SUMMARY

• Provided SAS & SQL trainings to the group of 25 members within the organization, helping them to grow technically.
• Extensively worked on Medicaid, Medicare, MyCare and several other Managed care plans and products.
• Worked with the business owners, project managers, stakeholders, vendors, regulatory bodies for various data extracts and submissions.
• Extensive experience working with various business areas like the Claims, Encounters, Enrollment, Provider Networking, Call Center, ACG, Pharmacy, Disease management and Case Management etc.
• Specialized in Data Research, Data Extraction, Data Analysis, Data Cleaning, Data Profiling, Data Mining, Data Manipulation, Data Summarization, Data Visualization etc.
• Experience in using the FACETS and CareAdvance for reporting and analytical purposes.
• Highly efficient in handling huge amounts of data (millions of records) through SAS, SSIS, SQL.
• High - level understanding of the VB script to convert the XML files to XLS format.
• Converted the .net code to SAS code
• Used the advanced concepts of MS Excel such as pivot tables, graphs and advanced functions
• Deployed the code through different non-prod environments using Team City and Octopus Deploy.
• Worked in Agile, Scrum and Sprint environments and worked closely with the business end users.
• Using the SAS Macros created several complex reusable programs for various needs.
• Knowledge of the statistical analytical methods like Correlation analysis, ANOVA, t-test, market basket analysis.
• Extensive experience in BASE SAS, SAS EG, SAS MACROS, SAS/ACCESS, SAS/GRAPH, SAS/Proc SQL, SAS ODS in Windows environment.
• Experience in generating reports in various formats like the Excel, RTF, PDF, TXT, CSV formatted files using SAS ODS to produce ad-hoc reports for presentation and further analysis.
• Automated the SAS EG adhoc programs and scheduled them on Tidal.

TECHNICAL SKILLS

Statistical Packages: SAS 9.1, 9.2, 9.3, R

SAS Tools: SAS/BASE, SAS/EG, SAS/MACROS, SAS/SQL, SAS/STAT, SAS/ACCESS, SAS/ODS, SAS/GRAPH, SAS/Enterprise Miner

ETL Tools: SSIS 2012, Informatica9.6

Databases: SQL SERVER 2008 R2, SQL SERVER 2012, MS Access

Office Tools: MS Office (Word, Excel, Power Point, Visio, TFS), Ultra edit, NotePad+

Business Intelligence: SAS Management Console, SAS Data Integration Studio

Operating Systems: Windows 98/2000/XP, UNIX, MS-DOS

Other Tools: SQL, PL/SQL, T/SQL, TortoiseSVN, Git, Tidal, ServiceNow

PROFESSIONAL EXPERIENCE

Confidential, Dayton, OH

SAS Programmer/Data Analyst

Responsibilities:

• Worked with both the Claims & Encounters teams for the data extraction and data submissions of the claim and encounters data using both SAS, SQL.
• Extracted and handled huge amounts (millions) of claims and encounters data efficiently.
• Worked with the finance team, Claims team & the Operations team and made sure that all the Risk adjustment claims were submitted which accounted for additional revenue for the organization.
• Played a pivotal role in driving the RateSetting effort and helped to achieve a better rate per member.
• Worked closely with the Compliance team in successfully completing the auditing process done by IPRO.
• Created, peer-reviewed, validated several regulatory reports and the data pulls before submitting to AON, HSAG, ODM, KDMS and CVS.
• Performed the CDJ(Cash Disbursement Journal) analysis and helped to maintain a minimum of 99% of Cumulative total for the rolling 24 months period for the GA Medicaid Product.
• Identified the gaps in the CDJ reporting and helped to bridge them.
• Monitored the PDUP & CV records by closely working with the State (DCH, M &S, MMIS) and the Claims team for recoupment process.
• Created a Week over Week report for all LOB’s which captured all the Incoming claims paid in Facets vs their current situation in Edifecs and provided a better picture to all the operation teams thus helping in maintaining the Timeliness, Completeness and Accuracy measures.
• Created a repository for the business teams where they can store, manage data and monitor the downstream changes.
• Helped in setting up a local subversion repository (svn) thus helping the developers maintaining different versions of the code and also recording the changes made.
• Created the process/program that generates the input source files(both Linked & Unlinked ) for the Edifecs system which in turn creates the Chart review records (EDPS & RAPS ) for both MyCare & MA plans and had them submitted to the CMS.
• Converted .net process into a SAS Process thus owning the entire process.
• Created ETL packages combining all the Facets paid claims data, External Vendor data with the Encounters data.
• Modifying the existing jobs to accommodate ICD-10-CM and ICD-10-PCS d iagnosis and procedure inpatient codes. Validated several jobs after the ICD-10 implementation.
• Developed and maintained several SAS jobs, which creates Web Reports for case management, disease management, members, providers etc.
• Helped create reports on Pharmacy data, member data to demonstrate the high utilizers and drill down the data to member level.
• Perform data analysis for detection of Fraud claims and multiple enrollments of Plans through EDI Watch.
• Update and maintain data warehouse (EDW) and generate various claims, member and provider reports.
• Extensively use SAS Enterprise Guide for Ad hoc reporting.
• Write macros to organize data files to business specifications within standard office applications such as Excel, Access, Word, and PowerPoint
• Setting up and scheduling Stored Procedures in SAS BI server.
• Worked on Care Advance reporting and have good understanding of data structure.
• Used SAS for pre-processing data, SQL queries, data analysis, generated reports, graphics and statistical analyses.
• Automated the business process using SAS Macros, data steps, Proc Sql to remove the human error and dependency, parametrized the variables, created a batch job, which was scheduled on a Tidal and the output files, were then published on a centralized portal to be used by the end users.
• Created several new reports in various formats like RTF, HTML, XLS, TXT, Pdf, CSV etc. using Base SAS, SAS EG and SQL Server Reporting Services (SSRS).
• Created several stored procedures in both SAS and SQL Server to be used for reporting purposes.
• Debugging and fixing the job failures to ensure the timely submissions of the reports
• Responsible for generating several adhoc operational reports using SAS EG
• Worked on As-Is To-Be analysis of the ICD 9 - ICD 10 Conversion of the SAS Jobs and processes.
• Responsible for modifying and updating most of the SAS reports and programs that uses the ICD 9 Diag and Proc Codes and to pull the equivalent ICD 10 codes.
• Tuned in a lot of process using the “hashtag” concept in SAS. Using SQL pass through facility and the temporary tables the run time for many of the jobs have been improved.
• Was primarily responsible to test and analyze the changes as a result of the upgrade process
• Performed Unit testing, Integration testing, black box testing, regression and functional testing.
• Assisted the business users with the User Acceptance testing and documented all the test results on the HP Quality control to track down all the defects.
• Data Preparation: data sources identification, data extraction, maintaining data integrity, manipulation, processing, analysis & storage.
• Data Exploration: treating the outliers, handling missing values, summarizing categorical data
• Model Establishment: includes partitioning into validation, test & training datasets, planning appropriate model based on the data available, developing models through hypothesis testing, interpretation of the data, regression evaluation and to draw relevant conclusions.
• Created the input files, SAS Datasets needed for the ACG Software, which creates the risk Population, groups, risk scores, ADG, EDC etc based on several factors.
• Responsible for the conversion of the SAS Project to an SSIS package and included all LOB’s.
• Worked on grouping the population into the Clinical groups (ACG) using the John Hopkins Software and SAS.
• Developed new SSRS reports and Power BI dashboards and maintenance of existing reports.
• Researched and developed queries to bucket the population for the Open Enrollment.
• Designed and developed stored procedures, triggers, indexes, queries and views as needed.
• Used table variables and Common table expressions.
• Created and maintained several packages to extract data from different sources (Text, XML, Tables), transform them and load large volumes of data into a table.
• Analyzed data models, data relationships and dependencies for optimization and created several STM’s for the reports and dashboards.
• Provided an overview of the dashboards to the department and their KPI’s thus promoting the folks utilize the dashboards more often.

Graduate Assistant

Confidential, Brooklyn, New York

Responsibilities:

• Handled administrative tasks including preparation of PowerPoint preparations, data entry and analysis, collation of marketing materials and presentations.
• Conduct 4 hours per week of classroom presentations
• Provide assistance with event planning and supervision of undergraduate student workers
• Post materials in “MyCourses” and respond to student questions
• Assist with faculty research projects; Contribute to development of new material for departmental courses
• Tutored/helped undergraduate students with their Algebra & Geometry.