Rahul Kumar Email & Phone Number

Phoenix, Az, Us

Hartford, Connecticut, Us

Hartford, Connecticut, Us

• Managing Aetna’s two Medicaid plans claims and encounters operations, responsible for compliance, accuracy and timeliness of data and information management systems. • Leading the implementation project, ensuring smooth transition to a new Encounter data management system, handling the work-plan, FIT Gap analysis, Testing Plan and deployments• Liaison with third party vendors, IT and Health Plan to carry out daily operations

Hartford, Connecticut, Us

• Oversee day-to-day operations and analytics for 3 Medicaid Plans as Senior Technical Analyst• Subject matter expert on Health Insurance and Medicaid Plan operations including Claims and encounters• Involved in Information management, data cleaning, reporting and dashboards for Medicaid data.• Gain expertise in Health Plan operations, Provider, Member and Claim operations with end-to-end understanding of Health Insurance industry• Performed root cause analysis related to Medicaid claims and Encounter errors and eliminated system issues causing it• Completed migration projects working with different stake holders and IT• Developed automated data exchange and analytics setup using SSIS and SQL• Design test case scenarios and test all new implementations based on HIPAA requirements

Buffalo, Ny, Us

Worldwide, Oo

Data Analyst and ETL Developer:• Built an automated end to end Information management setup for Healthcare client using databases and tools like Teradata and Informatica which helped to reduce company’s cost to manually manage and send information to different vendors by around $1.2million. • Increased project’s operational and execution efficiency by creating quality assurance and standardization process used across the engagement to reduce turnaround time and enhance quality.• Analyzed and interpreted Healthcare trends and different Health Plans demand and feedback based on claims, provider , payers and revenue data from the data warehouse and passed on to Client to take effective business decisions. • Interacted directly with the HealthCare client, understanding the high level requirements, drafted the intricate level technical requirement and helped client come up with a very efficient plan to get it executed on time.• Gained in-depth knowledge and expertise of Informatica ETL tool and SQL coding in Teradata, experienced in various utilities like FastLoad, Multiload, BTEQ, FastExport and Teradata SQL Assistant. • Promoted to Consultant before leaving the firm for perusing higher studies.

• Worked with the Information Technology department of the company towards management and free flow of data communications including Satellite , Wired network and Mobile technology• Worked with Control and Instrumentation wing to understand the automation of the different mechanical devices, the complete process flow of thermal power generation and the role of electronic devices in the company

Master'S In Management Information Systems, Management Information Systems, General

Bachelor'S Of Technology, Electronics And Communications Engineering