Mita Banerjee

Experience

1. Hedis Quality Data Subject Matter Expert (Sme)

   Optum

   Jun 2021 — Present

   Provide subject matter expertise in quality data analytics for HEDIS, AMP, and state-specific reporting programs across multiple payer organizations using Optum• Develop and implement strategic data-driven metrics for performance on key quality measures and address care gaps.• Build and execute SQL queries and Alteryx workflows to validate and transform health plan data including Member, Provider, Lab, Pharmacy, and Encounter data.• Translate regulatory and audit requirements into actionable data processes, supporting the full audit lifecycle (HEDIS Roadmap, audit file preparation).• Conduct thorough data validation, using Excel and Alteryx workflows for automated quality tracking.• Integrate data from multiple sources and formats, ensuring integrity and consistency across claims, supplemental, and encounter data.• Guide internal and external stakeholders on data quality issues, regulatory specifications, and coding standards (ICD-9/10, CPT, LOINC, etc.).• Deliver client-facing presentations of analytic results via Microsoft Teams, transforming data into insights and power point presentations• Support matrixed project teams, prioritizing and managing high-impact deliverables under tight deadlines.

Education

• Lafayette College

  B.S.

• Rutgers University-New Brunswick

  B.A.

Skills

• Data Warehousing
• Kanban
• Medical Billing
• Oracle
• Test Cases
• Requirements Analysis
• Healthcare Reimbursement
• Business Analysis
• Test Planning
• User Acceptance Testing
• Medicare/Medicaid Reimbursement
• Sdlc
• Healthcare
• Process Improvement
• Claims Management
• Hospital Reimbursement
• System Testing
• Sql
• Microsoft Sql Server
• Ncqa
• Microsoft Office
• Test Management
• Agile Methodologies
• Regression Testing
• Test Driven Development
• Claims Handling
• Manual Testing
• QA Engineering
• Mss
• Integration
• Wikis
• Fitnesse
• Databases
• Hedis