Pratik Thakur Email & Phone Number

Greater San Diego Area

• Managed multimillion-dollar IT transformation and re-engineering initiatives for a top-tier healthcare organization to deliver profit growth, process efficiencies, and improved regulatory compliance
• Established strong client relationship while working with cross-functional teams in execution of diverse projects including systems implementations, process improvements, report remediation, quality assurance testing.
• Created business intelligence reports for billing, claims, subscriptions using SQL that helped the management to make vital - business related decisions
• Created visualizations using Tableau to understand customer demographics, claims and system performance
• Ensured precise Data Transfer from the legacy GE IDX system to the HealthRules Payor system
• Captured requirements by creating/updating a series of documentation for System Implementation projects such as the Requirements Traceability Matrix, UML Diagrams, Reporting documentation, Configuration Workbooks.

Costa Mesa, California, United States

• The client is one of the largest health plans company in the United States and is making significant investments in modernizing its healthcare systems. As the client’s business model and the overall healthcare market.
• Designed current state IT operating model based on data captured from current state interviews and identified key claims processing workflows
• Facilitated business and IT conversations between multiple teams, conducted interviews with SMEs to identify client manual processes and integrations
• Owned the process of data collection and preparation of data to be applied to data mining techniques like multiple linear regression, logistic regression, K-means clustering to understand the relationship of various.
• Performed exploratory data analysis to understand compositions of manually processed claims.
• Perform feature engineering to identify most relevant inputs for Machine Learning algorithm performance

Project 1: The scope of the project was to replace the existing in-house system with QNXT Administrative system by Trizetto for Utilization Management. The legacy system faced serious limitations in coordinating interactions among members, employers, brokers and providers whereas QNXT application helps increase administrative efficiency and improve the.

Master’S Degree

Master'S Degree

Bachelor'S Degree