Anthony Cerna Email & Phone Number

San Francisco, Ca, Us

Santa Monica, Us

- Created multiple dashboards to track various KPI's, including Pharmacy Margin, high/low revenue medications, and claims data integrity. Tools: Redshift and Looker.- Compiled monthly/quarterly Admin Fee reconciliation reports for Finance. These reports were used to ensure that our monthly PBM revenue aligned with our internal data and to recoup any missing revenue from our partners.- Assisted with the transform layer in ELT processes on a weekly and monthly cadence using a combination of Redshift, SQL, and dbt.- Researched various ad-hoc requests related to our claims data for multiple teams, including Engineering, Finance, and Pharmacy Strategy.- Assisted data scientists with investigative tasks and feature engineering for various predictive models.- Audited new partner contracts to identify any downstream effects.

Menlo Park, California, Us

- Created multiple Power BI dashboards to track various KPI's throughout WelbeHealth. These data models utilize the following data sources: Azure Database, Snowflake Database, and Excel Workbooks housed in SharePoint.- Built an "820/834 Reconciliation Tool" for the Benefits Team. This tool allows the team to track any paid and outstanding Medicaid payments that are due from the California Department of Health Care Services. This tool was tracking $30M+ worth of payments.- Performed various ETL processes on a weekly and monthly cadence.- Created flows with Power Automate to stream line repetitive tasks.- Assisted operations staff with the preparation of monthly, quarterly, and yearly reports.- Served as a liaison between the Analytics Team and the Information Technology & Security team in order to plan for the creation of a master Data Warehouse.

Eden Prairie , Mn, Us

- Compiled month end audit data to report out team metrics to the team’s directors, managers, and supervisors.- Migrated static excel reports into user-friendly Power BI dashboards.- Assisted with root cause analysis for all coding related issues.- Performed beta testing on tools that are being rolled out to the audit team.- Assisted with the tracking and updating of various documentation that are used by BAT and CQA.- Served as a liaison between the implementation and audit teams to provide a better understanding of new changes within our process and how they might cause downstream effects.

Eden Prairie , Mn, Us

- Subject Matter Expert (SME) for the Medicaid and Medicare Part D lines of business.- Assisted with the creation and implementation of training materials for new hires.- Wrote a six page research paper that outlines the benefits and validity that comes with the usage of a strong sampling design, which was distributed to the entire team.- Specialized in the Government (i.e. Medicaid and Medicare Part D) and Commercial (i.e. PacifiCare / ProAct) lines of business.

Eden Prairie , Mn, Us

- Performed system audits and pharmacy claims testing to reduce errors and improve processes, which determines OptumRx's support of contractual performance guarantees.- Executed database queries to extract large data sets using Excel and Access.- Obtained an all-around understanding of RxCLAIM: an online claims processing system used for prescription drugs.- Specialized in the Government (i.e. Medicaid) and Commercial (i.e. PacifiCare / ProAct) lines of business.- Collected data elements and documented audit results to facilitate performance analysis.- Well-versed in internal process improvement strategies through the use of Root Cause Analysis, Six Sigma, and Lean methodologies, as well as statistically-based risk management methods. Accomplishments:- Maintained a 100% accuracy rate (i.e. caught every system defect) throughout my 1 year + 2 months tenure.- Achieved and maintained an above-average turn around time for my audited projects when compared to the team averages within the Medicaid line of business.

Berkeley, Ca, Us

- Administered academic surveys to collect psychosocial, behavioral, & academic data from diverse high schools in the Bay Area. More information on the joint longitudinal study between UC Berkeley and UCLA: www.uclaschooldiversityproject.com.- Managed multiple undergraduate data collection teams throughout the semester.- Extracted and prepared survey data for the analysis

Berkeley, Ca, Us

- Assisted a Ph.D candidate with their dissertation research that revolved around math teachers’ learning supported by coach-teacher interactions- Utilized InqScribe to analyze and fully transcribed video recordings of coaching sessions with various math teachers around the Bay Area- Identified potential sources of evidence for her dissertation paper

Los Angeles, Ca, Us

- Coordinated daily academic seminars for first generation minority high school students to cover statistical/mathematical concepts. - Provided mature leadership to 60+ high school students during two separate summer programs. - Held weekly meetings with the staff to analyze and address students’ behavioral and academic progress

Berkeley, Ca, Us

- Collaborated with a research team of graduate students to develop a data-driven classroom observational scheme with an emphasis toward equity.- Coded qualitative & quantitative data in MS Excel to relate pedagogy to student performance- Utilized inferential statistics to advise research team about appropriate hypothesis test implementations for classroom exam scores.- Received monthly stipends from the National Science Foundation (NSF) for the conducted research

Berkeley, Ca, Us

- Collaborated with a team of staff & undergraduates STEM students to provide exceptional academic services, such as afternoon review seminars, to first-year college students- Explained mathematical/statistical concepts in layman's terms to assist students with their thought process- Oversaw mock midterms and final exams to increase the students probability of obtaining a high passing grade

- Provided literacy services at LeConte Elementary for 1st and 2nd grade students through the Berkeley United in Literacy Development program. - Created lesson plans used throughout the week- Strategized with the site leader on optimal methods needed to raise the students reading level

Los Angeles, Ca, Us

- Coordinated daily academic seminars for first generation minority high school students to cover statistical/mathematical concepts. - Provided mature leadership to 60+ high school students during two separate summer programs. - Held weekly meetings with the staff to analyze and address students’ behavioral and academic progress

Los Angeles, Ca, Us

- Assisted with day-to-day office tasks, including front-desk customer service- Performed high-speed data entry and invoicing services

Bachelor Of Arts (B.A.), Statistics

Immersion College Certification, Data Science

High School Diploma