Snehal Yesane
Senior Healthcare Domain Analyst| Healthcare SME
Pune
Summary
Strategic and results-oriented Senior Healthcare Business Analyst with over 8 years of experience driving performance across leading healthcare organizations including Evolent Health, Cotiviti, and Sciformix(Covance). Extensive expertise in payer-side operations—covering claims, encounters, enrollment, utilization management, and care management—for Medicare, Medicaid, and commercial LOBs. Skilled in delivering actionable insights through advanced analytics, regulatory reporting, and operational performance improvement. Proficient in SQL, SAS, and AI tools like Copilot to enhance data extraction, quality analysis, and reporting workflows. Experienced in using JIRA and Confluence for agile project tracking, documentation, and cross-functional collaboration. Strong in mentoring and bridging business–tech communication to deliver impactful, domain-driven solutions.
Overview
8
8
years of professional experience
2017
2017
years of post-secondary education
5
5
Certifications
3
3
Languages
Work History
Senior Healthcare Domain Analyst
Evolent Health International India
Pune
08.2021 - Current
- SME for Medicare, Medicaid, and Commercial payer lines supporting claim and operational analytics.
- Owner of standard operational reports including SLA/OLA, interest penalties, claim aging, and inventory.
- Collaborate with Business Analysts and Developers to deliver high-quality, requirement-aligned reports.
- Conduct domain learning sessions, mentor new joiners, and lead internal documentation practices.
- Manage internal projects, develop charters, maintain WBS, and ensure stakeholder coordination.
Specialist - Payment Accuracy
Cotiviti India Pvt Ltd
Pune
01.2019 - 08.2021
- Served UHC and BCBS clients in duplicate claim analysis and Rx audit processes.
- Conducted clinical record reviews including ICD, CPT, NDC, and HCPCS coding validations.
- Identified inefficiencies in reports to streamline processes and reduce false positives.
- Recognized for preparing comprehensive training materials for audit team.
Junior Safety Data Analyst
Sciformix Technologies Pvt Ltd (Covance)
Pune
08.2017 - 05.2019
- Managed case triaging and data entry into ARISg and SCEPTRE safety databases.
- Assessed seriousness of adverse events, ensuring regulatory compliance and audit readiness.
- Validated and documented ICSR cases with high quality and adherence to SOPs.
Education
Master-s in Pharmacy -
MAEERs Maharashtra Institute of Pharmacy
Bachelor-s in Pharmacy - undefined
Bharati Vidyapeeth College of Pharmacy
Skills
- US Healthcare Domain (Medicare, Medicaid, Commercial)
- Claims Processing, Encounter Management, Enrollment, UM & CM
- Healthcare Reporting & Compliance (HIPAA, CMS)
- SQL, SAS, MicroStrategy, AWS
- Project Coordination (PMP Certified), BRD/FRD Creation
- JIRA, Confluence, Azure, Amazon Workspace
- Data Quality, Duplicate Claims Audit, Report Validation
- Team Mentoring, SME Support, Stakeholder Communication
Certification
Project Management Professional (PMP) : PMI
Awards
Star Award, Spot Award, Best Cross-Skilled - Evolent Health, Spotlight Recognition - Cotiviti (for training documentation), Smart Performer - Sciformix (100% target & quality), Best Outgoing Student (M.Pharm, 2017), Winner - State Level -Campus to Corporate Ace- Competition (2014)
Tools & Technologies
SQL, SAS, MS Excel, MicroStrategy, JIRA, Confluence, Azure, AWS, BI tools
Timeline
Senior Healthcare Domain Analyst
Evolent Health International India
08.2021 - Current
Specialist - Payment Accuracy
Cotiviti India Pvt Ltd
01.2019 - 08.2021
Junior Safety Data Analyst
Sciformix Technologies Pvt Ltd (Covance)
08.2017 - 05.2019
Bachelor-s in Pharmacy - undefined
Bharati Vidyapeeth College of Pharmacy
Master-s in Pharmacy -
MAEERs Maharashtra Institute of Pharmacy
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