Santhosh Gunnala E-Mail: adiv7a@r.postjobfree.com

Mobile No: +1-716-***-****

SUMMARY

Have 10+ years of experience in Business Intelligence Microsoft technology stack, Informatica, Green Plum, Tableau etc. and working with GGK technologies INC, Duluth GA.

Experience in designing and developing data warehouse and analytics solutions. Good at data analysis and data profiling.

Designing data models (logical, physical, dimensional and relational 3NF models) for OLAP and OLTP systems

Hands on experience in Query Optimization and Performance Tuning using tools SQL Profiler, Index Tuning Wizard and database Engine Tuning Advisor

Experience in providing ETL design strategies for various data loads using - Informatica, SSIS, Data Stage.

Expertise on SQL Server, Oracle, Sybase ASC, IQ, GreenPlum and My SQL.

Business Intelligence reporting using SSRS, Excel. Tableau & Power BI

Good Experience in US healthcare domain Medicare, Medicaid and Commercial lines of business Enrollment, Member Services, Claims, encounters submission and risk adjustment processes

Good communicator and facilitator, able to drive onsite meeting with Business users, and good at understanding and validating of business requirements.

Had good understanding on Payer and Provider electronic communications EDI 834, 820, 837P/D/I, 277, 835, 270, 271, 277, 276, and 278 files

Strong knowledge of HIPAA compliance.

Helped payers in submitting Medicaid, Medicare and commercial line of business encounters to State and CMS. Helped payer in increasing encounter submission acceptance rate from state.

Good at analyzing the members health conditions ICD, HCC codes and identify the suspect list for risk adjustment operations.

Knowledge on healthcare standards and usage of CPT, HCPCS, POS, bill type codes.

Designed solutions to submit supplemental diagnosis codes to CMS EDPS, RAPS and state systems.

Helped payers in calculating and reconciling the risk scores.

Helped payers in increasing the capitation payment from CMS by identifying members for interventions through CMS MMR and MOR files

Designed ETLs to process EDI 834 Benefit Enrollment and Maintenance and EDI 837P/I files.

Skilled at analyzing, extracting and modeling data, ETL tools and spreadsheets, demonstrated experience in writing and reviewing technical specifications. And document logical data models based on business. In addition to this, Involved in designing ETL source to target mapping queries and OBIEE report queries in ORACLE

Strong programming skills using T-SQL Profound knowledge and ability to write complex queries.

Designing of new mappings and updating the existing mappings for change requests

Develop test cases and test scripts based on business requirements & technical specs.

Develop unit test cases to track the changes in an application

TECHNICAL SKILLS

Scripting

T-SQL, PL/SQL, PostGreSQL

Data storage

SQL, SQL Server, Oracle DB, PostgreSQL, Greenplum, Sybase ASC, IQ, MySQL, Azure SQL warehouse

Data integrations and processing

SSIS, Informatica, Data Stage

Analytics

SSRS, PowerBI, Tableau

Centene Corporation, USA, Duration: Nov 2017-Present

Role: Data Analyst

Responsibilities:

Create stored procedures in Teradata to load the data snapshots into data warehouse tables for end user reporting.

Use SAS to load the data into Teradata tables from Excel and csv files.

Improve stored procedure performance by optimizing the SQLs.

Work on submitting regular encounters and risk adjustment supplemental diagnosis codes to state and CMS.

Work with vendors to share the enrollment, claims, provider, pharma, and lab data extracts and consuming chart review results from them.

Validate chart review results and submit them to state and CMS systems.

Prepare requirements to enhance existing risk adjustment and encounter solutions to meet new state and CMS guidelines.

Review MOR, MMR, RAPS response, error and return files.

Going through CMS HPMS Memos and make necessary changes to system.

Generate reports for business users on acceptance rates, submitted supplemental diagnosis codes etc.

Tools and Technologies:

Visual Studio 2012, Teradata, SAS, Data Stage, Sql Server 2016, Greenplum, Sybase ASC and IQ, SSIS, Jira.

Trusted Healthplan Washington DC, USA, Duration: June 2015-Oct 2017

Role: Data Architect

Responsibilities:

Designed data warehouse solution and ETL’s to maintain Enrollment, membership, claim and encounter information from Healthplan core administrative system.

Designed SSIS data and control flow jobs to share the membership and provider information to third party vendor and consumed their portal services

Performed case management system data migration from Oracle to Azure Sql server

Developed ETL jobs to generate provider, member, plan, claim files to third party vendor to calculate HEDIS score and processed care gaps information into Payer system

Environment:

Azure SQL, SQL Data warehouse, SSIS, Oracle, Tableau.

Blue Cross Blue Shield of IL, Duration: March 2012-May 2015

Role: Data Integration Architect

Responsibilities:

Played key role in designing and developing member services and producer portal.

Participated in business meetings with business users to collect the requirements.

Designed complex ETL packages to transfer data to other downstream systems.

Redesigned and optimized existing ETL packages and improved the performance

Designed data marts to process encounter information from vendors and generated reports

Improved applications performance by implementing the exchange partitions on SQL Server tables.

Environment:

Informatica, SQL Server, SSIS, DB2, SSRS, HP quality Center

COX Communications – ETL Solution, Duration: Aug 2010-Feb 2012

Role: ETL Developer

Responsibilities:

Data warehouse to capture the data from all other Database sources and other sources involved in the business.

Developed ETL Framework (mappings, mapplets, workflows) which would process flat files of different structures using a single maintainable package.

Handled parallel ETL processing design to process multiple files at a time.

Developed summary reports for business using OBIEE.

Environment:

Informatica, SQL server, SSIS, SSRS, Oracle, HP Quality Center

Personal Information:

Full Name : Santhosh Gunnala

Father’s Name : Thukaram

Date-of-Birth : 08-10-1989 (MM-DD-YYYY)

PAN : AMLPG4927H

Marital Status : Single

Nationality : Indian

Languages Known : English, Telugu

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