Summary
Overview
Work History
Education
Skills
Websites
Languages
Projects And Internship
Timeline
Generic
PRIYANKA KARAMBALKAR

PRIYANKA KARAMBALKAR

Bangalore,KA

Summary

Dynamic professional with extensive experience in Medicaid analytics at IQVIA, excelling in quality assurance and data validation. Proven track record in government pricing strategies and regulatory compliance management. Adept at Excel reporting, I effectively resolved disputes and enhanced team practices, demonstrating strong analytical and communication skills.

Overview

11
11
years of professional experience

Work History

Assoc Project Sppt Analyst

IQVIA
Bangalore
02.2020 - Current
  • Medicaid Analytics: Worked with assigned states to obtain the Medicaid summary invoice, summary data file, and claim-level invoice each quarter, and reviewed them to ensure the completeness of the information received.
  • Conducted an initial quality check on summary data for all claim submissions to ensure rebate eligibility, and data consistency.
  • Performed claim-level detail validation. Reviewed suspect claim records and determined if the record should be disputed for payment.
  • Resolved disputes and proposed recommended amounts to be paid for historical outstanding utilization that are routinely submitted with Medicaid claims.
  • Made recommendations on state disputes, applied proper amounts to be paid, and ensured CMS codes are applied correctly; notified states of results and findings.
  • Completed Medicaid analysis and documentation on assigned states and programs. Communicated with the manager about key findings and changes to state programs.
  • Provided backup for Medicaid team members in any necessary functions, and worked with the team to establish best practices within the Client Medicaid work environment.
  • Experience in reviewing the Formulary Preferred Drug List.
  • Developed an advanced Excel template to inform analysts of their mandatory submission deadlines.
  • Developed and updated work instructions and SOPs as related to government pricing and Medicaid.
  • Managed Care Analytics: I worked on managed care rebate processing during off-peak times, where I reviewed, validated, and processed incoming rebate submissions from PBMs, MCOs, and other payers.
  • Confirmed the eligibility of claims based on contract terms, formulary status, utilization criteria, and timelines.
  • Government Pricing: Participated in government pricing calculations and reporting, average manufacturer price, best price, average sales price, non-federal average manufacturer price, and states' reporting as needed.
  • Reviewed and validated incoming chargeback data and direct sales data.
  • Confirmed contract eligibility of customers (e.g., hospitals, clinics) using internal databases or customer masters.

Associate –Quality Assurance

Mylan Laboratories Ltd
Bangalore
05.2018 - 08.2019
  • Preparation, review, distribution, and retrieval of Standard Operating Procedures applicable to QC operations.
  • Handling of QMS (OOT, OOS, failure investigations, change controls, and CAPAs related to investigational products).
  • Documentation control (review and approval of master documents).
  • Review of executed batch manufacturing documents and review of master batch.
  • Ensure calibration of equipment (weighing balance, pH meter, VITEK 2 Compact).
  • Review and approve the Product Validation Protocols and Reports.
  • Ensure the collection and handling of routine samples, stability samples, and swab samples from various equipment used in production.
  • Maintaining GMP quality standards for incoming materials, ensuring stringent adherence to quality standards, norms, and practices, and identifying gaps and corrective actions.
  • Performing as a QA representative for regulatory and customer audits, and establishing the process for products and their filing.
  • Implementing systems, processes, and technical capabilities, enhancing, and conducting failure investigations at all levels.
  • Reviewing quality plans in coordination with production and quality teams.
  • Faced all major regulatory audits, like USFDA, MHRA, TGA, GCC, HC, and customer audits.

Microbiologist-1

Apotex Research Pvt. Ltd
Bangalore
02.2015 - 03.2018
  • Reviewing the data or documentation corrections with analysts to ensure that all records are complete.
  • Performing second verifications of all the test results in LIMS, and ensuring the accuracy of the data.
  • Ensuring investigations are assigned, completed, and referenced for data or documentation, as appropriate, prior to the release of microbiological data.
  • Handled the validation of glycerol stock preservation of in-house cultures and media hold time study.
  • Hands-on experience in handling the VITEK 2 compact system for the identification of microorganisms and reviewing the data in solid dosage drug products.
  • Involved in the evaluation of the objectionable microorganisms in the drug products to determine the potential hazard to their users.
  • Review of Growth Promotion Tests of different culture media.
  • Good experience in environmental monitoring in the production environment, and maintaining accurate log books of all performed procedures.
  • Expertise in LIMS software.

Trainee Scientist (R & D)

BIOCON limited
08.2014 - 02.2015
  • Prepared procedures to maintain Cell banks for Streptomyces and fungal cultures.
  • Performed Cell line selection of Streptomyces and fungal cultures.
  • Handling Fermenter and Media Autoclaves.

Education

M.Sc. - Applied Microbiology

Vellore Institute of Technology
Vellore
01.2014

B.Sc. - Microbiology

Fergusson college
Pune
01.2012

Skills

  • Medicaid analytics
  • Quality assurance and data validation
  • Government pricing strategies
  • Excel reporting and analysis
  • Regulatory compliance management

Languages

  • English
  • Hindi
  • Marathi

Projects And Internship

  • 6 months project on Physical and Biochemical analysis of renal crystals, 5th International Conference on “Science, Engineering and Technology in VIT.
  • 6 months project on Extraction of Pigment from Actinobacteria and its Industrial Applications, 6th International Conference on “Science, Engineering and Technology in VIT.
  • 6 months project on Decolourization and Degradation of textile dye (Reactive black 5) using different bacteria, 7th International Conference on “Science, Engineering and Technology in VIT.
  • Participated and presented a paper titled “Extraction of pigment from Streptomyces fradiae VITIPMSB and its Industrial Applications”, Conference in Biotechnology organized by PSG College of Technology, Coimbatore.
  • 6 months internship on Significance of Heat Shock Protein antibodies in different diseases by ELISA, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore.

Timeline

Assoc Project Sppt Analyst

IQVIA
02.2020 - Current

Associate –Quality Assurance

Mylan Laboratories Ltd
05.2018 - 08.2019

Microbiologist-1

Apotex Research Pvt. Ltd
02.2015 - 03.2018

Trainee Scientist (R & D)

BIOCON limited
08.2014 - 02.2015

M.Sc. - Applied Microbiology

Vellore Institute of Technology

B.Sc. - Microbiology

Fergusson college

Similar Profiles

CREATE PROFILE