Peter Gazelka Email & Phone Number

Hibbing, Mn, Us

Sugar Land, Texas, United States

• Working with the State of AZ Medicaid cost containment area, AHCCCS, as a Healthcare Financial/Business Analyst-Medical Economist.

Minnesota, United States

• Coaching and mentoring multiple individuals looking for opportunities.• Enhancing skills in the following tools and creating demo implementations with +16M records of de-identified Medicare for individual, membership, claims, and Rx data:• ChatGPT – using for problem solving, coding, database samples, and knowledge acquisition.• Python – creating scripts for statistics, machine learning, and AI applications.• Azure SQL – configured environment and upsized large test databases from SQL Server.• Azure Databricks – configured environment, uploading more and more data, running SQL and Python scripts.• Azure AI – building on recent AI certification and expanding AI abilities.• Power BI – strengthening existing skills in data modeling, visualization, reporting, DAX, Power Query, and the M Language.• Power Platform – working on certifications with Power Apps, Power Automate, Power Virtual Agents, and Power Pages.

Hibbing, Minnesota, United States

• Developed reporting and analytics for a healthcare company primarily serving universities and their students.• Developed content for the Medical Management Report (MMR) and pitched this monthly to a group of executives. This report helped identify issues and opportunities at a book of business level and for individual schools.• Managed, coached, and mentored a Medical Economics Analyst, building technology, project management, and other skills.• Medical Economics Reporting Tool (MERT)• Created MERT in Excel Power Pivot.• Partnered with the Reporting team to acquire +7M claims records and +6M member month records for analysis.• Used Power Query and the M Language to load 10+ tables with an ETL file load and data translation.• Created 15 DAX measures such as Unique Claimants, Unique Claims, Unique Services, Paid PMPM (per member per month), Cost Per Claimant, Cost Per Claim, and Cost Per Service with equivalent time period (ETP) vs life to date (LTD) versions.• Loaded claims and member month tables (at different levels of granularity) and joined these via parent/bridging tables of plan year, group/school, line of business, coverage, member, and other tables. • MERT enabled complex summaries and deep dives with these fields: utilization metric, service description, procedure, diagnosis, school, age group, provider, network, PPO code, claim#, claim line, and CMS diagnosis hierarchy.• Also developed a prototype MERT tool in Tableau.• Performed utilization, volume, and unit cost analysis at all levels of detail with paid amount, claim count, claimant count, charge amount, %PPO discount, and PMPM.• Wrote complex SQL Server queries with an extensive use of #TEMP tables, UNIQUE CLUSTERED INDEX and WITH statements, and looping and other techniques. • Implemented simple project management for our team with key fields in Excel worksheets for Client, Project, Task, and Time.

Minneapolis, Minnesota, United States

• Developed reporting and analytics for a healthcare startup serving seriously ill patients using Power BI, Power Query, SQL Server, and Databricks SQL.• Partnered with Accounting to upgrade billing system with 17K patients and $7M of monthly fee for service billings. Utilized SQL Server, Databricks SQL, and Excel. Reduced cycle time from 5 days to 1 day, earning accolades from the CEO on the financial impact of getting billing out much earlier.• Partnered with marketing and developed provider engagement reporting, a top priority for the business and key to sourcing new business. The design included reporting in Excel, fed by SQL Server feeds, loaded by Power Query, and driven by advanced formulas.• Developed provider involvement reporting to ensure coordination of care across multiple providers, a vital need for seriously ill patients. Utilized SQL Server, Power Query, and Excel.• Developed care flow reporting in Power BI. Cleaned up malformed JSON files and loaded them both in Power BI and SQL Server. Parsed the multi-level files in SQL Server and merged with a number of other key tables.

Eden Prairie, Minnesota, United States

• Lead six sigma black belt and other IT projects with weekly report outs to senior leadership.• Lead, coach, and mentor Optum Global Solutions (OGS) offshore resources and provide them with application/database architecture and design assistance. • Architected and directed the development for these applications:• ProHealth BI Metrics – Directed a G/L load and audit effort on a 2 M record database and development of feature-rich Tableau reporting solution for OptumCare ProHEALTH NY Finance & Accounting with an annual savings of $1.7 M.• Contract DB – Developed a contract database app for OptumInsight Finance which will enable the business to increase billings based on contract parameters and triggers currently not identifiable with other systems. Savings projected at an annual increase in billings of $2 M.• Revenue Backlog Tool – Analyzed current OptumInsight Finance process with 11 capabilities, 30+ Excel workbooks, and 80+ calculation points and developed application to dramatically reduce analyst effort with the ability to run reporting on an ad-hoc basis.• Completed 4 weeks of six sigma black belt training with an extensive statistics and Minitab training. Scored +97% on weekly tests.• Coached team of 2 offshore IT/analytical resources based in India.

Eden Prairie, Minnesota, United States

• Provided project coordination with updates to SVPs in partner organizations.• Provided leadership as an IT architect and database architect to an organization of over 25 people.• Provided training and internal consulting on the Microsoft BI suite of tools.• Designed and developed databases and a suite of analytics for a variety of medical/behavioral integration (MBI) projects. Elements of pitch pages for the project were presented by our OptumHealth CFO to Steve Hemsley, UHG CEO. Extracted billions of claims, eligibility, and pharmacy records for Oxford and UHC E&I populations, using SAS, SAS Grid, Optum’s Enterprise Data Warehouse (EDW), and UHG’s Galaxy data warehouse. Audited, transformed, categorized, and stratified data. Developed dynamic, “what if” analytics and tools using Microsoft Excel pivot tables, custom reports, and SQL Server using key, intermediate summaries of much larger databases. Found initial savings opportunity of $30 M on a portion of the portfolio.• Designed and developed the MedExplorer dashboard which is used by the entire Healthcare Economics team, a tool that blends Claims, Membership, and Unique Patient information with a dynamic hierarchy of user-selected groupings. Provide PMPM, Unit Cost, Utilization, Penetration, ALOS, AVPP, and other calculations and indicators in a drill down format. Addressed a reporting deficiency that has existed for many years. Enabled the Healthcare Economics department to move towards more consultative work with our internal client/partners.• Managed team of 2 offshore IT/analytical resources based in India.

Eden Prairie, Minnesota, United States

• Reported directly to VP of Healthcare Economics and Affordability.• Provided leadership as an IT architect and database architect to organization.• Developed MedEx dashboard with PMPM, utilization, penetration, ALOS/AVPP, unit cost, and other metrics to provide deep insights to +70 clinical, management, and executive users. Loaded over 10 M claims, patients, membership, and eligibility records per month with a sophisticated ETL process. Developed VBA code, T-SQL, and SSIS to load, summarize, and systematically analyze data. Developed mix calculations that can be generated at scale using claims attributes such as age, benefit level/type, licensure, provider, procedure code, and many other values. Reduced monthly cycle time on ETL process from 4 days to 4 hours. Reduced report generation time on dashboard from nearly 5 minutes to approximately 30 seconds.• Developed “deep dive” capabilities which provide eligibility cohort and utilization cohort analysis for populations, a process which requires data analysis at the eligibility/person and claims-detail levels. Summarized up to 96 M records for larger populations, using advanced SQL Server tools and techniques. Reduced cycle time for creating these insightful analyses from 3 days to 3 hours.• Developed integrated medical/behavioral analysis, using Life Print medical data and OHBS behavioral data for a pilot. This project represents a commercialization opportunity for the business. Developed sophisticated “rules engine” to select candidates for closer review and care management. Developed “patient profile” to enable in-depth analysis of selected individuals with charts, graphs, summary, and detail data on claims, authorizations, case notes, prescriptions, and eligibility. Integrated over 7 M claims records, 3 M prescriptions records, and 1 M eligibility records from medical and behavioral sources into a generic database for rules application and reporting. • Managed the OptumHealthMedEx SQL database.

Greater Minneapolis-St. Paul Area

• Assist with sourcing and recruiting for consulting firm.• Worked with a Fortune 500 logistics company to convert an international logistic system from Access 97 to Access 2003 with a SQL Server 2008 backend. Loaded 500+ Access tables to SQL Server 2008. Converted Access functions to SQL Server. Enhanced data integrity and enabled sophisticated reporting with SQL Server in a new system. Managed project plan and task list for a portion of the project. Enabled business growth and application stability and maintainability with this new platform.• Developed marketing e-mail system using Windows Forms, VB.NET, ADO.NET, SQL Server 2008 R2, and SMTP. Enabled quarterly newsletter and other mailings to a thousand contacts.

Minneapolis, Minnesota, United States

• Directed consulting firm with responsibilities in consulting services, operations, finance, marketing, human resources, accounting, billing, tax, and legal areas. • Provided management, training, mentoring, and coaching to 12 consultants with diverse backgrounds, life perspectives, and nationalities, including India, China, Taiwan, Venezuela, Colombia…and the United States.Executive Projects – Project Management, Rapid Response, Mission Critical Solutions • Managed $2.7 M IT telematics project for a Fortune 100 financial services company.• Provided project management and development support on a workflow management tool for a Fortune 100 financial services company. Over 90,000 documents passed through this system.• Worked closely with the National Accounts team of a Fortune 100 financial services company to develop Excel digital dashboards and supplemental client reporting to the largest 100 clients, resulting in a substantial increase in customer satisfaction with this key client base. Dashboard workbook consisted of 40 pages of charts, graphs, and commentary.• Worked on two (2) mission critical, operational-disaster-recovery “SWAT” projects with a team of executives from a Fortune 100 financial services company, including the CEO, CIO, and COO. Developed title tracking, bar coding, and advanced quality/process metrics system. Worked closely with a team of senior leaders assigned to the six sigma quality organization. Designed and built systems and processes to scan in 325,000 title documents into a mainframe. Fed data from 3090 mainframe download files, Oracle, MS Access, MS Excel, and other sources into a relational database.Other Projects – High Impact, High ROI Solutions• Worked closely with cross-functional teams from a Fortune 100 financial services company to develop forty (40) high-impact, high-ROI systems. Loaded data from 3090 mainframe download files, Oracle, MS Access, MS Excel, and other sources into a relational database.

Master Of Business Administration - Mba, Management Information Systems, General, 3.7

Bachelor Of Arts - Ba, Accounting, 4.0