Data Analyst Health Care

Harshitha

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

PROFESSIONAL SUMMARY:

•Around 8 years of hands-on experience as a Data Analyst and Business Analyst, I possess extensive knowledge in clinical data and business analytics within the health care, insurance, and pharmaceutical domains.

•Experienced in HIPAA, HITECH, ICD, CPT Codes, HL7 FHIR Messaging system, SNOMED CT, RxNORM and LONIC, with a deep understanding of their applications and implementations.

•Extensively involved in the analysis of data derived from claims, healthcare, and pharmaceutical sources, which are collected from EHR and EMR system.

•Proficient in Electronic data Interchange (EDI) transaction, claim processing, and problem resolution, with a focus on ensuring accurate and efficient data entry.

•Worked with the HIPAA gateway interface, overseeing inbound and outbound healthcare transactions utilizing EDI eligibility 270,271, and health care claim status request 276, 277, and healthcare claims 837, 834 and 835.

•Experienced in online transaction processing for various types of healthcare plans, including individual or group plans, as well as Medicare and Medicaid plans.

•Worked on designing and creating Business Required Documents (BRD), Functional and Non-Functional Requirements, use cases specifications.

•Engaged in the SDLC requirement-gathering phase using Agile Scrum Methodologies and contributed to the development of User Stories using JIRA.

•Worked on health care data extraction using Extract, Transform and Load (ETL) to integrate data from source to target (Teradata).

•Worked on integration of cloud database to other databases by using data warehousing, Business Intelligence, and data mapping.

•Developed dynamic dashboards in Excel using advanced formulas, pivot tables, and charts to visualize and track key performance indicators (KPIs), enabling data-driven decision making.

•Experienced on data architecture such as snowflake schema, star schema data modeling.

•Proficiently created tables, view, secure views, user defined functions in snowflake cloud data warehouse.

•Performed analysis on raw healthcare data and developed data dictionaries to optimize workflow and meet data integration requirements.

•Worked with the Python (NumPy) library to perform statistical analysis on large datasets, identifying trends and patterns in the data.

•Developed complex SQL Queries to extract, transform and load to compile the data to interpret and analyze the big data from electronic health records (EHR) using SQL.

•Worked on analyzing and coordinating the clinical trials and generated reports, tables, listing, graphs using SAS.

•Proficiency to document API specifications by converting Service Data Dictionary (DD) into a mapping document, working with REST API.

•Responsible for conducting Ad-Hoc analysis to extract data from different sources to generate and visualize using Tableau, power BI.

•Experienced in doing exploratory data analysis, combined sheets and developed dashboards to visualize using Power BI/Tableau.

Technical Skills:

HealthCare Expertise

HIPAA, HL7, FHIR, EHR, EMR, HIMSS, EDI, Medicare, Medicaid, HITECH

MEDICAL CODING

CPT, ICD-10- CM, ICD-10-PMS, SNOMED CT, RxNORM, and LOINC

TOOLS

Power BI, Tableau, SAS Software, MS OFFICE, DATABRICKS, SNOWFLAKE, MS Azure, Google Cloud, AWS Cloud, Informatica, Talend, SAP Project, Crystal Projects, HTML CSS, PYTHON, ETL.

EHR SYSTEM

Epic, Cerner Citrix

DATABASES

MySQL, MS SQL, SQL server, Oracle, MS Access

METHODOLOGY

AGILE, SCRUM, WATERFALL

Education:

B.Sc Biotechnology, Meenakshi University, 2015

Professional Experience:

United Health Group, Hartford, CT July 2021 - Present

Business Data Analyst

Health Data Integration and Management

Responsibilities:

•Worked on health data integration of medical claims database with EHR EPIC (Electronic Health Records), clinical data repositories, pharmacy systems, laboratory systems.

•Handled transactional sets in health care claims, payments, Remittance and maintaining them according to HIPAA Standards.

•Created HL7 FHIR compliant APIs for healthcare systems to enable interoperability and exchange of clinical data between systems.

•Responsible for claim processing in Medicare, Medicaid, private health plans for submission for Online Transaction Processing (OLTP) using claims such as EDI transactions (834,835, and 837).

•Involved in data mapping the diagnostic codes and treatment codes with ICD-9, ICD-10.

•Developed and implemented EDI standards and protocols such as HIPAA, EDI ASC X12, transactions for various insurance processes including claims, policy administration, enrollment, and billing.

•Worked with clinical documentation with SNOMED CT, RxNORM, and LOINC to maintain integrity.

•Gathered the data from CRFs (Case report form) and converted into electronic data interchange (EDI) to identify and minimize the errors for seamless exchange.

•Created business required documents (BRD), functional, nonfunctional requirements, use cases by collaborating with the SME.

•Presented data modeling designs and findings to executive SME’s and stakeholders, effectively communicating complex technical concepts in a clear and concise manner.

•Worked based on Agile methodology and coordinated with other teams.

•Migrating the data from traditional SQL database to AZURE cloud using the Extract Transform Load (ETL) pipelines.

•Conducted comprehensive data cleansing and manipulation in Excel, utilizing techniques like text-to-columns, data validation, and conditional formatting to ensure data accuracy and integrity.

•Created and executed manipulating large data sets using SQL for transforming data.

•Performed data migration from different sources to Snowflake.

•Designed and implemented a cloud data warehousing solution using Snowflake, providing scalable and flexible storage for large datasets.

•Created an interactive dashboard, visualized to communicate with stake holders using Power BI.

•Created customized reports after doing ad-hoc analysis and visualized using the Power BI by importing RWD.

•Optimized data warehousing performance through indexing, partitioning, and aggregation techniques, ensuring efficient data retrieval and analysis.

•Environment: EHR, EPIC, EDI, X12, Medicare, Medicaid, HIPAA, HL7, MySQL, Oracle, Power BI, Agile, AWS, JIRA, Azure, Snowflake, Excel

Pfizer, Groton, CT March 2019- June2021

Business Data Analyst

Data Governance and Maintenance

Responsibilities:

•Developed and maintained data maintenance and governance practices within the organization, ensuring the accuracy, integrity, and security of clinical trial and research data.

•Proficient in analyzing and interpreting clinical trial data, including demographic information, medical history, treatment efficacy, adverse events, and patient outcomes.

•Designed and executed Data management plans (DMPs) for clinical trials, including data collection, validation, cleaning, and integration processes.

•Ensured the data complies with HIPAA, HL7, FHIR, DICOM, LOINC, ICD 10 standards as per non-functional requirements.

•Worked on all the phases of clinical trial data (Phase I, II, III, IV) and ensured data integrity and completeness.

•Gathered the data from different system using HL7 (FHIR) and electronic data interchange (EDI) to identify and minimize the errors and fasten the claims and non-claim processing.

•Built a clinical data repository that used SNOMED CT, RxNORM, and LOINC to standardize data across different sources, enabling more efficient data sharing and analysis.

•Worked on managing large patient data from clinical system for Health Information Exchange (HIE).

•Created Business required documents (BRD) along with functional and non-functional requirements to develop user stories.

•Worked in Agile methodology by gathering updates from the sprint cycle.

•Performed data profiling and analysis to identify data quality issues and gaps in existing data models to improve accuracy and quality of the data.

•Developed and maintained data mappings and transformation rules to ensure data integrity and consistency across the Enterprise Data Warehouse (EDW), data marts, and other reporting structures.

•Conducted user acceptance testing (UAT), identified and resolved any system-related issues or discrepancies.

•Developed complex models in Excel to evaluate investment opportunities, perform sensitivity analysis, and assess risk factors, supporting strategic decision making and financial planning for the organization.

•Created data model on cloud and coordinated in developing data pipelines for unit test and to ensure data quality.

•Collaborated with a team of data engineers and analysts to build a data pipeline that extracts data from various sources, transforms it, and loads it into Snowflake.

•Responsible for writing complex SQL Queries to conduct Ad-Hoc analysis to analyze the data collected from EPIC System.

•Analyzes complex health problems and issues using data from internal and external sources to provide insight to decision-makers using Power BI.

Environment: SQL, JIRA, Power BI, Data Warehouse, Azure, Agile, SAS, Python, Jupyter Notebook, Tableau, EHR.

NJ Transit, Maplewood, NJ April 2017 – Feb 2019

Business Data Analyst

Health Data Migration

Responsibilities:

•Implemented EHR system and migrated data from different healthcare system, CFR (Case report form).

•Collected health data from different system and identified the variables and gathered from Epic Health System by maintaining HIPAA.

•Developed and identified schema for tables and maintained backups to database for multiple systems and interoperability of different systems using HL7, FHIR.

•Worked on hospital related data including patient data, claims data, laboratory data, pharmacy data and integrated with EMR.

•Designed a terminology mapping tool that enabled users to easily convert between SNOMED CT, RxNORM, and LOINC codes.

•Improved interoperability between different healthcare systems and reducing the risk of information loss.

•Integrated EDI systems with insurance core systems, such as policy administration, underwriting, and claims management, to automate data transmission and enhance operational efficiency.

•Conducted thorough investigations and analysis of claim denials, identifying root causes and implementing corrective measures to minimize Medicare and Medicaid claim rejections and maximize revenue.

•Developed and executed an API for aligning business objectives with technical capabilities and identifying opportunities to leverage APIs for enhanced customer experience, process automation, and data sharing.

•Development of HL7 interfaces for healthcare systems, utilizing HL7 v2 and v3 protocols to ensure the seamless exchange of clinical data.

•Created business required documents (BRD), functional, nonfunctional requirements, use cases by conducting interviews with the SME’s.

•Created functional and nonfunctional requirements, user stories, and conducted user acceptance testing (UAT).

•Worked on Agile methodology to be responsible, accountable, Concerned and Informed about all the process about the project.

•Responsible for monitoring the stages of project by using JIRA to track, raise issues and bug tracking.

•Responsible for extract, load and transform the data from traditional source to target by using ETL Pipelines.

•Expertized in using relational database such as MYSQL, SSMS to create databases to store the data.

•Used complex SQL commands, aggregate functions to extract the data gathered from multiple sources such as Electronic Health Records (EHR) and visualize to stake holders.

•Created a flow diagram for live data using Tableau to create datasets, dashboards to visualize insights after analyzing the data.

Environment: MySQL, MS SQL, PostgreSQL, JIRA, Tableau, EHR, Agile, SAS, Python, Jupyter Notebook.

Acadia Healthcare, Franklin, TN Oct 2015– March 2017

Business Data Analyst

Health management system

Responsibilities:

•Developed data analysis frameworks and methodologies for a health management system, enabling effective tracking and analysis of key health indicators, patient outcomes, and program performance metrics.

•Ensured the data complies with HIPAA, HL7, FHIR, DICOM, LOINC, ICD 10 standards as per non-functional requirements.

•Worked on a research project that used SNOMED CT, RxNORM, and LOINC to analyze healthcare utilization patterns and identify opportunities for cost savings and quality improvement.

•Collected various data sources such as EMR/EHR, Patient demographics, medical history, Lab Reports, Treatment Outcomes, Patient survey and Clinical trial data by implementing CI-CD pipeline.

•Collaborated with external data sources to integrate and analyze disparate datasets, providing a holistic view of pediatric health indicators and outcomes.

•Monitored and analyzed population health indicators, such as immunization rates, growth and development milestones, and disease prevalence, identifying areas for improvement and designing targeted interventions to promote child health and well-being.

•Transformed the extracted data and performed file processing by organizing data into structured format using MySQL.

•Extracted health data using AWS (Amazon Web Services) and performed data integration and data validation by performing range checks, missing and duplicate data checks, coding checks, edit checks, source documentation verification.

•Conducted joint application development (JAD) sessions and created business required documents (BRD), functional, nonfunctional requirements.

•Acted as SME and translated to technical requirements, worked on user stories and tested for user acceptance (UAT) using Agile methodology

•Implemented data processing pipelines using Python libraries such as Pandas and NumPy, transforming raw data into structured formats for further analysis and visualization.

•Worked with the cross-functional teams using Agile SAFe framework by developing and refining user stories that aligns with the requirements defined in the Program Increment (PI).

•Performed visualization using Tableau to show insights and support decision making by creating dashboards and presenting them to the healthcare providers.

•Utilized Jira to log, track, and resolve issues related to data and collaborated with the team to prioritize tasks.

Environment: HIPAA, HL7, FHIR, AWS, MS-Excel, SQL Server, Agile SAFe, Tableau, Python, SAS.

Contact this candidate