SUMMARY
TECHNICAL SKILLS
MS SQL/SSIS/SSRS; CRE XI/10/9/8.5; Oracle 10g; Business Objects; FACETS; GE Centricity; Teradata; BI Query; DB2; Lotus Notes; SAS 9.0; SAS BI/DI; ETL; Multi-tiered architectures; WAN/LAN; TQM; RAID; Very large-scale database; HL7; NSF 2.0; EHR; EMR; CPT; ICD9-CM; HCPCS; NDC; GPI; LOINC; UB04; HCFA1500; BHI
AREAS OF EXPERTISE
NCQA; HEDIS; NYC DOH; NYC CIR; operation analytics, finance analytics, and marketing analytics; program development, provider profiling, and hospital profiling; TQM
PROFESSIONAL EXPERIENCE Senior Clinical Informatics Analyst, Confidential,2009 - 2010
Responsible as a core member of clinical informatics team for development, maintenance, clinical staff training, and help desk support in a large-scale GE Centricity implementation at a 500+ employee multi-site health clinic. Primarily responsible for design and deployment of clinic-wide high-performance data warehouse/BI solution (SSRS and Crystal Enterprise XI) for point of care support, research and regulatory data collection, decision support and medical billing. Quality initiatives include cervical cancer screening, lead screening, children’s immunization, breast cancer screening, and others. Act as system analysis coordinator for pediatrics department for care management initiatives and EMR implementation. Primarily responsible for Crystal Report’s design and implementation for regulatory reporting to New York City, state and federal agencies. Lead Programmer/Analyst, Confidential,WellPoint, 2003 - 2008
Senior lead in a 6-staff department. Responsible for database and data warehouse design for claims data of 28 million members (commercial/Medicare/Medicaid). Successfully lead server conversion project from SQL 2000 to SQL 2005 including converting DTS packages into SSIS packages. Responsible for coaching and mentoring staff on study projects, ETL process and advanced SQL programming skills. Responsible for ETL and QA of medical claims, pharmacy claims and enrollment data. Responsible for review SQL programs for accuracy and efficiency. Subject expert in LabCorp and Quest Diagnostic data feed. MIS Manager, Confidential,Newark, DE, 2000 - 2002
Define and establish the overall data warehouse architecture for SFC business; develop an integrated data model covering the entire business technical database and analytic platform, and system/data integration approach. Budget and supervise 6-staff MIS department. Coordinate with marketing and IT departments on company’s primary e-commerce initiatives using Windows NT, BackOffice and VB Scripts. Provide weekly, monthly and ac-hoc reports for senior management and large investment institutes such as PNC and Wilmington Trust. Reporting Analyst, Confidential,Philadelphia, PA, 1999 - 2000
Interact with accounting/finance, contract management, provider relations, member service, compliance, and other departments; analyze requirements with regard to statutory reporting, HEDIS, NCQA, HIPAA, and other internal and external reporting. Rx projects include formulary review and prescription profiling of PCP networks. Produce analytics tools such as utilization reviews; claim processing, and PMPM costs by gender, age, eligibility/program, and PCP. Responsible for quality assurance of weekly ETL of claims and enrollment from mainframe into company data warehouse. Implement and maintain relational database systems to warehouse claims, enrollment and provider information. Perform all data analysis related to periodic reviews of provider contractual reimbursement. Senior Associate, Confidential,Philadelphia, PA 19103, 1997 - 1998.
Participate in IS audits based on firm’s system review methodologies. Some client projects as follow:
PrudentialCare - lead a 9-associate audit team performing healthcare cost analysis of 450 large self-insured corporations. Audit covers 5 years of information on enrollment, inpatient, outpatient and pharmacy costs. Various Hospitals - develop advanced analytical tools and apply sophisticated business rules in hospital contracts with commercial payors. Audit contractual reimbursement for potential underpayment especially in claims involving carve-outs and stop loss. American Hospital Association - develop knowledge databases within Coopers & Lybrand Healthcare Compliance/Regulatory Group. Coordinate web exchange with AHA for commercial sales of the expert system to member hospitals. PwC National Support Group – responsible for workflow solutions within HR division. Deliver applications that eliminated manual process of collecting and tracking annual performance reviews for 7,500 staff nationwide. EDUCATION
MBA, accounting and MIS B.S., computer science B.A., engineering economy
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