Data Sql Server

Richard Langseth

*** ******* **** **** ? Warwick, RI 02886 ? 401-***-****

401-***-**** (cell)

*******@********.***

PROFESSIONAL SUMMARY

o ICD-9 to ICD-10 Working Group and conversion studies - Meaningful Use

o Health Claims Processing Systems - HIPAA 837-I and 837-P and 5030

o X.12 and XML Healthcare Data Sets

o Clinical and Pharmaceutical Research Studies - HEDIS NDC CPT ICD

o Data Warehouse Setups

o Data Modeler and Architect

o Data Dictionaries and Corporate Data Conformance

HEALTHCARE ANALYSIS:

Engagements -

Consultant - Alternative Health Systems - Health Claims

Senior Data Analyst - Verispan - NDC ICD-10 and HIPAA Trans

Sets

HIPAA & HEDIS Resource - NEMC - New England Quality Care Alliance

( EMR Meaningful Use Studies - Pay for

Performance )

Data Architect - Pfizer

PBM & HMO Consultant - Mashantucket Pequot Tribe

Consultant (Project Management) - United Healthcare

Consultant (Adverse Events, AIDS) - PAREXEL International

HIPAA Trans Sets - Keane, Inc.

HEDIS - HMO Blue (Massachusetts)

Claims Analytics - MicroStrategy

PROFESSIONAL EXPERIENCE DETAILED:

Healthcare Data Architect and Senior Consultant 1986 - 2010

I have been engaged in health plan data studies under the name Alternative

Health Systems and have worked with several employers dealing with SQL and

data modeling / data architecture issues. See the list of clients on the

following pages. They include RBS Citizens, Fidelity, Pfizer, and several

others. This base of operations allows me to continue to work on healthcare

data issues while staying current with mainstream database toolsets.

Typically I use PowerDesigner as a data architecture tool to generate

conceptual and physical maps and Erwin to build SQL database generation

code. I have current experience with On Line Transaction Processing (OLTP)

as well as with data warehousing structures.

Here is a review of healthcare acronyms that I work with: I am reviewing

Health Information Technology for Economic and Clinical Health ( HITECH )

Act and Electronic Health Record ( EHR / EMR 21 CFR 11 ) strategies. I have

built Pay for Performance architectures and am now studying Meaningful Use

and PQRI rules as they relate to HEDIS measures and generalized

contextual search tools. (See Clarabridge for details on this toolset.) I

have mapped ICD-9 CM, CPT, and NDC to ICD-10 and have worked extensively

with HIPAA 837 transactions. I have served on Agency on Healthcare

Research AHRQ working groups studying ICD coding and HIPAA privacy

requirements.

RBS Americas and Citizens Bank - 01/08 - 07/10

My primary function was to oversee the daily transmission of credit risk

management data to the Royal Bank of Scotland's central facility for the

calculation of positions and other credit risk data. I also built a data

model of the existing credit risk database and performed some SQL Server

stored procedure and trigger modifications as required.

Data Architect - Fidelity Investments - 01/07 -

12/07

I served as the data architect for a team developing an equity trading

system for Fidelity Management Company. The mission was to build a data

model for a Java/Data Cache based transaction system, employing an in-

memory, high-speed data store (Oracle's TimesTen). I used PowerDesigner to

convert a conceptual/logical model to a full machine-level physical model.

Senior Data Analyst - Verispan - 04/06 - 11/06

My basic responsibility was the data modeling and mapping of pharmacy

scripts and medical (physician) procedure data ( NDC HIPAA 837 and ICD 9

CPT and ICD 10 data ) collected from switches and pharmacy chains into X-12

and XML formats for data exchange with pharmaceutical companies. The

medical encounter data ties to the Verispan pharmacy script database to

allow for longitudinal studies combining medical encounters with pharmacy

scripts to link to whar are now called Meaningful Use datasets for outcomes

and pharmaceutical studies.

New England Medical Center - New England Quality Care Alliance 01/05 -

04/06

I project managed a SQL Server/dot net project to develop federal HEDIS

measures and a patient registry. I served as the data architect, data

modeler and query writer. This is a web-based reporting system to help

physicians meet their Harvard-Pilgrim, Tufts Health Plan, and Blue Cross

quality objectives under Federal guidelines. Meaningful Use issues

addressed.

Pfizer 08/04 - 09/05

I worked with the drug discovery area on chemistry- and biology-based

enterprise entities that reach across the corporation. 21 CFR 11

compliance was sometimes required. I also reviewed data models across

Pfizer to determine if they meet the corporate standards. ERWin and

ModelMart were used in this mostly Oracle activity. Casewise Corporate

Modeler used for conceptual data modeling and process modeling including

case studies.

Other Consulting Engagements 1986 - 2004

Mashantucket Pequot Tribe - PBM & HMO Consultant

United Healthcare - Consultant ( Project Management )

PAREXEL International - Consultant ( Adverse Events, AIDS )

Keane, Inc. - Consultant ( HIPAA Transaction Sets )

HMO Blue (Massachusetts) - Concurrent Review, Physician Profiles,

HEDIS

RI Business Group on Health - Large employer group data analytics

Consolidated Group Trust - Alternative Provider Networks

Rhode Island Pharmacy Assn - On-Line Pharmacy Claims System

MicroStrategy - Claims Analytics

GIGA Information Group - Web/Database Strategy

TOOL SETS:

Data Architecture and Business Analysis: PowerDesigner, Corporate Modeler,

and ERwin data modeling. Zachman Framework, and other business analysis

tools. Skilled at architecture views including "swim lanes." Entity

Relationship diagrams. Patch complex SQL views and queries back into data

modeling tools.

OLAP Data Warehouse: MicroStrategy, Excel & Access, Cognos. Major

database platforms include Oracle and SQL Server. OLAP examples include

HEDIS outcomes, managed care, physician prescribing patterns, clinical

trial adverse event analysis and insurance buyer behavior analysis models.

OLTP: Mainframe and Oracle TimesTen in memory, object-based equity

trading systems. Mainframe and networked transaction systems including

equity trading, swaps, health claims processing including TPA setups, and

life insurance administration systems.

SQL: (As a language) Microsoft T-SQL, Oracle PL/SQL triggers, stored

procedures and SQL*Plus. Some Oracle data warehouse petition architecture

experience. Experience with Oracle TimesTen in memory database setups.

DBA: SQL Server DBA including tuning strategies and restoration plans,

various ETL (Extract Transform Load) data loading tools. Team building

experience in large database clusters with multiple DBAs engaged in the

integration of UNIX systems and mainframes.

EDUCATION:

University of Connecticut, School of Insurance, Hartford, CT - Bachelor of

Business Administration in Insurance - Research Paper: Impact of Medicare

on Insurance Industry.

FAMILY:

Son Justin is co-founder of Strategy.com and Clarabridge ( Voice of the

Customer - Contextual Search - Meaningful Use studies )

rel 9/26/2010

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