Data Engineering and Data Science Graduate Program

Instructor for the Digital Technology department leading courses in data analytics and database programming

Specialize in data science approached hospital revenue management reporting, automated charge reconciliation and charge capture. Worked on various healthcare provider clients, including large academic medical centers, managed care organizations and community hospitals with electronic medical record optimization and management.Established a Revenue Integrity team leveraging Big Data analytics to provide data-driven approach to investigate and resolve revenue variances in the clinical departments. Revenue Integrity Team realized over 2 million in annualized net revenue opportunity through the combined efforts of charge capture education, linked charges, coding reconciliation activities and charge router improvements. Led data analytics team to develop custom patient encounter reconciliation reports across scheduling systems, clinical notes and billing systems to determine charge capture opportunities for systemic improvements in the provider Inpatient, Outpatient and Surgical settings. Specialize in Epic Clarity Report writing, NLP behavioral identification and Tableau report resign. Developed custom analytics to assess the Charge Description Master for compliance with current billing and reimbursement policies and identify potential opportunities to improve CDM HCPCS and revenue coding in order to produce clean claims and enhance first pass yield. Analysis requires strong understanding of provider medical records and billing datasets, CMS Regulations and SQL database manipulations.

Drive value based care initiatives and program implementation with strategic managed care provider partners

Leading integration and implementation efforts with high performing high volume provider groups

•Collaborated with the subsidized health insurance product, Commonwealth Care, and unsubsidized, Commonwealth Choice, in determining similarities and differences in preparation for the merger of the two health insurance programs•Aggregated data across both programs to create a member profile consisting of both programs, as well as projections of the new target population

Model provider payer contract terms, creating initial scenario reports through the Rate Rationalization software and producing final charge description master recommendation based on client parameters. Analysis requires a strong understanding of provider medical records datasets, CMS fee schedules, health insurance payer contract terms and Access database management.

Concentration on Health Policy and Management

• Interacted with client executives to overcome challenges and meet monthly quality measures• Trained new Clinical Care Extender Hospital Internship Manager while supervising current Managers• Provided coverage for internship operations at multiple client facilities in Southern California (e.g. Hoag Hospital, St. Mary Medical Center, St. Francis Medical Center, St. John Regional Medical Center)• Recruited and interviewed for cross-divisional internal positions• Involved with divisional rebranding and restructuring to meet the needs of our clients and alumni

• Oversaw 500 active interns and managed a team of 40 Leadership Team members• Conducted intern Root Cause Analysis to investigate increase in intern related incidents• Involved in standardization of internship training, policies and practices at all eight pipeline facilities • Assisted in creating a Request For Proposal for divisional online profile management database• Participated in companywide committees – Quality Assurance, Performance and Quality, IT Committee and Team buildingAdditional consulting role with health center client to create and compile a community-wide survey to assess the community needs and developed the appropriate services