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Pratik Maharjan

@pratikmaharjan012

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Principal Data Analyst specializing in US healthcare analytics, claims, and AI-assisted data pipelines.

Nepal

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What I'm looking for

I’m looking to lead US healthcare analytics—building scalable SQL/cloud pipelines and automating decisioning with agentic workflows and AI-assisted development—while partnering with stakeholders on claims, payment integrity, ROI, and quality metrics.

I’m a Principal Data Analyst with 7+ years in US Healthcare—claims processing, payment integrity, ROI analytics, and HEDIS/Risk Adjustment. I translate complex business requirements into scalable SQL and data pipeline solutions, with a growing focus on agentic workflows and AI-assisted development.

In my current role at Maitri Services, I author BRDs and source-to-target mappings for claims pipelines, payment integrity, and ROI analytics. I define schemas, transformation specs, business rules, and acceptance criteria, then develop and validate SQL across large claims datasets to drive quality and alignment.

I’ve also led technical BA work at Techkraft Inc (Abacus Insights), including ownership across end-to-end lifecycles for US Healthcare Risk Adjustment and HEDIS engagements. I led a team of Technical BAs, partnered with engineering to refine data processing workflows, and mentored junior analysts while resolving client and development issues.

Earlier, at Cedar Gate Technology and Deerwalk Inc, I worked across healthcare claims processing, data validation frameworks, and production troubleshooting. I’ve built automation with Python/S3, helped migrate legacy systems, and consistently focused on turning data into actionable insights that improve accuracy, efficiency, and delivery.

Experience

Work history, roles, and key accomplishments

Current

Principal Data Analyst

Current

Maitri Services

May 2025 - Present (1 year 1 month)

Authored BRDs and source-to-target mappings for claims pipelines, payment integrity, and ROI analytics, defining schemas, transformation specs, and acceptance criteria for engineering handoff. Built agentic data processing capabilities and developed an interactive healthcare flow simulation platform for claims processing training and analytics.

SQL Snowflake Databricks DBT Claims Processing Payment Integrity Source To Target Mapping

Principal Business Analyst

Techkraft Inc

Jan 2024 - May 2025 (1 year 4 months)

Led end-to-end project ownership for US Healthcare risk adjustment and HEDIS engagements, aligning stakeholders and optimizing processes. Managed a team of Technical BAs and supported delivery against business objectives across analytics and reporting workflows.

Stakeholder Management Requirements Engineering Project Lifecycle Ownership Risk Adjustments HEDIS Agile Scrum Data Modeling Jira Process Optimization Gap Analysis

Senior Business Analyst

Techkraft Inc

May 2023 - Dec 2023 (7 months)

Delivered analytics for US Healthcare risk adjustment, HEDIS, and Stars metrics by defining technical requirements for dashboards and client-facing reports. Resolved issues, performed gap analyses, and partnered with engineering to refine data processing workflows and validate test cases against business intent.

Risk Adjustments HEDIS Requirements Definition Dashboards Data Quality Analysis Agile Delivery

Senior Business Analyst

Cedar Gate Technology

Jan 2023 - May 2023 (4 months)

Worked on US healthcare claims processing, focusing on accurate and efficient handling of patient and insurance data. Designed data validation frameworks, led stakeholder alignment, and mentored junior analysts to support timely delivery.

Claims Processing Data Validation Requirements Analysis Project Delivery Error Free Processing Mentoring

Business Analyst

Cedar Gate Technology

Jun 2021 - Jan 2023 (1 year 7 months)

Acted as a liaison between business and engineering teams, translating stakeholder needs into requirement documents and data flow diagrams. Supported implementations and deployment strategies and validated test cases and test plans to ensure alignment with project objectives.

Requirements Gathering Data Flow Diagrams Deployment Test Plans Healthcare Analytics

Data Engineer

Cedar Gate Technology

Sep 2019 - Jun 2021 (1 year 9 months)

Built custom SQL functions and Python/S3 automation for healthcare data processing. Designed scalable ETL pipelines, supported legacy system migration, and handled production troubleshooting to keep data workflows reliable.

SQL Python S3 ETL Data Migration Production Troubleshooting Healthcare Data Processing Data Automation

Associate Data Engineer

Deerwalk Inc

Sep 2018 - Sep 2019 (1 year)

Processed and transformed healthcare datasets by authoring cleansing scripts and standardization documentation. Supported HIPAA compliance and automated data validation processes to improve downstream accuracy and reliability.

Data Cleanse Data Standardization SQL Python HIPAA compliance Data Validation Data Quality Assurance

Data Analyst Intern

Deerwalk Inc

Jun 2018 - Sep 2018 (3 months)

Conducted US healthcare domain research and created analytical reports to support data-driven insights. Assisted with data import and transformation activities to enable analysis and reporting workflows.

Healthcare Domain Research Reporting And Analysis Data Imports Data Analysis