Dhanusu Varadharaja

Healthcare Data Analytics & Engineering Professional
Expert in data integration, transformation, and management, focused on delivering accurate, compliant, and actionable healthcare data solutions.

Key Skills & Responsibilities:

Healthcare Data Integration:

Lead creation and maintenance of healthcare data layouts, Source-to-Target Mapping (STTM), and transformation algorithms.
Standardize and enrich data for rule execution, ensuring seamless flow from raw data to insights.
Rules Data Management:

Oversee sourcing, building, and managing reliable PostgreSQL tables, including record tracking (new, modified, deleted).
Conduct thorough validation checks to ensure data integrity and compliance with business and regulatory standards.
Advanced Data Profiling & Validation:

Perform in-depth data profiling at column, cross-column, and cross-table levels to ensure data accuracy.
Build robust data models with validation steps to maintain high-quality data.
Technologies & Tools:

Proficient in dbt, PostgreSQL, DBeaver, AWS Athena, MySQL StarRocks, Apache Superset, MS Excel, MS Access, Python (YData profiling, Pandas, Numpy).

• Created data inbounds and outbounds
• Played an important role in data quality and data integrations

• Healthcare data extraction and outbound to vendors
• Created platform to inbound data from vendors
• Performed data analysis and data quality assurance
• Performed mandate projects like - files to CMS and BCBSA etc
• Worked on HL7-FHIR based projects
• Worked for multiple state BCBS programs

• Played a key role in developing claims modules in Novus application
• Module includes health plan configuration, EDI (837), claim processing, claim adjudication rule engine and payment integration
• Clients are local unions exist in United states of America
• E.g
• IAM, Local30, CIR, Local478

• Played a key role in developing Medical Billing workflow application
• Module includes automated claims audit process, claim preadjudication rule engine in provider perspective
• Clients are medical and hospital service providers exist in United states of America
• E.g
• MBMS

• Played a key role in developing Payer payment integrity system
• Policy rule engine system includes Medicare, Medicaid, and commercial insurance claim adjudication rules
• Clients are payers exist in United states of America
• E.g., Aetna, Amerigroup, BCBS, Cigna, Coventry, Excellus, Health first, Humana, Molina, Select health, Well care, Well mark and Well point

• Played a key role in developing Computer Assisted Coding (CAC) application
• Automated assignment of CPT, ICD, and modifiers to the medical records
• Clients are medical and hospital service providers MBMS