Brian Lorber Email & Phone Number

Glen Cove, New York, United States

Hawthorne, Ny

• Initiated and ran multi-year Pay-for-Reporting (P4R) Projects (DSRIP Actively-Engaged Patients, PAM Patient Activation Measure) which included partner recruitment/customer relations management, data collection and analytics, and data validation/clean up from 40+ partners each submitting up to 7 projects. Also responsible for NYS data submission and data audit preparation and response. Successfully collected all potential revenues (over $4 Million to date) based upon reaching significant thresholds of data volumes.• Performed complex analyses in support of WMC Health’s Network Development department to support network strategy development, physician/practice recruitment and Workforce/Staff Impact.• Created and analyzed quarterly ‘Funds Flow’ of PPS Partner Payments, including audit preparation and response.• Ran, Participated in, or Supported several DSRIP oversight committees including those for Quality, IT, Workforce and Finance.• Designed a Pay-for-Performance (P4P) reimbursement methodology to reward the PPS’s clinical and community DSRIP partners based on their contribution to improvement of complex clinical measures.

Rego Park, Ny

• Researched, Implemented, and controlled all inpatient, outpatient, lab pharmacy and other rate schedules maintained in the provider’s payment system for Medicaid, Medicare and Health Exchange beneficiaries. Performed financial impact studies related to shifts in Federal and NYS reimbursement methodologies and rates. Assisted in development of physician and hospital reimbursement policies and strategies to support corporate goals. Designed a PC-based pricer to adjudicate the new NYS psychiatric inpatient methodology which could not be performed by the existing claims payment systems.• Maintained current knowledge of Federal and State reimbursement rules and methodologies and served as a subject matter expert.• Performed weekly claims review and related analyses necessary for accurate payment determination and tracking.• Acted as Finance department’s “Employee Survey Champion” to analyze and deliver internal workplace survey results, and to create and implement action plans for improvement in key areas.

White Plains, Ny

• Primary analytics expert for VHA regional office serving 25 hospital members throughout NY, NJ, CT and PA. Designed, implemented and presented analyses from diverse data sources to high-level hospital and VHA audiences. Based on results, direct hospitals to VHA or external resources (i.e. perform sales function) to pursue opportunities. Also presented data studies at national conferences (HFMA, Solucient)• Designed and produced materials used by office executives for the Board of Directors, committees, councils and other member-facing events. Also provided analytic support and direction for various other initiatives delivered through the VHA Empire – Metro regional office by co-workers. • Served as ‘Advisor’ for VHA ImperativTM, an analytic software suite powered by data and methodologies from Truven Health, to help hospitals identify performance improvement opportunities across a broad spectrum of healthcare analytics (clinical data, value-based purchasing, patient safety, supply chain, operations, workforce, HCAHPS/Patient Experience.) Delivered results to senior executives at all member hospitals and helped to craft solutions to bring data into action. Assisted the national VHA team with various elements of design and proofing for several modules of the Imperativ tool.• Provided support to national VHA teams and several regional offices in areas such as revenue cycle, documentation and coding effectiveness analysis and tool development.• Lead user of external tools at VHA Empire – Metro from Truven Health (Action OI, Care Discovery, Polaris, Fathom) used to provide patient level, hospital level and system level data and interpretation to member hospitals.

• Analyzed managed care rate proposals and negotiated contracts, including legal language, for a university-affiliated teaching hospital, 2 community hospitals, physician-hospital organization, home health agency, and various carve-out specialty providers. Methodologies included per-diems, case/DRG rates, primary care capitation, partial and full-risk contracting, stop-loss, etc. Acted as primary contact between the managed care organizations and the healthcare system for contract and reimbursement issues.• Gathered and analyzed hospital utilization and financial data to evaluate cost-effectiveness of new business proposals as well as existing product lines. Assimilated data from disparate sources both inside the hospital (Medicare cost reports, ad-hoc data loads from mainframe information system) as well as external sources (HFMA, HANYS, GNYHA, NYSDOH, Internet)• Helped coordinate and execute revision of the hospital CDM (charge description master) to prepare for the Medicare Hospital Outpatient Prospective Payment.• Acted as the hospital’s sole operator of ‘Healthshare One’ system, a third-party software suite which employed NYSDOH utilization data for comparisons of service costs and efficiencies across competing institutions.

Master'S Degree, Health/Health Care Administration/Management

Bachelor'S Degree, Biology, General