Data Analyst Office
Resume:
MALINI PATEL
adhxvx@r.postjobfree.com
SUMMARY:
Possess over 10+ years of profound experience as a Business and Data Analyst with excellent project management skills in various domains such as Banking, Healthcare, Telecom, and E-commerce.
Proficient in all phases of Requirement Management, including gathering, analyzing, detailing, and tracking requirements.
Administered test planning, test preparation, test execution, issue resolution, and report reneration to assure that all aspects of a project are following the business requirements.
Seasoned professional of the health care industry claims management process, and Medicaid and Medicare Services.
Direct experience with HIPAA Standards and Compliance issues, HIPAA privacy policy, requirements gathering in compliance with HIPAA standards, and corresponding EDIR transactions.
Experience in configuration of claims processing applications, claim adjudication process, Electronic Medical Records / Electronic Health Records (EMR/EHR) and Medicaid Management Information System (MMIS), and Medicaid Information Technology System (MITS).
Defined data rules to migrate data from EMH (Enterprise Meta Data Hub) to the data lake via Ab Initio GDE, Express IT, metadata hub.
SQL background, including data validation, data migration, and data fall out reporting using SQL.
Extensive awareness and experience in health care/claims adjudication with knowledge of industry compliance standards like HIPAA and EDI X12 transactions (834, 837, 835, 270/271, 276/277).
Experience on HEDIS (Healthcare Effectiveness Data and Information Set) measures. PROFESSIONAL EXPERIENCE:
Wells Fargo (Insight Global), Dallas TX May 2019 – October 2020 Data Quality Analyst
Our mission is to provide centralized data management solutions to ensure enterprise data is accurate, consistent and enables Wells Fargo business priorities.
Enterprise Data Quality Monitoring (eDQM) is a part of Data Management & Insights (DMI) & Data Management Solutions
(DMS) organization functions. DMS provides centralized and consistent solutions manage Wells Fargo data. This include data quality monitoring, metadata management, data lake management and master/reference data management. Responsibilities:
Responsible for the Intake Form Process per Enterprise Data Governance (EDG) Policy from the data movement and data detective perspective.
Executed on the data migration project as a data quality business analyst for over 24 applications under the Traded Products and Assets Sales Data domain umbrella.
Key player in migrating all of the Traded Products Data from EMH (Enterprise Meta Data Hub) to the Data Lake via Ab Initio GDE, Express IT, and metadata hub.
Developed business rules for all 6 data dimensions such as completeness, accuracy, consistency, validity timelines, and uniqueness.
Documented business requirements and physical data element information from the ABDO in the rule spec workbook.
Identified and submitted gaps in movement control coverage onto the eDQM DQ Control Coverage Gap Tracker and worked with the business support team to ensure the gaps were remediated within the timeframe agreed-upon with application partners.
Maintained a checklist throughout the process to ensure key steps were completed for all Data management catalogs.
Performed DEV, UAT, and PROD testing for configurations being promoted in the current release cycle including E2E testing.
Solid grasp of the ETL methodology for data transformation using Ab Initio, Data warehousing.
Reviewed and updated all catalogs based on eDQM internal QA team feedback with bi-annual updates. Page 2 of 5
Conducted driving remediation activities with Jira by coordinating with application business owners and technology data managers.
Responsible for initially reviewing data movement controls to ensure the 10 minimum controls existed and that their required attributes are documented in alignment with the EDG Policy.
Collaborated with ABDO to create meaningful rule specifications that accurately captured the defined business rules as established by the ABDO.
Communicated with multiple business teams to streamline processes and coordinate monthly data releases.
Produced and maintained the eDQM initial release checklist for applications that were recently identified as in-scope for eDQM.
Conducted internal quality assurance reviews of the catalog to identify problems and ensure the catalog met eDQM expectations before submitting to the ABDO for approval by finalizing enterprise repository upload on external SharePoint.
Updated entries in the rule spec workbook on the deliverable tracker to notify eDQM RPQR QA team.
Created and delivered initial reviews before submitting to manager.
Mentored junior resources by providing coaching and guidance. Environment: Share Point, Ab Initio Express IT; Ab Initio Enterprise Metadata Hub (EMH), Collibra, Jira, Aqua Data Studio, Tableau, MS Office (MS Word, MS Excel)
IBM Watson Health, Dallas TX Sept 2018 - Mar 2019
Data Delivery Specialist
IBM Watson Health provides the healthcare industry a protected, cloud-based analytics platform that harnesses big data for clinical integration, predictive analytics, and business intelligence. Its platform empowers the country's leading provider organizations to more effectively utilize their data to improve care quality, patient satisfaction, and deliver value- based care.
Responsibilities:
Executed the integration of various Customer Data Sources and provided Data Mapping and Data Validation from various sources like CCD (Continuity of Care Document), Meden, and McKesson Paragon into the target centralized customer data source
Responsible for running and utilizing Care Analyzer (NCQA HEDIS Certified Software) to obtain HEDIS measure rates for monthly and annual reporting to management.
Ensured HEDIS data issues were submitted both timely and accurately to NCQA (National Committee for Quality).
Technically experienced with the EMR Data Validation process.
Engineered various HEDIS data submissions to state and federal agencies on a timely basis and ensuring that the quality of the data submitted meets, at a minimum, the various regulatory requirements.
Actively worked with Quality Improvement Claims and other operational business owners to ensure the accuracy of HEDIS data.
Performed all phases of Data Validation such as Internal Data Validation, Standardization Data Validation, Client Data Validation, and Content Data Validation.
Implemented and followed the Agile best practices Software Development Life Cycle throughout the project.
Executed the HIPAA compliance life cycle from gap analysis, mapping, implementation, and testing to support client's measures, attribution, and registry.
Facilitated the User Acceptance Testing (UAT) with EPM System and the Implementation Team, Standardization Team, Business Users, and the Client.
Authored SQL Queries to extract data from the SQL Server Database for QA testing and report data validation.
Operated manual testing and UAT with the Client and Development team. Tracked and managed validation issues to resolution.
Partnered with the coordination, data integration, standardization, and configuration teams to resolve issues with client products/results.
Experience in integrating various clinical information systems/EMRs.
Successfully lead validation to ensure that timelines are met, and client expectations are exceeded.
Defined Test Cases, analyzing bugs, and interacted with the team members to fix errors. Page 3 of 5
Assisted in implementing an effective EMR system to improve efficiency and reduce cost, client’s measures, attribution, and registry
Environment: MS Office (MS Word, MS Excel, MS PowerPoint), Jira, Jenkins, IBM Explorys EPM (Enterprise Performance Management EPM: Measure, Attribution, Registry), FileZilla, DBeaver, SQL Server, Confluence, IBM Lotus, Slack Saint Mary's Health Care, Grand Rapids, MI Jan 2017 - Sept 2018 Business Analyst
Analysed legacy system documentation, file and record formats, system flow charts, and other information to develop a comprehensive depiction of the existing environment as it relates to HIPAA rulings. Involved in data migration and claim processing.
Responsibilities:
Assisted in designing, planning, and managing the data migration process.
Performed source system data analysis, and gap analysis to manage source to target data mapping.
Performed migration and testing of static data, and transaction data from one core system to another.
Worked on claims including claim adjudication, membership, and eligibility.
Responsible for system integration testing of 837 claim files, 834 eligibility files, and 270/271 interface files to ensure required interactions were met during the SDLC process.
Performed data mapping to validate and customize claims’ daily load for processing transactions.
Validated 837 inbound and outbound transactions, including but not limited to the loading and correcting any errors with the process of EDI inbound and outbound files.
Validated outbound 835 transactions including mapping and system configuration with the vendor.
Experience in health care payer and provider operations, re-engineering claims, benefits, enrollment, and eligibility processes.
Experience with different modules within healthcare
Invented the 'Business Glossary' to facilitate and efficient understanding of the business process amongst the other teams.
Environment: MS Office (MS Word, MS Excel, MS PowerPoint, MS Visio), MS Access, Agile, SQL, and SharePoint. State of NY, NYC, NY Jan 2014- Dec 2016
Business Analyst
The State of New York provides quality health insurance and administers the Medicaid and Medicare programs. The objective of the project was to develop the Medicaid Management Information System for the State of New York following HIPAA standards. The web-based Health Care Management System is developed using HIPAA guidelines and regulations which keeps track of Healthcare transactions like Eligibility Request/ Response, Request and Response for Claims Status, Prior Authorization, and Claims Payment.
Responsibilities:
Interacted with the Subject Matter Experts (SMEs) and stakeholders to gather business requirements to obtain a better understanding of business processes.
Validated the following: 837 health care claims or encounters, 835 health care claims payment/remittance, 270/271 eligibility request/response, and 834 enrollment/dis-enrollment from a health plan.
Researched the existing client processes and guided the team in aligning with the HIPAA rules and regulations for the systems for all the EDI transaction sets.
Conducted JAD sessions with management, SME, vendors, users, and other stakeholders for open and pending issues.
Generated daily, weekly, and monthly reports using MS Office Tools and submitted to the Team Leads and Manager for reporting, status reporting, and analyzing purpose.
Developed gap analysis document, logical and physical design, and remediation plan.
Captured, communicated, managed system requirements, and maintained requirement traceability matrix to keep team members up to date with the latest testing results.
Responsible for training and testing transactions.
Analyzed existing procedures and reported them to management to improve productivity.
Involved in the creation of test plans, scenarios, and cases for system, and system integration testing. Page 4 of 5
Environment: MS Project, MS Office Suite, SQL, MS Visio, Requisite Pro, Rational Clear Quest. Kindred Healthcare, Louisville, KY Apr 2012-Dec 2013 Business Analyst
The applications program to determine the impact of the HIPAA final rule one EDI Transaction Set and Code List implementation and defined the changes to bring the affected systems into HIPAA compliance. Analyzed legacy system documentation, file, and record formats, system flow charts and other information to develop a comprehensive depiction of the existing environment as it relates to HIPAA rulings. Involved in claim processing for 837, 835, and 276/277 according to HIPAA implementation rules.
Responsibilities:
Coordinated the upgrade of Transaction Sets 837P, 835, and 834 to HIPAA compliance.
Responsibilities included the analysis of inbound and outbound interfaces and extensions to the claims processing system.
Completed data mapping for group and detailed product analysis and report writing.
Worked closely with EDI to ensure accuracy in data transmissions and shared processes.
Worked on mapping documentation using the Implementation Guide for EDI HIPAA 834, 835, 837.
Coordinated the upgrade of Transaction Sets 837P, 835, and 834 to HIPAA compliance.
Responsibilities include the analysis of inbound and outbound interfaces and extensions to the claims processing system.
Designed and analyzed the facets data model to ensure optimal system performance and tuning.
Configured modules such as claims, membership, billing, benefits, and plans.
Worked closely with EDI to ensure accuracy in data transmissions and shared processes.
Involved in the claim adjudication process.
Generated reports using SQL and MS Excel spreadsheets.
Involved in source data analysis and design mappings for data extraction. Environment: Windows, Oracle, MS Office (MS Word, MS Excel, MS PowerPoint, MS Visio), MS Access, Agile, SQL, ETL, UML, Quality Centre, and SharePoint.
Tele Pacific Communications (TP x Communications) L.A, CA Jan 2011 - Apr 2012 Business Analyst
TPx is the nation’s premier Managed Services Provider, delivering unified communications, managed IT, and network connectivity to 80,000 customer locations across the country. I worked on many projects like Data Migration Project, create a new Ordering form Project, Price Increase Project, and SID Disconnect Project. Responsibilities
Proactively communicated and liaised with stakeholders from various business units to uncover and document business information needs using interviews, document analysis, requirements workshops, process, and workflow analysis.
Formulated and defined the system’s scope and objectives through research and fact-finding, combined with an understanding of applicable business systems and industry requirements
Analyzed business needs and uses system knowledge to formulate functional solutions, which may take the form of new, enhanced, or adaptations of existing functionality with forethought to the business implications of the proposed functionality to the current environment.
Developed and delivered business and functional requirements document(s) consisting of analysis of “As-Is” and “To- Be” functionality to identify business process gaps and containing various process diagrams such as activity, system interface, use cases, user stories, and GUI wireframe prototypes for approval.
Maintained organization methodology standards for requirements gathering and documentation and provided traceability of project objectives of business requirements to proposed solutions.
Performed back-end data analysis and provided a data dictionary to assist developers in mapping new functionality to existing functionality with internal or external applications.
Acted as the liaison between Business and IT throughout the entire lifecycle of the project. Page 5 of 5
Managed project documentation library, version control, and maintained a historical record of requirement activities in the requirements document.
Identified and communicated business requests that require change control initiation to the PM.
Wrote business rules for migration from the legacy system to a web-based application. Environment: MS- Project, Visio, Word, Access, PowerPoint, Excel, SharePoint, Office 365, Quick Base, Jira, Confluence Wiki, Outlook, Kronos, Quality Center, MS Access, Oracle, SQL Server. Target, Minneapolis, MN May 2009 – Dec 2010
Business Analyst
Responsible for day-to-day management, involving marketing/pricing strategy, financial analysis, sales/inventory projection, import commits/domestic ordering, safety stock calculations, supply chain/logistics coordination, and reporting to leadership for six highly profitable and visible categories. Involved in the implementation of the POS solution Responsibilities
Interfaced with team leaders to identify and analyze the given information, procedure, and decision flow.
Worked with end-users to Map Business Processes (BPM) to technical specifications.
Created daily, weekly, and summary reports and performance insights and even performance for tab, including advertised vs. non-advertised sales, Power Hours, Early Birds, BOGO, and like-themed events.
Conducted previews and User Acceptance Test (UAT) sessions with the marketing team.
Worked with system analysts to create an application’s functional and non-functional requirement document.
Developed USE cases for the application and prepared the detailed workflow diagram based on the proposed enhancements, business logic, and rules and translated them to USE Cases for Live Archive.
Collected requirements interviewing stakeholders, business partners, and end users.
Organized JAD sessions with business stakeholders/SMEs for gathering requirements for the newly upgraded platform: estimated project resources, timing, and sequence of deliverables.
Building templates and dashboards for customized views of the data specific to each group and line of business. Environment: SharePoint, MS Office Suite, Quick Base, Jira, Confluence Wiki, Kronos, Quality Center, Oracle, SQL Server. CheapOAir, New York City, NY Mar 2008 – May 2009
Business Analyst
Worked on Ticket/Reservation Management System that was part of the Resource Allocation and Resource Management which plans, implements, and controls the efficient, effective forward and reverse flow of tickets and reservations and related information between the point of origin and the point of consumption to meet customers' requirements. Responsibilities:
Performed stakeholder analysis to identify key players for project success.
Identified and involved all key stakeholders, contributors, business, operations, and technical resources that must participate in a project and ensured that contributors are motivated to complete assigned tasks within the parameters of the project plan.
Prepared interview questionnaires for the clients to gather requirements.
Executed SQL queries and documented them as part of validating the Business Object reports and for testing purposes.
Responsible for maintaining and enhancing the ERP application according to the changing business requirements.
Performed validation testing on the application for various scenarios and reported the errors.
Conducting JAD sessions and gathering software requirements and Business intelligence rules. Environment: Agile, Waterfall, Rational Rose, Rational RequisitePro, Windows, MS Visio. EDUCATION:
Bachelor of Arts - Economics (Gujarat University, India) - 2000. CERTIFICATIONS:
CSM (Certified Scrum Master) – 2018
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