Muhammad Umar Email & Phone Number

Philadelphia, Pennsylvania, United States

With a proven track record in spearheading pivotal projects, I have led transformative initiatives such as the Softphone Project, where I orchestrated the automation of call data processes for the EIM team, streamlining operations and enhancing efficiency through data automation. As the Lead Business Systems Analyst for the Financial Reconciliation Interplan Management (FRIM) project with the Blue Cross Blue Shield Association (BCBSA), I oversaw the sourcing of ITS Claims data (EDI 837), ensuring seamless integration and data accuracy. Additionally, I managed the submission of Provider data to the FEP Bridge Provider Database for the Federal Employee Program (FEP) project with CareFirst, while also serving as the Subject Matter Expert (SME) for Labs Data. Throughout my career, I have successfully onboarded new vendors, including TruHearing, Optum, Cayabacare, Progny, Cancer Care, Propeller, Incomm, Tandigm, and Quartet, showcasing my expertise in project management, data analysis, and vendor integration within the healthcare domain. My responsibilities encompassed gathering and analyzing project requirements, developing comprehensive documentation, designing and implementing data capture processes, providing training and support to end-users, conducting end-to-end testing, and troubleshooting data issues. Leveraging advanced SQL skills in Google Cloud BigQuery and Teradata, I meticulously profiled, verified, and analyzed datasets to ensure data accuracy and completeness. Furthermore, I possess a deep understanding of IoT technologies, successfully implementing IoT solutions in previous roles. My proficiency in SQL for data cleansing, transformation, visualization, and reporting, coupled with my experience in relational database fundamentals, has equipped me with the expertise needed to drive impactful projects and deliver results in complex environments.

Memphis, Tennessee, United States

In my role at FedEx, I played a pivotal role in the migration of enterprise data from Hadoop (Hive) to Microsoft Azure (Databricks), overseeing key projects aimed at ensuring seamless transition and uninterrupted data flow. As part of these initiatives, I contributed to the creation of pipelines in Azure Data Factory for extracting, transforming, and loading data from various sources, including Hadoop, data warehouses, and legacy systems. Leveraging SQL in Azure Databricks, I facilitated data validation and retrieval processes, while utilizing Jira for project tracking. Additionally, I led the development of Business Requirement Documents for live dashboards in Tibco Spotfire and crafted Power BI dashboards from multiple data sources using intricate SQL queries. My responsibilities encompassed the production of data flow diagrams, use cases, data dictionaries, wireframes, and user interfaces, alongside implementing data cleansing, security, profiling, and monitoring processes. I also played a crucial role in data integration, migration, and modeling efforts, contributing to the design and implementation of data flow and business process diagrams. Known for exceptional problem-solving abilities, I tackled complex challenges and devised effective solutions, demonstrating expertise in ETL methodology, Power BI report development, SQL scripting for data loading, and technical documentation. My commitment to excellence extended to generating UAT test scripts, test cases, and detailed reports, ensuring the detection and resolution of issues during testing phases.

Virginia Beach, Virginia, United States

With a proven track record in driving organizational transformation, I have led initiatives to establish AI-ML Centers of Excellence, notably orchestrating a four-phase project to deploy an AI-ML-driven claim auto-adjudication program, elevating the auto-adjudication rate from 78 to 92 percent. Leveraging advanced data pre-processing algorithms, I optimized historical claims data for model building, training, and continuous evaluation. As Product Owner and Domain Expert, I led a dynamic scrum team and collaborated with executive leadership to conceptualize project vision and requirements, translating insights into comprehensive plans and documentation. I maintained precise Electronic Health Records (EHR) using the Epic EMR system, ensuring HIPAA compliance, and bridged IT-clinical staff gaps, fortifying security measures for patient data confidentiality. Collaborating with client teams, I established data lineage, designed integrated architectures, and authored user stories and technical documents. I facilitated scrum ceremonies, designed wireframes and data models, and orchestrated UAT approaches to validate model predictions, presenting outcomes to senior leadership to drive informed decisions.

Plymouth Meeting, Pennsylvania, United States

I have played integral roles in two major initiatives: Healthcare Claims Migration to FACETS and Implementation of EDI 837I and 837P Claims Processing. In the FACETS migration project, I led efforts to transition a healthcare company's claims processing and member management to the FACETS platform, focusing on streamlining operations and ensuring compliance with healthcare regulations. This involved collaborating with technical teams to configure FACETS modules, conducting GAP analysis, and overseeing the implementation process. Concurrently, I spearheaded the implementation of EDI 837I and 837P claims processing for a large healthcare provider, aiming to enhance efficiency and accuracy in claims adjudication and reimbursement cycles. My responsibilities encompassed collaborating with cross-functional teams, validating data, conducting GAP analysis, and ensuring compliance with industry standards. Throughout both projects, I demonstrated proficiency in SDLC methodologies, government healthcare programs, HIPAA EDI transactions, SQL, ETL technologies, and big data analytics. My expertise in translating business requirements into technical specifications, facilitating smooth transitions, and providing ongoing support and training underscores my commitment to driving success in healthcare IT initiatives.

Carson City, Nevada, United States

I served as a Business System Analyst at The State of Nevada Benefit Programs, overseeing critical assistance programs such as SNAP, TANF, CHIP, and Food Stamp Programs. Recognizing the complexity of the eligibility determination process and the challenges posed by outdated systems, my focus was on enhancing efficiency and accuracy through innovative solutions. Working alongside multidisciplinary teams of developers, data analysts, and stakeholders, I spearheaded initiatives to modernize data management and processing systems. Key responsibilities included analyzing existing processes to identify improvement opportunities, implementing new data validation rules and profiling processes using SQL, and developing automated workflows to streamline operations. Collaborating closely with developers, I played a pivotal role in designing and implementing a new eligibility determination system that seamlessly integrated with existing infrastructure. Additionally, I led user acceptance testing efforts and provided comprehensive training to ensure smooth adoption of the new system. Furthermore, I was entrusted with responsibilities spanning HIPAA compliance lifecycle management, including gap analysis, mapping, implementation, and testing for Medicaid Claims processing. With expertise in Child Welfare, SNAP, TANF, and CHIP, I conducted thorough requirements analysis, designed technical specifications, and facilitated the transition from legacy systems to modern solutions. Embracing Agile Scrum methodologies, I drove project agility and responsiveness, while also demonstrating proficiency in cloud technologies, contributing to the deployment and management of applications on leading cloud platforms. My tenure at The State of Nevada Benefit Programs underscored my dedication to leveraging technology and data-driven insights to optimize service delivery and positively impact the lives of those in need.

Master'S Degree, Information Technology Project Management

Master’S In Project Management