Premera Blue Cross
As part of their compliance with the Federal No Surprises Act and other internal program initiatives, Premera Blue Cross wanted to put the processes in place that would handle the exchange of updated provider information with other systems, including both internal and external ones (like Quest).
Initially, the request was to have the inbound data from Quest parsed and reorganized into an internal record format. The ETL work on this inbound provider data was sent to Premera Blue Cross in the form of a csv file. The Federal No Surprises Act necessitated that the data be kept current and updated within 48 hours of any change. The acquisition of that inbound data from Quest was transitioning from a push process from Quest to a pull process by Premera by accessing a newly created remote Quest API and pulling that data on an as needed basis.
My Responsibilities, as Developer, included:
- Continue to develop the inbound data model to include previously unused data elements included in a daily csv file sent to Premera from Quest, a third-party clearing house that provided updates to Provider data.
- Analyze the output of multiple API calls that Quest was just beginning to make public so that the daily acquisition of Provider data could be done on an as-needed basis through a data “Pull” rather than waiting for Quest to “Push” the data to Premera.
- Analyze the data format provided by Quest inbound file pertaining to the providers’ hospital affiliations, and parse that data into a collection of an internal data format associated with the rest of the provider data.
