Brandon May Email & Phone Number

Spring Hill, Tn, Us

Nashville Metropolitan Area

In this role I have been tasked with helping to modernize our Risk Adjustment processes and infrastructure which currently are scattered across various servers, technologies, manually updated spreadsheets, etc. This is a new team that I have been allowed to build out and we have focused on a few core principles: - Getting data to a common platform so all people within the Risk Adjustment space have the same data- Determine sources of truth and clean out the noise- Build out scalable pipelines for automation and data ingestion/ movement which we have done using Airflow- Automating processes currently done manually to free up internal resources for more impactful work- Uniting the larger group around common definitions and methodologiesAdditionally I have been tasked with reengineering the CMCR process from the ground up. This is a critical Risk Adjustment process that is responsible for between $60m and $100m in revenue. Within 9 months of moving into the role I was able to reconstruct this process from a 100k+ line code base to less than 2k while improving it's run time from 3 weeks to under 20 minutes, all while adding significantly more capability and traceability from a data lineage standpoint. Other accomplishments of note:- Automation of datamarts for Risk Adjustment that provides versatile "source of truth" tables able to answer the vast majority of analytics questions- Assembling data for all reports in a single location allowing all reporting to leverage the same data sources to improve the stakeholder trust in their data- Automating pipelines for external vendor files- Setting up ML Ops to manage existing data models- Automation of Audit work to allow more rapid, consistent outcomes and reducing turnaround time by an average of 6 weeks per audit

Nashville Metropolitan Area

I lead three teams within the Government Business Analytics Segment:Infrastructure TeamDesign and manage the ETL Infrastructure for the entire Government Business Segment Analytics (GBSA) team. This includes the claims, enrollment, and provider areas of the org. Application Development TeamDesign, develop, and deploy web-based applications using a PostGres, Django, and React stack. All applications are internal and designed to improve performance for various Cigna teams.Data Management TeamDesign and deploy large data feeds that function as backends for self-service tools and Tableau dashboards, build Python processes to consume and stage vendor, government, and financial data via extracts or API.Additionally my leadership with Cigna was recognized by being selected for the Leading With Excellence program which is an elite leadership development program designed to build Cigna's future leaders.

Franklin, Tn

• Created dashboards that handle all client facing reporting for the COB Smart product• Handle adhoc reporting request for eligibility 270 & 271 transactions, COB Smart reporting, data quality, and payer request• Produce all daily and monthly reporting for Executive leadership• Process and system flow designs with management and development team• Requirements gathering and documentation (usually done in conjunction with our Tech Writer)• Data research projects as requested by clients or leadership• Assist QA team as needed• Handle sprint tickets as assigned from management, development, or implementation teams

Brentwood, Tn

• Designed, developed, deployed, and maintain the Backup Recovery Information Console (BRIC).• Provide ad-hoc, scheduled, and on demand reporting for 12,000+ server environment.• Oversee compliance projects for Backup and Recovery.• Manage backup tape inventory for corporate environment including predictive use analysis and ordering. • Process improvement and refinement for existing processes as well as creation of new processes.

Franklin, Tn

• Subject Matter Expert (SME) for Enrollment, IT, and Reconciliation departments. In this capacity I am the point person for any questions or issues that arise regarding CMS rules and regulations. • Designed, developed, deployed, and maintain the Sales Representative Database System (SRDS) which has been used to track and report credentialing, production, and compliance information for our organization’s 3,000+ agents across 21 states.• Designed, developed, and deployed the Compliance Tracker System. This system is used to work and report all sales allegations and complaints and keep our organization within CMS compliance. • Designed, developed, and deployed Broker Application Tracking System (BATS) which was utilized to track and report on an average of 15,000+ sales per year.• Executive level reporting and trending of sales allegations as well as any other data requested by our CEO or Executive Committee. • Compiling and reporting of data regarding sales allegations, scope of appointment calls, CMS rejections, sales, cancellations, etc. • Conducting of internal audits on our Sales Department to be sure they stay within CMS regulations. • Assisting the Director of Sales Oversight with the completion and submission of CMS audit information. • Conducting training classes for new Sales Representatives.

Brentwood, Tn

• Full managerial duties; including hiring, scheduling, termination, etc, of a department of 12 full time employees. • On site work at various client hospital facilities as well as weekly conference calls with Business Office Directors of the facilities. • Compiling and reporting call and result data to Executive leadership as well as hospital leadershipKey Accomplishments at Ingram and AssociatesBy creating an innovative accomplishment and reward system for my department we were able to break the company collection record of over $100,000 in fees per month for 3 consecutive months. This was a record that had not been broken once in the prior 10 years.

Franklin, Tn

• Investigating non-traditional healthcare claims to determine Coordination of Benefits for over 150 hospitals. These included auto accidents, worker’s comp claims, and litigation.• Dealt directly with patient attorneys in reaching settlements that would be satisfactory for the hospital.Key Accomplishments at Medical Reimbursements of AmericaBecame the company point person for state’s differing worker’s compensation laws as well as dealing with reconciliation of “pay and chase” insurance carriers.

Denver, Co

• Managed full billing operations for three dermatology clinics as well as one OBGYN clinic• Handled insurance contract negotiations for providers including acceptance of Medicare and Medicaid• Handled required coding to be sure claims met Medicare coding standards prior to submissionKey Accomplishments at Harvard Park Medical ManagementTwo of the clinics under my direct guidance saw a significant turnaround in the accounts receivable within six months of my taking over their operations. Most significantly Roaring Fork Dermatology saw their receivables more than double after I renegotiated their contracts with Rocky Mountain HMO and Pacificare.

Franklin, Tn

• Investigating non-traditional healthcare claims to determine Coordination of Benefits for over 150 hospitals. These included auto accidents, worker’s comp claims, and litigation.• Dealt directly with patient attorneys in reaching settlements that would be satisfactory for the hospital.Key Accomplishments at Medical Reimbursements of AmericaBecame the company point person for state’s differing worker’s compensation laws as well as dealing with reconciliation of “pay and chase” insurance carriers.

Brentwood, Tn

• Traditional medical collector role of patient balances for CHS hospitalsKey Accomplishments at Professional Account Services IncorporatedTwice won “Collector of the Month”. On the first instance I received a bonus of $3,500, which was well above what the company wanted to pay out so they altered the bonus structure to avoid such a large bonus. The following month I again won “Collector of the Month” and again garnered a larger bonus than the company planned – this time $1,700 – causing them to yet again alter the bonus structure.