Pavan J Email & Phone Number

United States

• Implemented Agile methodologies to adapt to changing business needs and stakeholder requirements, resulting in improved project outcomes and stakeholder satisfaction.• Spearheaded Agile teams in the development and implementation of healthcare data analytics projects, ensuring alignment with organizational goals and timely delivery.• Collaborated with revenue cycle teams and subject matter experts to validate data integrity, ensure compliance with coding standards, and improve billing accuracy and revenue capture.• Orchestrated sprint planning sessions and managed product backlogs, prioritizing tasks based on business value and stakeholder needs.• Utilized Agile project management tools, such as Jira or Trello, to track project progress, monitor team velocity, and communicate project status updates to key stakeholders.• Good knowledge of Health Insurance Plans (Medicare Part A, B, C, and D), managed care concepts (Medicaid and Medicare), and experience in determining membership eligibility, and billing experience within life and disability in health plans.• Worked closely with IT teams to enhance data integration solutions and ensure seamless data flow across systems and platforms.• Facilitated regular scrum meetings, retrospectives, and sprint reviews to foster collaboration, identify risks, and address project roadblocks in a timely manner.• Spearheaded revenue cycle optimization projects, utilizing Excel for in-depth data analysis on RCM processes, led to the identification of bottlenecks, optimized workflows, and a significant reduction in claim cerneragile.• Developed complex SQL queries to perform cohort analysis, trend analysis, and predictive modeling, enabling proactive identification of revenue cycle bottlenecks and opportunities for process improvement.• Conducted in-depth analysis of claims and billing data using SQL, identifying anomalies and discrepancies to improve billing accuracy and revenue cycle management.

Texas, United States

• Conducted thorough requirements gathering and analysis from an end-user perspective, ensuring alignment with feasibility and SDLC practices.• Managed change requests to maintain project scope in accordance with established requirements.• Led Joint Application Development (JAD) sessions involving subject matter experts, developers, and testers to discuss viability, obtain feedback, and secure approval.• Developed and monitored burndown charts and other key performance indicators (KPIs) on a daily/weekly basis.• Collaborated with UI/UX designers throughout the project to create and update mock-ups.• Created a copy deck in Confluence serving as a source of truth for developers aligning with front-end data fields.• Implemented data transformations, including adding calculated columns, maintaining relationships, and performing various data manipulations.• Designed and developed Informatica mappings and workflows for loading data into staging areas, data warehouses, and data marts in SQL Server and Oracle.• Conducted data connections, joins, and data preparations across multiple sources.• Addressed issues in existing Informatica mappings to ensure correct output.• Optimized queries through normalization and de-normalization using joins and indexes.• Monitored data integration events and established notifications for success/failure.• Collaborated with product managers, scrum masters, and engineers to implement Agile processes and document projects.• Excel was exclusively used for data analysis and mapping to analyze data fields based on business requirements.• Demonstrated extensive knowledge of portfolio management, asset classification, and negative balance holding split for various product types.• Worked as a functional tester, creating UAT test scenarios and executing test cases based on business requirements and technical specifications.

India

• Implemented data quality checks for Membership data, Provider data, Medical Claims, and Pharmacy Claims data using both Base SAS and Advanced SAS Techniques.• Developed SAS macros for the automation of data quality processes and other requirements related to membership and claims data.• Managed and updated Reference tables to meet business requirements.• Executed data refreshes on Tableau server biweekly and monthly, ensuring accurate representation of changed data in views and dashboards.• Utilized SAS programs to extract data from text files, Excel files, and databases like DB2, SQL Server, and Teradata, creating SAS datasets and modifying existing ones.• Cleaned up membership demographics fields, including city names, county names, state, and zip codes.• Conducted data analysis using healthcare claims, eligibility & enrollment, medical provider, and financial data.• Applied programming with SQL, including data management principles such as joining datasets, data aggregation, and sub-setting using Proc SQL.• Developed, tested, and wrote programs and reports in SAS based on client specifications.• Demonstrated extensive experience and proficiency in using SAS/ODS to create output files in various formats (RTF, HTML, PDF).• Prepared new datasets from raw data files using Import Techniques and modified existing datasets using Set, Merge, Sort, Update, Formats, Functions, and conditional statements.• Created dynamic healthcare utilization dashboards in Tableau using claims data and generated KPIs in Power BI using calculated functions and DAX.• Developed Tableau scorecards and dashboards with stack bars, bar graphs, scattered plots, geographical maps, heatmaps, and bullet charts to present key information for decision-making.• Conducted data importing, cleansing, analysis, and profiling using complex SQL queries on various source systems, including DB2 and Teradata.

India

• Oversaw and provided training for a team of Data Specialists in the processes of data scrubbing and loading into the internal system.• Collaborated with the Project Management Office (PMO) on various projects, ensuring adherence to project deadlines.• Identified high-risk products and updated inventory using Excel and Access.• Generated specialized reports in Crystal Reports to summarize sales by region, incorporating SQL queries for data retrieval.• Imported data into SAP for manufacturing specifications, Bill of Material (BOM), and pricing conditions.• Regularly collaborated with the PMO on ongoing projects, maintaining open communication channels.• Evaluated requests related to material substitutions, pricing, status changes, and updates to Bill of Material (BOM) in support of purchasing and procurement departments.• Managed Material Master pricing records in SAP to identify discrepancies and facilitate seamless order execution.• Reviewed and approved the creation and maintenance of product Master data across all disciplines.• Applied Excel functions and formulas for data analysis and reporting purposes.