SAI SANDEEP KANAKAMEDALA
Bridgeport,CT
Summary
Dedicated Healthcare Informatics Master's graduate with a GPA of 3.87 and a proven track record as a Pharma Benefit Analyst. Leveraging strong analytical skills, database management expertise, and a solid pharmaceutical background, I am eager to contribute to the success of your organization.
Overview
1
1
years of professional experience
2
2
Certification
Work History
Pharma Benefit Analyst
Quess Corp Pvt. Ltd on contract role for Optum Global Solutions Pvt. Ltd (part of UNITED HEALTH GROUP)
Hyderabad, Telangana
06.2021 - 01.2022
- Maintained process quality and performance resulting in a 15% improvement in efficiency as a Pharma Benefit Analyst.
- Conducted testing in AS400 (Rx Claim) to ensure a 99% accuracy rate in claim adjudication.
- Gathered data to address Pharmacy Benefit management (PBM) business issues.
- Acquired knowledge of Rx Claim (AS400) functionalities and Book 2 Environment.
- Responded to claims processing inquiries from various departments.
- Analysing benefit requests like deductibles, Co-pays, Co-insurance, MOOP, Ancillary charges, Benefit Max, Accumulators, Networks and securing all necessary data for appropriate claim adjudication.
- Identifying opportunities for process improvement and contributing to the development and implementation of best practices in the department.
- Conducting data analysis and modeling to support decision-making processes.
- Planning, documenting, evaluating, and tracking testing results to ensure projects are free from defects.
- Maintaining acceptable and appropriate quality levels and production turnaround times.
- Creating Plan codes, implementing plan options, Testing and Validating plan codes via tools POET, PDLP, and E&I CHECKLIST in the applications AS400, BOOK-2, and Batch Productions.
- Involving in Auditing the claims internally.
Summer Intern
Goldfish Pharma Pvt. Ltd.
Hyderabad, Telanagana
06.2019 - 07.2019
- Completed a comprehensive 30-day program at Goldfish Pharma Pvt Ltd., gaining hands-on experience in various aspects of pharmaceutical manufacturing processes.
- Executed tasks related to the manufacturing of pharmaceutical products, gaining proficiency in Tablet granulation.
- Played a pivotal role in quality control processes by conducting inspections, testing, or ensuring compliance with industry standards.
- Assisted in maintaining meticulous documentation, ensuring accuracy and compliance with regulatory requirements. This involved specific tasks, such as data entry, record keeping and documentation.
Education
Master's in healthcare informatics -
Sacred Heart University
Bachelor of Pharmacy -
CMR College of Pharmacy
Skills
- Database Management (SQL)
- Data Analysis (Microsoft Excel, Tableau)
- Claims Testing
- Claims Processing
- Electronic Health Records
- Microsoft office
- Power BI
- Communication skills
- Teamwork
- Quick learner
- Adaptable
- Leadership skills
Certification
- Awarded Certificate for outstanding Poster Presentation entitled Ebola Virus at the International Biotechnology and Emerging Trends (IBET-2017) event hosted by CMR College of Pharmacy in September 2017.
- SQL Certification (LinkedIn Learning)- Feb 2024
Key Skills Acquired: SQL fundamentals, Database design and management, Query writing and
optimization, Data manipulation and retrieval.
Research Papers
- Bachelor of Pharmacy: Investigated the mitigative effect of VITEX NEGUNDO L. Leaf extract against Fluoride-induced Hepatotoxicity in male Wistar Albino rats.
- Masters: Conducted a Capstone Project on the Optimization of Remote Patient Monitoring for Patients with cancer disease, aiming for enhanced healthcare outcomes. (Not published)
Timeline
Pharma Benefit Analyst
Quess Corp Pvt. Ltd on contract role for Optum Global Solutions Pvt. Ltd (part of UNITED HEALTH GROUP)
06.2021 - 01.2022
Summer Intern
Goldfish Pharma Pvt. Ltd.
06.2019 - 07.2019
Master's in healthcare informatics -
Sacred Heart University
Bachelor of Pharmacy -
CMR College of Pharmacy