SUMMARY:

High Achiever Health Analytics professional equipped with strong work ethic, leadership skills and a passion for Healthcare data analytics, mining and Informatics to improve organizational efficiency and patient outcomes. Expert in Business Intelligence, SQL databases and Enterprise Data Warehouse. Subject Matter Expert surrounding Clinical Quality and Clinical Integration of physicians, specialist groups and facilities for value - based reimbursement and incentives. Works collaboratively with skilled professionals yet equally comfortable working independently.

CORE STRENGTHS:

• Business Intelligence/Data Warehouse
• EMR and Claims data
• Inpatient and Ambulatory Clinical Quality measures and analytics
• Medical Vocabularies (ICD,CPT/HCPCS,LO INC, RXNORM,SNOMED,NDC, HL7)
• Managerial and Team Lead Skills
• Medicaid/Medicare/Regulatory Reporting
• Nursing Workflow

TECHNICAL SKILLS:

Enterprise Data Warehouse/STAR schemas

Data Analyst/Data Modeling/DBA

SQL

ETL

HTML/XML/CSS/JavaScript

Java programming

Reporting Tools (SSRS, Business Objects, Excel, Tableau)

Data and network security

Dashboards and Visual Presentation

SharePoint

JIRA, AGILE Scrum

PROFESSIONAL EXPERIENCE:

Confidential

Manager, Medicaid Data Reporting and Analytics

Responsibilities:

• Directs data analytics team of data analysts and business analysts providing on-demand and recurring data analytics and reporting for traditional and Managed Care Medicaid programs. Dashboards and reports are developed in SQL. Visualization dashes are Excel or Tableau
• Serves as liaison to Office of Medicaid Policy and Planning, Health Department, Fraud Investigation Unit and other internal and external partners for Medicaid data reporting needs provided by Enterprise Data Warehouse
• Directs vendor resources in requirement determination, design and development of reports and Medicaid executive dashboards for HIP 2.0
• Fully supported reporting and analytics for HIP 2.0, Indiana’s Medicaid Affordable Care Act expansion, and Hoosier Care Connect program including conversion populations, special populations, medically frail and high-risk populations, pharmaceutical, capitation reporting, and newly eligible populations
• Works with vendors to support new data sources and transform into SQL/EDW ODS and reporting schemas
• Interacts, supports and participates in executive meetings surrounding Medicaid issues and reporting solutions
• Implemented standards for requirements documentation, User Acceptance Testing (UAT), and work processes
• HEDIS like Quality Reporting on vendors providing Indiana’s Managed Care Medicaid providers
• Keeps abreast of Medicaid Policy and new Medicaid initiatives/programs and advises of Medicaid program key points
• Participates in data acquisition and data mart design meetings
• Implemented utilization of steward based value sets (NCQA, AMA,etc) for standardization and accuracy in clinical reporting
• Ensures regulatory reporting (CMS) needs are met and timely
• Designed for accommodation of ICD-10 claims and forward and backward reporting between ICD-9 and ICD-10 CM/PCS across EDW

Confidential

Clinical Quality Specialist/Architect

Responsibilities:

• Researches and defines requirements for clinical measures for addition, enhancement and customization used for Vision Clinical Integration software product portfolio.
• Vision product is developed with MS-SQL backend and java/ front-end.
• Acquires and maintains full understanding of prospective and retrospective clinical quality performance across chronic population, preventative and clinical effectiveness domains
• Support new and existing healthcare customers/clinician specialists in selection and customization of measures
• Monitors assigned clients performance of individual and aggregated measures across physician, specialist group and network.
• Performs internal unit and UAT testing to ensure working as specified
• Assists data/development teams with data acquisition, extraction and translation from variety of EMR’s into enterprise data warehouse (EDW) in support of Population Health and Clinical Integration for Performance Management, Risk Management and Financial Incentive Programs.
• Maintains subject matter expert on CQM program requirements (HEDIS, ACO, CHIPRA, PQRS)
• Designed and Implemented SharePoint site for Clinical Quality Team
• Partner with In-House physicians on special projects offering SQL Database and Data Mining Support
• Lead for impact analysis and recommended solution for ICD-10 CM and PCS
• Promoted to Architect and was instrumental in major product software refactoring design to HL7/HQMF representation of measures used by new java executor engine
• Develop Patient Information model virtual design and supporting SQL data structure and HL7 C-CDA for transport
• Presents architecture and key projects to executives and software development teams

Confidential

Consultant

Responsibilities:

• Consulting project for Confidential in creating an integrated dashboard of Clinical Quality measures across programs that Confidential participates in including Hospital Inpatient/Outpatient Quality Reporting, Meaningful Use and Accountable Care Organization metrics
• Worked as collaborative team to analyze reporting requirements, map data and develop SQL using available hospital EMR’s data and recommending customization, orders, or workflow changes as necessary
• Documented and prepared presentations for complex measures (Hospital Acquired and Surgical Infections)
• Maintain global data dictionary of data items and defined measures as electronic specifications
• Support development of mapping translation and product schemas (SQL) with conversion of local EMR taxonomy data to standard taxonomies

Confidential

Business Intelligence Analyst, Sr.

Responsibilities:

• Delivered Senior BI services to EDW Project to accommodate Meaningful Use across major health network with 126 hospitals.
• Requirements planning, design and development for-patient clinical data integration into central corporate Drummond certified EDW supporting ONC/CMS Meaningful Use Clinical Quality Measures (CQM)
• Assisted DBA’s and ETL resources with mapping of acquired data into staging and star EDW schemas as needed for CQM reporting
• Researched and modeled design for facilities using different EMR’s to be added to EDW and presented and reviewed functional and technical requirements to development team
• Developed Microsoft SSRS Reports for Global integrated metrics and executive dashboards and attestation
• Conducted education sessions on Meaningful Use and CQM

Confidential

Senior Data Analyst

Responsibilities:

• Assisted highly skilled architects with a component based distributed java architecture with Oracle database backend and Web Logic web application servers
• Collaborates with Architects and Development Project Lead to ensure design is compliant with interoperability, security and standards
• Adherence to Agile Scrum Methodology with Sprints, Daily Scrums and JIRA
• Designed Data Model for support of medical record auditing and reporting for HIPAA compliance
• Implemented two-way encryption with implementation of PKI certificate infrastructure for exchanging medical records and insurance information
• Installation and maintenance of web logic instances for development and testing environments
• Installation and maintenance of Oracle RDBMS Virtual database servers
• Serves as added resource to java team as available

Confidential

Consultant

Responsibilities:

• Served as senior database administrator /analyst for classified DoD projects in multi-team environment
• Led efforts to extract and document requirements from Functional Users and designed a new Reporting Module for key global application developed in Java with STRUTS framework and embedded SQL.
• Obtained Security+ (computer security) certification and led conversion of key applications from user password to SSI CAC card certificate logons
• Developed application security models
• Initiated project development team for refactoring a major legacy applications that was performing poorly
• Provided tuning and performance consultation with travel to facilities experiencing severe systems performance issues.
• Migrated Oracle 10G databases to Oracle 11G and implemented Oracle Advanced Compression for embedded documents
• Supported application web servers for key project
• Replacement of web servers and databases with newer hardware
• Migrated public facing application and database servers to private subnets

Confidential

Business Information Coordinator

Responsibilities:

• Reports to VP of Case Management and is tightly intertwined with the Decision Support team working closely with Case Management Directors at three 150+ bed hospitals
• Generated comprehensive reports and dashboards for Hospital Case Management supporting key hospital metrics such as admissions and discharges, length of stay, census and payer mix across facilities and physician scorecards
• Rendered continuous support to Midas+ version 7.0 Case Management software and worked closely with field Case Managers and Social Workers ensuring they are supported
• Trains New Case Managers on Midas+ software
• Works closely with the Decision Support/Financial Reporting team using McKesson HPM tool against data warehouse (EDW) for advanced analytics and data mining
• Developed new reports using Crystal Reports (Business Objects)
• Prepared Excel graphs and charts for regulatory requirements
• Developed of dashboards and customized key metrics for Hospital Managers and network HIQR initiative
• Data mining and reporting of financial metrics for encompassing outliers, patient readmissions, direct variable costs, delays and denial revenue recovery
• Successfully transitioned from student nurse to experienced RN able to serve as Charge Nurse and to move to higher patient acuity unit (Renal Oncology)
• Deliver outstanding primary care to medical post-surgical in-patients and out-patients using primary care model. Monitored patients, delivered infusions to outpatients, and assisted physicians with outpatient procedures
• Devised nursing care plans, executed physician orders, performed patient assessments, discharge education, and medication reconciliation.
• Continuous communication with physicians on patient status and needs
• Presented on pathology, symptoms, testing and prevention of nosocomial infections to unit clinicians and aides
• Served as instructor in network-wide initiative to educate entire hospital staff on techniques to reduce medical errors

Confidential

Database Administrator - Data Warehouse

Responsibilities:

• Senior DBA for data warehouse administrator for mortgage company specializing in loan origination and loan servicing brought on to help correct and underperforming EDW project
• Collaborated with Business Subject Matter Experts to develop workflows and collect key metadata
• Design database staging model and STAR reporting model and interfaces from legacy applications
• Researched and Evaluated reporting software middleware options
• Assist ETL programs to extract data from legacy system and with data cleansing and transformation rules
• Installed, patched, and configured the Oracle RDBMS software with OLAP, IIS web servers, and Business Objects Middleware
• Prepare and Test Disaster Recovery Plan for EDW databases

Confidential

Database Administrator (DBA)

Responsibilities:

• Lead database administrator for geographically distributed team.
• Data modeling and design, risk analysis and requirements, disaster recovery and optimization
• Full responsibility in engineering data model architecture of major Internet retailer high-traffic website developed in Java with embedded Oracle SQL.
• Assisted Java development effort of web-based retail application refactoring with backend design
• Implemented effective Oracle replication data model reducing site downtime to effectively zero.
• Supervised a team of database administrators and collaborated with marketing in the implementation and addition of features, which facilitated significant improvement in revenue