summaries, individual and group SAS and project assistance, and conversion of SAS 9.3 Source code to EG 5.1 projects utilizing prompts for macro variables instead of hard coded values as needed.

Confidential

Sr. Programmer

Responsibilities:

• Reviewed inefficient existing SAS programs in the production environment. Teamed with DB2 DBA s to Update 100+ programs consolidating DB query selection criteria for efficient utilization of existing database indexes. Significant reductions in CPU usage and elapsed run time were universally experienced.
• Batch Maintenance: Responsible for maintenance of existing production batch JCL streams, procedures, and SAS programs to conform to, current business requirements. The batch processes maintained access SAS and DB2 tables currently containing more than 800 million claim records as well as SAS and DB2 tables containing supplemental information needed for reporting and analysis.
• New Development: Coordinated all phases of SDLC in the creation of new production jobs and programs according to written specification given by assigned project managers and business analysts. New jobs are developed, tested, and reviewed by business analysts and clients, and approved electronically before integration into the production environment is initiated.
• AR Contracts Migration Project: Migrated the current 350+ Contract specific SAS AR Libraries into normalized DB2 tables in a Server environment. Mainframe batch elements were added, modified, and released on a predefined schedule in order to provide continual access to the data and production reports.
• ICD10 Development and Remediation Project: Analyzed and modified existing SAS programs in order to conform to the new requirements of ICD10 claim record keeping. Responsible for unit and system testing, and staging elements for implementation in 2015.
• Handled all aspects of ad - hoc reporting, maintenance of claim level data, and associated tables across a single, multiple, or full range of existing contracts. Managed 24/7 coverage, remediation, and resolution of any SAS production issues that arose during my allotted one week per month support schedule.

Confidential

Lead Programmer

Responsibilities:

• Commission System Updates: Developed new batch streams for existing payroll cycles that allowed users to test, confirm and update via online screens, and initiate re - testing cycles to confirm payroll payments for 8K+ financial advisors. Initiated updates necessary for numerous new adjustment types and earnings codes added to all post-closing batch processing cycles. Oversaw unit/system testing of all team batch cycles, including DB2 table loads, and job overrides with updated system components.
• Commission System Rewrite Project: Managed DB conversion tasks from legacy M204/Cobol commission batch system, to a new rules-based Web On-line/Cobol/DB2 batch system. Decommissioned legacy commission system. Utilized SAS batch processes to complete Book Analysis data streams for downstream users (Compensation, Order and Trade level detail files). Created processes for 100+ outbound files to downstream users from new commission system files in legacy commission system format.
• New Financial Advisor Net New Accounts Compensation Project: Designed, tested, and implemented new SAS Database process for the commission system to provide reports and compensation adjustments for 800+ new financial advisors in their first 5 years of service based on gross production levels and assets in net new specified accounts.
• Broker Report Card Project: Designed and developed a rolling three-year SAS historical DB system with more than 1,500 data items for each FA in UBS, monthly updates reported statistics for more than 8K brokers at the broker, branch and regional manager levels, with annual automatic system updates.