Our team connects platforms faster, enabling interoperability and information exchange between healthcare systems.

Goals

• Operationalize monthly pharmacy and medical claims reporting processes across multiple data sources and organizations.
• Reduce manual processing by creating an advanced data processing workflow to streamline extraction, transformation, and data loading procedures.
• Create a ledger to sequence and track records through the claims back-out and adjudication processes.

Approach

Working closely with stakeholders across multiple agencies, we implemented an integrated ETL data pipeline capable of processing raw claims files into historical and incremental reports. We worked collaboratively with stakeholders on several complex issues to define and develop business logic that addressed invalid enrollments and claims back out and sequencing errors. Using an agile software development approach, we developed a detailed release plan, with solution delivery scheduled every 2 weeks. Through iterative execution, we were able to deliver the agreed upon reports at each scheduled release.