Business/Data Analyst
Resume:
Neeraja Mallu
Business Systems Analyst Analytics
************@*****.***
OVERVIEW
Business Systems/Data Analyst professional with cumulative 10+ years of experience working both as a clinician and business analyst. Deep understanding of healthcare process work flow and business operations with an ability to synthesize business needs and help integrate with technology solutions. Skilled at learning new technologies quickly, team builder with excellent communications, time & resource management & continuous client relationship development skills.
CAREER ACHIEVEMENTS / CORE SKILLS
Certified Scrum Master (CSM)
Microsoft Certificate in Data science essentials
Knowledge of all phases of Software Development Life Cycle (SDLC) methodology
Experience gathering requirements, creating use cases and Business requirements documents including data mappings and workflow diagrams
Experience identifying, gathering, synthesizing, mining and analyzing healthcare payer data ensuring project completion on time with the desired results.
Knowledge of building Supervised and Unsupervised Machine Learning experiments using Microsoft Azure utilizing multiple algorithms to perform detailed predictive analytics and building Web Services models
Validating test cases and assisting in User Acceptance Testing (UAT)
Written SQL queries for data validation and data manipulation
Create ad-hoc reports as needed for Finance, Utilization management, Claims, and regulatory compliance.
Expertise with MS Office – including Word, Excel, PowerPoint, Visio.
Experience with Tableau for monitoring trends, providing data insights and creating data visualizations.
Core Competencies
Certified Scrum Master
Certificate Microsoft professional in Data Science Essentials
Licensed Physical Therapist
Business Requirements
Data Mapping
Test case / UAT
Azure Machine Learning
Programming and Tools
Microsoft Excel
Tableau
Talend
Gretl
Azure Machine Learning
Project Lifecycle:
Requirements Analysis
BA Analysis and Monitoring
Requirements Elicitation
Project Scheduling
Operationalization
Databases
MS Access
MS SQL Server
Value-Added Leadership:
Team Building & Mentoring
Client Relations & Presentations
Business & IT Planning
WORK EXPERIENCE
Business Analyst – Pharmacy Benefits Manager – CVS Health April 2018 - Current
Cognizant Technology Solutions
Gathering requirements from the client for Medicare -D and Medicaid plan build in RXClaim system
Liaison between the configuration team and the client providing functional specifications and clarifications as needed
Working with QAs, BAs, Clients and Devs to make sure work is in scope and requirements are delivered in a timely manner
Supporting leadership vision to automate new plans build (RPA) by leading automation activities, providing mapping documents, functionality support, and UAT of developed plans
Involved in troubleshooting parallel processing issues (discrepancies identified in claims output between legacy system and RXClaim system) providing analysis and configuration fixes if any required.
Business Systems Analyst Sep 2016 – Aug 2017
Santa Clara Family Health Plan
As a Business Systems Analyst, acted as a liaison between the business units, software development, and production support teams, under various projects supporting SCFHP objectives and regulatory compliance.
Provider Dispute Resolution (PDR) Letters Automation
Conducted / attended meetings with internal teams and management to understand the overall project objectives and success criteria
Gathered requirements from business users and SMEs and created BRD defining project scope.
Created test cases and performed Unit testing to ensure system functions end to end
Member & Provider Portal Implementation – HealthX
Created source mapping and thorough extraction logic for enrollment & eligibility, claims, authorizations and provider files. Mapping was done to extract files from the new system (QNXT) in anticipation of future implementation of Medi-Cal and Healthy Kids line of business
Developed a detailed test plan and test cases to cover all the requirements.
Conducted extensive testing and validation in legacy, interim and new production environments
QNXT System migration – Authorizations and Claims migration from legacy Xpress system to QNXT system
Conducted meetings with business SMEs and executive leadership team to gather requirements
Documented business requirements defining scope and post go-live process plan
Created extensive source-to-target data mappings to assist in migration of claims, service groups and authorizations from legacy Xpress system to new QNXT system for Authorizations
Created test cases and conducted extensive UAT and validation in dev, test and prod environments
Identified core data errors and fall-outs during conversion and recommended clean-up post Go-Live
Assisted in configuration of custom fee schedules in QNXT
Assisted with identifying configuration defects related to service groups
CMS and DHCS Regulatory reporting - Compliance
Project managed annual CMS Compliance reporting
Created and maintained log of Compliance issues that helped define new remediation projects
Assisted/Generated reports for CMS and DHCS yearly reporting
Reporting
Written SQL queries to generate ad-hoc reports for Claims, Finance, Compliance, Enrollment, Providers and Utilization management reports as requested
Automated reports on report portal as needed for recurring use.
ID Card Implementation - HealthLogix
Conducted meetings with marketing, enrollment, vendor and management teams for project planning and gather business requirements
Created BRD to unify ID card process for Cal MediConnect, Medi-Cal and Healthy Kids lines of business
Created data mapping to extract ID Card files from the new QNXT system
Created test data in test environment for validating test cases
Physical Therapist Mar 2008 – Jun 2016
Worked as a Physical Therapist in various settings – skilled nursing facility, home health and long-term care in NJ, WA, CA and TX.
EDUCATION
BS in Physical Therapy
Certified Scrum Master (CSM) – 1027015
Certified in Microsoft Data Science Essentials
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