Data Engineer

• May 2022 - Present

Senior Data Analyst

• May 2016 - May 2022

 Successfully Architected and implemented SBM,ARPA, Redesign of1095A/B,H36,H41, QHP and MA Recon projects using Informatica and PostgreSQL/IBM DB2 to send/receive Member Health, Financial, Eligibility and Enrollment information to and from Carriers (CF, KP, UHG, CIGNA, Aetna etc.,), DHMH, MDH, CMS and IRS. Extensively worked on performance tuning of 1095A batch to reduce the run time from 9.5 hours to 45 mins.  Worked on 834 interface using PostgreSQL ,PL/SQL and DB2 that transmits QHP enrollment information to health insurance carriers like Care First, Kaiser, Cigna, Evergreen etc. Design ETL jobs to extract/transform/load data from multiple sources to database and/or data store.  Data Analysis – Analyze CMS and Carriers data to find discrepancies in the data and reverse engineer the data to find useful patterns. Clean-up Database – Clean-up database that has redundant/junk data. Worked on fixing the backend data to help reduce the number of discrepancies/disputes from external sources.  Actively worked in migrating Database from IBM DB2 to PostgreSQL Develop and maintain DB2 Views and PROC’s for daily adhoc file processing. Work within the EDI Operations team under the IT Project Management Office (PMO) to provide all EDI related services for the Exchange Production support. Analyze the 999 files from the Carriers, perform root cause analysis for exceptions.  Helped develop rules engine API for existing rules framework. Actively working on QlikSense data reporting tool to publish the adhoc/scheduled reports to the stakeholders Working on the UIPath RPA tool to automate 834 error processing and SBM discrepancy response process

Senior System Software Engineer

• Jul 2013 - May 2016

 Involved in Design, Development, testing, delivery and quality process.  Problem management involves Analysis, Estimation, design, development, testing and implementation of permanent fixes for issues encountered in Financial Systems Group applications.  Performance tuning by placing STROBE’s and redesigning the existing application to run in a more efficient manner whenever and wherever needed. Performing automation of mainframe tasks using Jenkins Actively supervise the FSG (Financial Systems Group) Batch and Online application trails on a Daily/hourly basis and Preparing the Impact analysis documents. Identifying any abends that may occur during the batch trails and resolving them to ensure a smooth execution of FSG applications and batch trail. Performing Root Cause Analysis on the repetitive issues and come up with a finalized solution to fix the issue permanently. Coordinate professionally with various Business users and understand the issue and respond based on the timelines in high priority. Catering to business user requests for any new requirements, build new functionality if required. Providing technical and functional leadership to SS&MO (Solution Support and Maintenance Operations) team for problem resolution and service restoration. Document suggestions for continuous process improvements for both Solution Support and Maintenance Operations Services and development activities.

Senior System Analyst

• Feb 2012 - Jun 2013

• Involved in preparing the Customer front-end documents for all new requirements. • Providing design or involved in design discussions for all new requirements. • Involved in Estimation and designing of the new enhancement work. • Attending requirement meetings, conference calls. • Guiding team members during preparation of various documents and coding. • Developed and tested the programs using COBOL, CICS, VSAM, JCL and DB2.• Created adhoc reports using Easytrieve against VSAM and Flat files.• Prioritize work packages and to keep track of on going developments in the sub-system. • Manage and single point of contact for the CSS Billing Support project that include all support to be provided to Application Support Group's, other components etc. Keep track of the fault stack and ensure these are tracked/reduced appropriately.

System Analyst

• Mar 2010 - Dec 2012

 Involved in Preparing the TPL Requirements Traceability Matrix (RTM), business system design documents, functional specifications and technical specifications. Preparing the TPL business process flow diagrams and preliminary application structure. Analyze the Non Electronic Submissions i.e Paper claims imaged and data entered use the TPL database in claims processing for potential cost-avoidance/recovery determination. Involved in preparing the Processes and maintains Medicare Modernization Act (MMA) recipient data, Maintains and processes Health Insurance Premium Payments (HIPP) and Processes and maintains Medicare enrollment. Designed, developed and tested the batch and online programs using COBOL, VSAM, DB2, JCL CICS and DB2 Stored Procedures.  Supported reports generated using DMS/II non-relational databases for Business verifications.  Involved in preparing the low level design documents for all the TPL updates for Medicaid and NC Health Choice (NCHC) recipients are sent to EIS realtime via MQ Series. Similarly, TPL updates are sent to ACTS.  Working on multiple transactions like 270/271 eligibility request/response, 276/277 health care claim status request/response, 278 prior authorization response, 834 Benefit enrollment and maintenance, 820 payment order / Remittance. Written and executed multiple Test Cases (Unit, System and Integration) for multiple transactions include 837, 835, 276, 277, 270, 271(both inbound and outbound) transactions.