| | | 20,000+ Fresh Resumes Monthly | |
|
|
| |
Click here or scroll down to respond to this candidate Candidate's Name
EMAIL AVAILABLE| Austin, TX |PHONE NUMBER AVAILABLE
https://LINKEDIN LINK AVAILABLE
Professional Summary
Dynamic and results-oriented Business Systems Analyst/Product Owner with over a decade of
experience in IT. I have successfully navigated the project lifecycle from initiation (AHA) through
implementation for over 15 Fortune 500 companies. My expertise lies in managing complex data
Acquisition,integrations and migrations/consumption within data engineering, specializing in
architecture modeling, data profiling, ingestion, and quality management. I excel in balancing
financial acumen with a client-centric and data-driven approach to visualization. Proficient in SQL,
API integrations, and leading hybrid teams through project execution and delivery. As a certified
Agile practitioner, I leverage reusable solutions and frameworks to drive innovation and consistently
deliver exceptional results in dynamic environments.
Expertise & Skills
Data Integration & Visualization Project Management & RFP
Data Migration to Cloud Consultation
Application Analysis/Development Design Data Warehouse Solutions
Data Governance & IAM Security Healthcare Implementation
Key Achievements
Product Development :
o Key contributor in Product Quality of a Geneia(Startup,subsidiary) by Capital
bluecross to migrate of API product(Employer/Broker/Payor/Provider/Member) on
AWS cloud later on public Salesforce HealthCloud
o Point32health HRP Changes Migration(Member & provider) & Configuration , various
Vendor Integration on Provider Search & Complex Care Management,PBM
Accumulator
o UHC : Finance reconciliation of Merger Ingenix , Web rebranding, UDW Financial
/CDO integration Support (5+ source),CCARE
Enterprise IT Consultation :
o Data Quality Improvement: Managed multiple migrations and developed a
playbook that standardized the data migration approach for over 70 source systems,
resulting in an 11.7% improvement over an approximately 8-year period.
o Team Management: Successfully persuaded a multiple disheartened resources to
stay and transformed them into a productive client team, leading to a 40%
expansion of the portfolio
o Data Migration Lead(Change Manager): Led large-scale migrations for enterprise
health management systems including Unified Datahouse(UDW), CAQH,Source
,HealthRulesPayor (HRP), Facets, and GuidingCare.
o Data Configuration and Integration: Proficient in SQL, ETL, and Web Services
(Restful/SOAP) for data configuration, ingestion mapping Management of Change
Management (MOC) , and wrangling/profiling.
Healthcare Business Consultation :
o Context-Driven Decision-Making: Developed KPI dashboards and business
intelligence cubes to drive informed decisions.
Candidate's Name
EMAIL AVAILABLE| Austin, TX |PHONE NUMBER AVAILABLE
https://LINKEDIN LINK AVAILABLE
o Requirements and Stakeholder Management: Skilled in MoSCoW prioritization, client
interviews, and defining use cases. Configure expert on HP ALM, Rally, JIRA, and RACI
matrix within Agile frameworks
o Business Development and Compliance: Focused on ROI-driven improvements and
DUR Privacy, regulatory compliance (HIPAA) improving data quality defects
Experience (Major)
Data Designer/Business Systems Analyst AMS,Point32Health(Tufts) Sep2018 to Present
Develop various specs, content use case flow designer to initialize AHA requirements to
multiple release & retro outcomes and lessons learned for continuous improvement.
Implemented Next Generation Health Payer Rules(HRP) from legacy systems for Public &
Senior Plans needed to scale into 4 Millions Members & ~20K provider integration, with data,
system and network security intact while optimizing efficiency and minimizing overall cost.
Perform Map & Gap,data profiling, mapping, and quality control, create/update
EDI(834,835,837,278,270 etc)/csv mappings, and support JSON/XML connector Web Services
Identify & Execute RACI potential risks and issues that could arise during the blackout period.
Configured HRP system parameters for deductibles, co-payments, and out-of-pocket limits to
align with plan specifics ,specialties with custom taxonomy business requirements.
Analyze complex datasets using Oracle Script views, triggers, and SQL for data extraction
while configuring of User Defined Rules(UDT) for data governance and master data
management (MDM) within HRP Web Service API
Develop Privacy Operations processes including Privacy Impact Assessment (PIA),Records of
Processing Activity (RoPA), Legitimate Interest Assessment and Master Data Inventory
Analyzed legacy data table structures, conducted comprehensive GAP analyses, and
utilized SQL for data profiling and generating ad-hoc reports to rectify data discrepancies.
Primary point of contact for both the payer and Partners contracting vendors on
agreement requirements as it pertained to data relevant to special risk-sharing (Roster) and
incentive (Capitation) agreements while configuring coverage rules to determine eligibility
of medical services and treatments for reimbursement.
Design and develop ETL strategies, provide HRP system training to Users.
Ensure compliance with data governance standards and regulations, including HIPAA.
Managed coding edits to validate accuracy and completeness of claims data using
industry-standard code sets (e.g., ICD-10, CPT/HCPCS) with HRP.
Established Test data & drafted Specs documentation (Summary of Benefit Coverage,
Schedule of Benefits, etc.) or QHP Templates (Plans and Benefit, Pharmacy, Crosswalk, etc.)
Implemented Change Data Capture (CDC) with clinical data, TIBCO, ETL teradata/Postgres
including Open Payments (Sunshine) Act on DME and provider data environment.
Work in Agile + DevOps environments via Scaled Agile Framework (SAFe).
Business Systems Analyst/Product Owner(RFP) OPS IT, P3Health Nov2020 to Jan2020
Established and trained a first-quality assurance team, resulting in improved data quality and
a 15% reduction in deployment defect cycle times.
Candidate's Name
EMAIL AVAILABLE| Austin, TX |PHONE NUMBER AVAILABLE
https://LINKEDIN LINK AVAILABLE
Prepared Master Test Plans, estimated test efforts, and assessed test reports and metrics using
Unix/Python scripts to enhance knowledge sharing across multiple teams, leading to a 25%
decrease in Execution time.
Participate in JADS to prepare Data Quality advisory services within a cross-functional team.
Lead, Data Quality Product Development/OPS IT, Geneia Aug2015 to Oct2018
Recognized lead in adopting lean principles, driving vendor partners on effective delivery
Managed Organizational data Migration project from SAS to AWS (IAAS service),
encompassing 30+ Employer groups, 700+ hospitals, 800k+ members, remote monitoring
devices, 5 HL7 interfaces, and 3 connected data warehouses.
Key contributor in capturing RFP specs, vendor response assessments, vendor selection
recommendation, service transition and delivery of $2M managed service engagements
Created design specifications for various on-demand statistical models within python.
Conducted Reverse Engineering from Base SAS to assist ETL in resolving migration issues to
AWS Cloud Infrastructure (S3, EC2, Glue) to salesforce API portal
Implemented source integration on GIS ( SQL and NoSQL databases (Postgres, Hp vertica,
Teradata, MongoDB,Redshift)
Created/Maintained various Data visualizations for reporting and maintaining dashboards
Product Owner (POC) CRMP Maintenance GIST ,ADP May2015 to Jul2015
Integrated as Operations Scrum Master L3 support for daily batch automation test suite using
Oracle coded-UI on service-Oriented Architecture (SOA) using WSDL in SOAP
Developed a regression predictive model to improve users churn, achieving an accuracy
rate of 85% applying Advanced Microsoft Excel (PivotTables, lookups, charts)
Implemented Selenium WebDriver, JAVA, Grid, and Maven for automation Postgres POC.
Lead , Data Quality/Business Analyst Actuarial IT, Capital BlueCross Jul2014 to May2015
Worked closely with business subject matter experts to derive data extraction and mapping
requirements from overall business requirements;
Designed T-SQL-driven HL7 architecture for Master Patient Index (MPI) to consolidate records
across 3 Health Systems using Mirth Match & De-ID Concept Privacy Analytics.
Working experience with data exchange standards for sharing healthcare related data. For
example, Federal HIPAA EDI Transactions (ASC 270/271,278,276,835, 837, etc.)
Project IT Consultant OptumInsight,Health & UnitedHealth Group Feb2011 to July2014
Led Cognizant s team on monthly operational reviews against agreed service level
agreements with client vendor management to track overall service delivery performance
As a Technical Lead with a team of 20+ onsite/offshore ETL QA/DBA team.
Applied Six Sigma, reducing SLA report time by 75%.
Candidate's Name
EMAIL AVAILABLE| Austin, TX |PHONE NUMBER AVAILABLE
https://LINKEDIN LINK AVAILABLE
Resequenced DevOps model, cutting resources by 20%.
Hands-on SQL validation with SSIS for Integration, Functional Testing in Sandbox.
Implemented unix/python automated data testing, saving 25% in QA hours.
Managed scope across 15+ Employer groups, 900+ hospitals, ~1M+ members, with 8
connected data warehouses and 5 information systems.
Partnered with cross-functional teams and provided updates to the C-suite on integrating
change management activities into project plans
Conduct a simulated blackout exercise to test systems, processes, and preparedness
Education and Certifications
2016 Penn State University Certified Scrum Master, Scrum Alliance
2008-2009 Stratford University MS Management Information (Cyber Security Major)
2001-2005 SVITS, JNT University B.Tech Computer Science & IT
Professional Affiliations
Member, Scrum Alliance
Certified Business Analysis Professional (CBAP)
Technology & Tools
Functional Models OATS (Orthogonal Array Testing), TQP (Total Quality Process),
Agile/product Owner, Test Case Point (TCP) Estimation, Behavior
Driven Development, Data Model, Mapping
Validation,Customer/survey feedback
Healthcare Concepts Payer/Provider/Risk/NCQA/HEDIS/ESI/Attribution/TOS/Cost
Bucking/Attribution/Confinement/Cohorts & ID
Strat/Claims/ICD10/HHS/FACETS/PBM
Business & Data Visualization JIRA, HP Rally & Quality Center 12(ALM), Cognos 8.1 (Ad-hoc
Reporting package, cubes. Query/Report studio), Tableau, Trello, Service
Tools now ,PowerBI ,Health Rules Payer (HRP)
System,GuidingCare,Google Forms
Workflow Appian, Visio, Ewin,PEGA, SSIS, Data Stage, Informatica, SAS EG/DI Suite,
Apache Spark, MongoDB, API, SoapUI, python basic, MirthMatch,
MirthConnect, industry standard data formats (FHIR, HL7, X12)
Scheduler Tools Tivoli Work Scheduler (TWS), SQL Agent, Autosys,Airflow, Jenkins
Databases Oracle, MS SQL Server, Toad for data analyst, HP Vertica, Netezza,
PGAdmin/Post greg,Teradata
Candidate's Name
EMAIL AVAILABLE| Austin, TX |PHONE NUMBER AVAILABLE
https://LINKEDIN LINK AVAILABLE
FTP Cloud Technologies HL7, XML, S3 Archival, AWS, Azure, Electronics Communications
Gateway (ECG) , WinSCP/ SSH File Transfer Protocol,AWS lambda, glue
, athena
Testing Tools & Utilities Ervin, Remedy, SVN, GIThub/GITLab, Zephyr Devices, SQL, UNIX/Linux
Employment History
Company Location Designation From To Duration(Years)
Dotcom Team LLC Boston,MA Database Architect Sept 2018 Till date 6 years
Software Developer,
Acclaims Systems Inc Harrisburg ,PA III July 2014 Aug 2018 4.3 year
Cognizant Technology
Eden Prairie, MN Senior Associate Nov 2011 June 2014 2.6 years
Solutions
Logical Paradigm
Sterling,VA Consultant July 2011 Oct 2011 4 months
XcelTech Fairfax, VA Software Engineer Sept 2010 July 2011 10 month
Logical Paradigm
Sterling,VA Consultant Nov 2009 Aug 2010 10 months
NOA Soft Solutions Hyderabad,India Software Engineer June 2005 Dec 2007 2.7 years
DRDL Hyderabad,India Intern Trainee Aug 2004 Apr 2005 9 month
|
