RENJINI PRASANTH

Project: Bright Health Acquisition

• Led the migration and integration BA efforts of 125k Medicare enrollment membership data as part of the Bright Health acquisition.
• Gathered, documented, and analyzed business and functional requirements, utilizing business processes, descriptions, scenarios, business tasks, and workflow analysis.
• Facilitated and conducted complex research to support business operations within the Agile delivery model.
• Managed multiple squads, including Enrollment, Inbound, Outbound, and member PCP Assignment.
• Collaborated with cross-functional teams, including Molina Health Plan, business stakeholders, IT, and the Bright Health team, to ensure the seamless transition of enrollment data.
• Supported data loading and validation processes, identifying issues (such as QNXT to M360 sync) and assisting in resolving root causes
• Experienced in generating and sending vendor extracts (e.g., ID, CVS, National, Supplemental vendor and Regulatory CMS extracts), with complex eligibility logic, to migrated members in a timely manner.

Project: Reason Code Analysis (Member Outreach) BI Dashboard

• Analyzed Medicaid Enrollment Member data (834 files) for 19 states, including eligibility assessments, and identified business needs.
• Elicited and documented requirements, and developed both business and functional specifications to address complex challenges and optimize business processes.
• Collaborated closely with internal stakeholders, including Business and Health Plan teams, to define functional requirements for the Enrollment Dashboard (Power BI).
• Acted as a liaison between business and technical teams to ensure that technical solutions aligned with business needs.
• Supported the development, ongoing maintenance, and continuous improvement of the Enrollment Dashboard, ensuring accurate data validation and up-to-date reporting.

Other Projects supported: Tribal Custom Configuration and Claims Edit and MCO File Transfer Automation.

• Analyzed user and departmental data to develop reports that support the use of hospital and clinical data, improving resource management, clinical practice, accreditation requirements, and outcomes management
• Designed and developed standardized and ad-hoc reports and dashboards, implementing statistical analysis to help operations leadership understand practice patterns, trends in utilization, and ongoing organizational improvements
• Built analytical key performance metrics, indicators, and statistical measures for various dashboards (e.g., stroke data, moderate sedation, provider suspension)
• Experienced in acceptance testing, including test scenario use case documentation, testing execution, verification, and release, and implemented practices and procedures for end-user test plans
• Managed data gathering from various sources (databases/systems), analyzed, validated, summarized, cleansed, consolidated, and built master data for online reports/dashboards in various systems (EPIC, BI Launchpad, Vizient, Midas, Statit, Press Ganey HCAHPS, HSCRC, NDNQI, HARP, MIEMMS, CRISP, CMS)
• Oversaw clinical quality department processes such as ongoing provider performance evaluation (OPPE, FPPE), daily reports (re-admission, LOS), monthly reports (ED dashboard, ophthalmology dashboard, hospitalist dashboard), and provided data for leadership presentations
• Worked on core measure data harvesting and error handling to ensure accurate CMS data submission
• Served as system administrator for Midas and Statit applications, managing users, creating/editing data sources, designing indicators, reports, and dashboards
• Initiated projects, communicated, and coordinated with various internal and external stakeholders, tracked project progress, provided updates to leadership, and successfully delivered projects

• Managed medical student and university data, including preparation, uploading, and downloading for systems such as E-value, Exam Soft, Blackboard, and ParScore.
• Conducted data analysis for exam and student performance.
• Utilized and maintained Microsoft SharePoint to make grades, dashboards, and rankings available.
• Prepared data for student affairs to support the creation of medical performance student evaluation letters, utilizing data, creating formulas, and maintaining master data files.

• Collected data from Pioneer RX to analyze and report on patients, drugs, sales, inventory, and finance for various organizational actions
• Validated data accuracy and created various reports, including Accrual System Sales Summary, Rx Transaction Summary, Sales, Claims Data, and Inventory Reports
• Developed statistical analytical reports to measure the performance of products, sales, customer satisfaction, and revenue flow over specific time periods
• Organized, extrapolated, and disseminated data across departments to draw conclusions about the success of current methods
• Presented detailed reports on the meaning of gathered data to management, helping them identify scenarios utilizing modifications in the data
• Provided application support, communication, and user assistance, addressing end-user queries