MAYURI KANGUL
Hyderabad
Summary
Results-driven Business Analyst with 14+ years of experience in healthcare consulting, specializing in data analytics and automation. Analyze complex datasets, extract actionable insights, and align findings with strategic business objectives. Skilled in Python programming, SQL, and Snowflake, with hands-on experience in developing data validation strategies and creating executive-level summary reports.
A creative and strategic thinker with strong critical thinking skills, adept at multitasking, taking initiative, and adapting to evolving priorities. Experienced in communicating insights to senior stakeholders, and implementing Generative AI techniques to automate manual processes and enhance operational efficiency.
Overview
4
4
years of professional experience
1
1
Certification
Work History
Business Analyst
Optum Global Solutions
Hyderabad
09.2024 - Current
- End to End process reviews to analysis the process including controls, risks and opportunities, process redesign activities to refine and simplify existing processes to drive efficiencies, supporting the development and implementation of new processes, systems or analytics, including growth and ideation projects to deliver additional medical cost savings. The scope of these activities is focused primarily on M&R for projects or activities determined as priority initiatives by the business.
- Support the M&R Segment by taking a lead role in driving projects and activities to maximize COB Productivity (including Automation) or Growth and Ideation initiatives to deliver Medical Cost Savings.
- Drive the project and activities to completion including conducting all needed research, problem solving and requirements-gathering activities with business and technical stakeholders to identify, collect and document specific business requirements (i.e., business, functional and non-functional).
- Support the COB Growth and Ideation team in the implementation of the COB strategic plan to meet and exceed financial targets for the Optum COB.
- Identify potential concepts for prepay rule development, retrospective, and prospective savings through individual ideation and from several perspectives such as Coordination of Benefit, Medicare, and federal guidelines.
- Analyze different data sets to identify prepay rules and opportunities particularly related to Coordination of Benefit.
- Evaluate gaps in business processes through process/data analysis, identify opportunities for automation, payment policies, quality, and throughput improvements to increase the opportunity for medical cost savings.
- Conduct all needed research, problem solving and requirements-gathering activities with business and technical stakeholders to identify, collect and document specific business requirements (i.e., business, functional and non-functional).
- Lead business requirements front end reporting of Growth values (both actual and forecasts) to support business decisions and reporting.
- Manage cross-segment projects and initiatives that require problem solving, relationship building, influencing, and analyzing.
- Develop and/or contribute to training programs to support implementation of the solution.
- Establish and perform testing scenarios and provide direction to developers to ensure requirements are adhered to.
- Collaborate with business matrix partners to deliver value to our clients by ensuring key operational, financial and growth targets are achieved.
- Examine, assess, and document business operations and procedures to ensure operational efficiency and excellence.
- Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance.
- Use pertinent data and facts to ideate, identify and solve a range of problems within area of expertise.
- Communicate the outcome of this research in a manner suitable for the intended audience.
Associate Business Analyst
Optum Global Solutions
Hyderabad
08.2021 - 08.2024
- Conduct and manage outcomes of various studies that include analyzing, reviewing, forecasting, trending and presenting information for operational, business and technology planning. Support short and long term strategic business activities - by developing, enhancing and maintaining operational information and models. Also develop and implement effective technology solutions through research and analysis of data and business processes.
- Review the reimbursement policy, medical policy, and CMS guidelines for leakages and additional opportunities.
- Exposed to wide variety of US healthcare with medical coding ICD 10, CPT and HCPCS codes.
- Expert in planning, managing and tracking activities and translating them into high-quality digital healthcare solutions.
- Demonstrate and apply understanding of UnitedHealth Group's business (e.g., specific business capabilities, functions, processes and business cycles) and developing project work plans.
- Demonstrate and apply understanding of health care industry trends and their drivers.
- Demonstrate and apply knowledge of technology industry trends and tools.
- Demonstrate understanding of the difference between business requirements and technical solutions.
- Act as bridge between business and technology.
- Maintain awareness of best practices and approaches related to the business analysis discipline (e.g., Business Analysis Body of Knowledge).
- Define and update the project schedule to track/measure progress of the requirements-gathering process (e.g., status, milestones, tasks, and deliverables).
- Working with users to define existing or new processes and recommend solutions and improvements.
- Proficient in performing data analysis, querying data bases, and utilizing SQL query tools.
- Power BI Data visualization.
- Able to run SQL query independently to pull paid claim data.
Education
Bachelor in Commerce - B.com
JOB SKILLS
- Expert in planning, managing, and tracking activities, translating them into high-quality digital healthcare solutions.
- Spearheaded large-scale, end-to-end projects resulting in an estimated cost savings of $1.8 million, while driving business growth by mitigating anomalies, risks, and inefficiencies.
- Chaired and facilitated meetings and brainstorming sessions with key stakeholders, including internal teams, clients.
- Strong exposure to data management and visualization techniques, delivering actionable insights to support strategic decision-making.
- Proficient in modern data tools including Python, SQL, Excel and Power BI for data extraction, manipulation, and visualization.
- Successfully managed a team of 15 members, fostering collaboration and performance excellence.
- Exposed to wide variety of US healthcare with medical coding ICD 10, CPT and HCPCS codes.
- Well-versed in all major Lines of Business (Medicare & Retirement (M&R), Community & State (C&S), and Employer & Individual (E&I)), with hands-on experience in mirroring key concepts across systems.
Business Analysis
Requirement Gathering
Process Analysis & Improvement
Data Analysis
Stakeholder Communication
Solution Evaluation
Documentation
Project Support
Certification
Certified AHM250 course and designated as Professional, Academy for Healthcare Management (completed Feb '18)
Certified Scrum Master from the Scrum Alliance (completed in July '23)
Microsoft Azure (Fundamentals of Azure) certification issued by Microsoft (completed Oct'24)
PL-7008: Create and extend custom copilots in Microsoft Copilot Studio, completed May '25
Successfully completed the Generative AI Certification program at Optum Tech University, which included a capstone project
Languages
- English,Fluent
- Hindi, Fluent
- Marathi, Fluent
- Telugu, Fluent/Native
Language Libraries/Database Tools
Python
SQL
Snowflakes
Microsoft Copilot
Power BI
MS Excel
MS Word
MS PowerPoint
Visio
AHA
RALLY
DBEAVER
Personal Skills
•Cognitive Intelligence: Strong analytics & problem-solving abilities.
•Enabled strategic decision-making based on data points and logical rational.
•Showcased managerial skills by handling negotiation & interpersonal communication.
•Leadership: Confident, Agility, articulate, and Professional speaking abilities.
•EQ: Empathic listener, Maintaining Continentality, Authenticity & Integrity.
•Excellent analytical skills; Attention to detail; Strong delivery focus and quick learner.
•High attention to detail and willingness to learn.
Timeline
Business Analyst
Optum Global Solutions
09.2024 - Current
Associate Business Analyst
Optum Global Solutions
08.2021 - 08.2024