PROFESSIONAL SUMMARY

 of expertise as a Business Data Analyst in Finance and Banking Domain.

 Experienced in conducting GAP analysis, SWOT analysis, Cost-Benefit analysis, ROI analysis, and
developing Requirement Traceability Matrices (RTM) to ensure alignment between project objectives and
business requirements.
 Proficient in gathering requirements, creating BRD and FRD documents, and developing comprehensive data
documentation using tools like Collibra, SharePoint and Hadoop to bridge business and technical
requirements.
 Engaged in IT business analytics, data analytics, and data profiling for data accuracy and drive actionable
insights.
 Proficient in extracting, cleaning, and transforming large healthcare datasets from sources like EHR, EMR,
claims, lab results, and pharmacy data, alongside, analyzing clinical, provider, and FDA AHFS drug data.
 Experienced in leveraging cloud data solutions with AWS, Google Cloud Analytics and Azure Cloud Platform
to ensure secure data storage, analysis, and sharing, with a strong focus on cloud data security and
compliance.
 Experienced in performing root-cause analysis on patient outcomes, hospital readmissions, and operational
bottlenecks to support data quality improvement, with expertise in data lineage, data profiling, and data
cleansing.
 Experienced in compliance reporting, HIPAA compliance, regulatory submissions (HEDIS, CMS, NCQA)
and data security protocols to meet federal and state mandates, with in-depth knowledge of healthcare
standards such as HIPAA, HL7, ICD-10, and CPT coding systems.
 Developed and analyzed Healthcare Reimbursement Plans (HRP) to ensure compliance with regulatory
requirements and optimize reimbursement rates, leveraging data analytics to assess the financial impact of
reimbursement strategies on patient care and organizational profitability.
 Integrated insights from Health Insurance Exchanges (HIX), Health Information Exchanges (HIE), and
Encountered Data Processing Systems (EDPS) to enhance strategy effectiveness.
 Experience in Business Intelligence assets and ETL processes to streamline data pipelines using IBM Cognos,
Informatica PowerCenter, Informatica Data Quality OBIEE, Oracle and others for operational, and billing
systems.
 Involved in FACETS data model implementation, electronic claims and benefits configuration set-up testing,
inbound/outbound interfaces and Extensions, Load and Extraction programs involving HIPPA and proprietary
format files and reports development.
 Proficient in EMR/EHR modules, process flows, and healthcare datasets like claims, labs, and EMR, utilizing
standards such as NDC, ICD, CPT, HCPCS, and LOINC, building data marts to enable quick access to high-
frequency reports and dashboards for informed decision-making.
 Proficient in managing diverse datasets and tracking patient outcomes using KPIs such as Length of Stay
(LOS), Patient Satisfaction (HCAHPS), and readmission rates.
 : SAS (Ent. Miner), SQL, Visual Studio Data Analytics & Visualization: Tableau 10.1 | Power BI | Eclipse
IDE Data Reporting: MS Office – PowerPoint, Excel, and Word
 Software languages / Environments: Python and SQL, R.
Responsibilities:
 Responsibilities include gathering requirements, developing strategy for data cleansing and data migration,
writing functional and technical specifications, creating source to target mapping, designing data profiling and
data validation jobs in DataStage, and creating ETL jobs in DataStage.
 Developed data visualizations using Tableau and Power BI to effectively engage stakeholders and SMEs and
support data-driven decision-making.
 Analyzed business requirements and supported the technical team in developing MS Access databases and
related systems using VBA, SQL programming, and Python, all in accordance with established standards and
procedures.
 Conducted extensive testing in FACETS, focusing on subscriber and member functionalities, group setups,
eligibility, and enrollment processes, while validating outbound extracts to various vendors.
 Developed EDI documents and maps to create requirement documents, Project Charters, and logical design
documents for EDI transactions and code sets, additionally, leveraged Power BI to generate visual reports for
tracking EDI processes and performance.
 Designed algorithms for derived variables and metrics in data products, conducted exploratory data analysis
on healthcare datasets, and utilized Power BI to visualize insights effectively.
 Assured standardization of policies, procedures, workflows, in accordance with the organization's approved
EHR practices.
 Implemented defect tracking processes using HP Quality Center and JIRA, ensuring thorough review during
subsequent iterations of the application development lifecycle, while incorporating medical coding standards
such as SNOMED-CT, ICD-9, and HCPCS for accuracy and compliance.
 Utilized Salesforce CRM to manage customer relationships, streamline sales processes, and enhance client
engagement, while track performance metrics and drive data-informed decision-making.

 Created and transformed business requirements into functional requirements and designing business models
using UML diagrams - Context, Use Case, Sequence, Activity diagrams using MS Visio and Rational Rose.
 Integrated clinical and claims data for multivariate analysis using PostgreSQL and SAS to perform ETL
from DB2 and Teradata databases and created SAS datasets, SAS macros, Proc/data steps and SAS formats
as required.
 Conducted field-by-field analysis of the FACETS system data to support attribute mapping and
identification, leveraging Power BI for enhanced data visualization and insights.
 Conducted regular Joint Application Development (JAD) sessions with developers and quality testers
throughout the project to ensure thorough discussion of both critical and minor details, addressing issues
proactively.
 Managed SAP modules for administration, patient records, and billing operations, ensuring seamless data
flow, accurate invoicing, and efficient patient management across healthcare systems.
 Responsible for architecting the enterprise-level Identity and Access Management infrastructure to ensure
compliance with HIPAA regulations for patient health information security and privacy, while importing
large datasets (enrollment, medical claims, and pharmacy claims) into the SCIO SAS system.
 Applied Agile software development methodologies, leveraging Jira for project management and Power BI
for tracking progress and delivering actionable insights throughout the software and product development
lifecycle.
 Modified billing and premium collection processes to comply with 820 HIPAA transactions while working
on the CMS (Centers for Medicare and Medicaid Services) checklist, as well as conducting MITA, HIPAA,
and GAP analysis.
 Cleaned and prepared diverse healthcare datasets, including EHR, claims, and Social Determinants of Health
(SDOH), implementing data cleansing techniques and quality checks for meaningful analysis and actionable
insights.
 Developed risk stratification models for patients with chronic conditions.
 Collaborated with cross-functional teams to define project requirements and deliver data-driven solutions that
support research and clinical applications.
 Utilized Rational ClearQuest to manage change requests and conducted a gap analysis to evaluate the
alignment of the current system infrastructure, features, and functionalities with the new business design,
employing the "As Is" and "To Be" methodologies.
 Developed a solution to integrate genomic data from multiple sequencing platforms and public databases,
leveraging Python to build a comprehensive data repository for efficient storage and analysis.
 Implemented Six Sigma methodologies to identify and eliminate defects in processes, enhance quality, and
drive continuous improvement, utilizing data-driven techniques to analyze variations.
 Established metadata standards, data governance frameworks, and stewardship practices while implementing
master data management, ETL processes, operational data stores (ODS), data warehouses, data marts, and
analytics solutions, including reporting, dashboards, segmentation, and predictive modeling.
 Managed the EDI 834 file load into FACETS via the Membership Maintenance Sub-system (MMS) and
handled FACETS edits along with EDI HIPAA claims processing, including 837, 835, and 834 transactions.
 Developed and tested scripts for premium calculations, claim limits, and deductibles, incorporating genomic
data into workflows. Contributed to defining project objectives, creating data process flow diagrams, and
establishing timelines for successful delivery.