PROFESSIONAL SUMMARY:

• 17 years of experience as a SAS/SQL programmer and business analyst performing marketing campaign outcomes, customer segmentation, claims reconciliation, auditing, medical and financial data extraction and reporting Strong background in Medicare and Medicaid compliance and audits in a regulated environment.
• Reporting tools: Tableau, SAS, Alteryx Designer, Cognos, SSRS, SSAS, Business Objects.
• Previous work as a pharmaceutical chemist with GMP/GLP training. Experience with LIMS data systems, NDA requirements, FDA audits, GLP/GMP training and familiar with CFR Title 21.
• Extensive experience working with internal and external clients and users.
• Medical loss ratio reports, provider score cards, pay for performance, risk analysis of members for intervention, government reporting requirements for the healthcare industry. Reporting to actuarial, sales, marketing, membership, external clients. Reconciliation and auditing of Medicare Part D claims and eligibility in a Six Sigma environment. Familiar with project life cycle.

TECHNICAL SKILLS:

Databases: Oracle 9.x/10g/11g/12c, SQL Server 2008R2/2012, Teradata 12/13/14, MySQL

Languages: SQL, PL/SQL, T - SQL, C#, Visual Basic, SAS, AWK, SED, Unix shell scripting, PERL, Java, JavaScript, Python

Development tools: Toad, SAS-EG, SQL Developer, Queryman, Business Objects, Tableau, Alteryx, SSIS, SSRS, SSAS

Operating Systems: Unix, IBM z/OS, Windows

PROFESSIONAL EXPERIENCE

Confidential

• Marketing analysis and reporting using Oracle Eloqua, Tableau, SQL Server, Azure, Excel pivot tables. Interactive mapping, ‘what-if’ scenarios, parameterized reports in Tableau.
• Market segmentation, customer targeting/selection, implementation of process improvements, analysis of email marketing campaign outcomes for different marketing segments using Oracle Eloqua.

Confidential

Senior data analyst

• Company created a web based information system based on Quadramed to be interfaced with the new system for use by physicians and health care workers in a hospital setting.
• The system had an Oracle 12c, SQL Server and Unix back end and ASP.net front end. SAS EG 7.1 and Tableau was also used extensively to analyze data. The Oracle database was a dimensional database designed for Oracle Explorer.
• Created stored procedures used to load web pages per requirements. The stored procedures were used to bring in data and images stored on a Unix system.
• This involved the use of SQL and regular expressions to extract medical data from electronic medical records for presentation in the web based system. BFILES are used to load image data such as X-rays etc.
• Created stored procedures and functions using T-SQL on SQL Server 2010.
• In addition, research on New York State DSRIP using SAS EG was performed to locate the most suitable projects for HHC to participate in, including cost and utilization analysis of hospital claims data.
• Use of Alteryx and Tableau for data blending of patient information from different facilities and research.
• Performed analysis and flow charting of processes written in Java/Unix.
• The project was completed and went to production.

Confidential, Franklin Lakes, N.J.

• Designed and managed a Medicare Part D Broker database. This was created as per senior management.
• Performed weekly audits per CMS requirements against the Broker database.
• Created loading processes from an IBM mainframe into the Broker database.
• Accompanied senior management on CMS audits to answer all questions pertaining to data management.
• Created SOP’s for the maintenance and daily loading and auditing of the Broker database.
• Reconciled member accounts using CMS Medicare D database based in Washington D.C. and Express Scripts FACETS database.
• Analyzed outcomes for sales campaigns for the Marketing dept using SAS.
• Designed and developed database reporting interfaces using SAS EG and Excel/VBA in a Teradata environment to support marketing, actuarial and Medicare D enrollment and eligibility.
• Creation of base SAS and SAS macro programs.
• Implementation of Teradata based analytic solutions via Teradata SQL stored procedures.
• Interfaced with users to determine requirements for data, reports and training.
• Designed processes to extract, transform, cleanse and load data.
• Maintained, updated and tested SQL on IBM mainframe using BTEQ.
• Documented processes by creating SOP’s and flow charts.
• Designed and provided training sessions for Medco employees on Teradata and SAS.

Confidential, Brooklyn, N.Y.

Sr. Data Analyst

• Performed medical, financial and risk analysis reporting using Medstat, ViPS, Business Objects, SQL Server 2008 and Microsoft reporting tools against a Facets database on SQL Server.
• Medical loss ratio reporting, benchmarking of primary care physicians, PCPs, pay per performance measures for PCPs, member utilization and cost monitoring, over billing monitoring, relative risk comparisons vs. cost of providers and detection for the early intervention for members was performed.
• QARR/HEDIS formatted reporting to New York State SSRS was performed.
• PCP report cards and pay for performance using SSRS was performed.
• Scheduled the loading of daily inpatient data from Excel into SQL Server warehouse using SSIS.
• Managed, maintained and updated a reporting database in SQL Server2008.
• Was a member of the Readmissions project team - this role identified the readmission rate among members having COPD, asthma, pneumonia, CAD, CHF. Provided demographic information to the Readmission committee to improve aftercare and rates of readmission.
• Was a member of the HIV project committee - identified new members having HIV including the level of illness. Provided medical, pharmacy and demographic information on new members.
• Was a member of the Behavioral Health committee-identified new candidates for QARR/HEDIS studies and reported to the committee on the status of these members.
• Performed independent research for M.D. using Medstat.

Confidential, Manhattan, N.Y.

Sr. Data Analyst/Programmer

• Performed data extraction and reporting as per user and government requirements such as QARR/HEDIS MEDS II using SAS EG with an Oracle back end.
• Designed and implemented production and ad-hoc reports per user and government requirements using McKesson CRMS, SAS, SSRS Report Designer and Report Builder against a SQL Server back end.
• Performed analysis and reporting of claims data using SSRS for marketing/sales including changes in enrollment and renewal rates.
• Reports were created for internal and external users.
• Designed and created user interfaces such as ASP.NET web pages, Perl cgi, and SAS AF screens for user report generation.
• Scheduled data loading using SSIS from Excel, Access and delimited flat files into SQL Server warehouse.
• Performed government reporting such as MEDS II, QARR, HEDIS, ANSI X12 834 EDI, HL7 reporting.

Confidential

Programmer

• Project: Migration of SAS/DB2 jobs from IBM mainframe to an Oracle server environment.
• Interfaced SAS Enterprise Guide with Oracle data bases.
• Performed parallel testing on the new and legacy system.
• Validation was performed to verify the integrity of data tables and output report data of the new system.

Confidential, Manhattan, N.Y.

Database Manager

• Managed, maintained and updated the demographics, trending and historical databases and automated reporting software used by the membership, marketing/sales and actuarial depts.
• Maintained and updated the sales department database and website.
• The databases were on an IBM mainframe in DB2, VSAM, SAS and flat file format.
• Created reports for actuarial, marketing/sales and membership depts. such as rates of enrollment and renewal and sales commissions owed.
• Performed production and ad-hoc reporting using Business Objects, SAS, Excel/VBA macros to produce custom reports for users.
• Managed monthly, daily, hourly job streams on the mainframe.
• Assisted in HEDIS audits of information practices, control procedures, and data integrity.

Confidential, Manhattan, N.Y.

Programmer analyst

• Performed medical claims analysis and reporting using SAS, Cognos Impromptu, MS Office reporting tools.
• Performed HEDIS/QARR analysis using IBM mainframe and PC SAS.
• Wrote programs to NYS DOH and NCQA specifications.
• Conducted quarterly HEDIS reporting on quality measures per NCQA specifications.
• Streamlined quarterly data exchange processes with NYC Immunization Registry and Lead Registry.
• Assisted in using membership data for HIP's outreach programs.
• Reports were created using Cognos Impromptu, Crystal Reports, and SAS.

Confidential, Paramus, NJ

• Taught a core course in Base SAS with an emphasis on obtaining certification through the SAS Institute. Course was designed by myself.

Confidential, Fort Lee, N.J.

Programmer analyst

• Performed design and testing of programs and processes related to EDI reporting on IBM mainframe.
• Quikjobs, SAS, SQL and Report Writer were used.
• Assisted with issue tracking, data investigation, root cause analysis and problem resolution.
• Data was analyzed and reported as specified by HIPAA using ANSI X12 834 EDI standards. Output reports were tested for government compliance using Claredi a web based testing facility.
• All data mapping and data dependencies were examined using proc freq, proc tabulate and in house testing programs.
• Parallel testing was performed on new programs against production programs. A validation program was written to examine the integrity of output report data.

Confidential, Trenton, NJ

Mainframe/Unix Programmer

• Writing and testing of batch and CICS programs written in COBOL and Natural was performed. Reporting using base SAS, SAS macros on Unix(Red Hat) were performed. Use of Expediter, Intertest and SPUFI were used to test programs. Syncsort, generation of GDG and VSAM data sets was performed. Unix SAS, Proc Report., Proc Plot, Proc Chart, Proc CPORT CIMPORT. Creation of VSAM files, repro of flat files into VSAM files and verifying them was performed. Testing of programs against Adabase, Unix shell scripting was performed.