Member of the Data Intake, Transformation, and Quality Assurance team for Pharmaceutical Strategies Group. My main responsibilities include the implementation of new clients and the recurring maintenance of existing clients into Artemetrx, which is the analytics and data platform for PSG. • Created the transformation SQL code to process client source data (eligibility, medical claims, and pharmacy claims) into standardized Artemetrx core tables/fields.• Completed QA review on new… Show more Member of the Data Intake, Transformation, and Quality Assurance team for Pharmaceutical Strategies Group. My main responsibilities include the implementation of new clients and the recurring maintenance of existing clients into Artemetrx, which is the analytics and data platform for PSG. • Created the transformation SQL code to process client source data (eligibility, medical claims, and pharmacy claims) into standardized Artemetrx core tables/fields.• Completed QA review on new clients test or production data sets to make sure product requirements have been met.• Work with internal and external account teams to review findings from QA review.• Process the transformation SQL code to import/process the historical eligibility, medical, and pharmacy claims data into Artemetrx. • Work with internal IT teams to set up automated ETL processes for recurring maintenance clients. • Participate on external client meetings to review results once client has been implemented.• Work with internal account teams to make routine modifications to client specific hierarchy data structures Show less

Member of an enterprise-wide Value Reporting team that was responsible for the development, standardization, and processing of all outcomes (Financial, Utilization, Clinical) for the Health Plan and Direct-to-Employer contracts. • Implemented a standard Data Acquisition and transformation process (Eligibility and MD/RX Claims) for all contractual claims based outcomes that freed up resources for other departments• Reduced outcome completion time from 4+ weeks to less than 2 weeks… Show more Member of an enterprise-wide Value Reporting team that was responsible for the development, standardization, and processing of all outcomes (Financial, Utilization, Clinical) for the Health Plan and Direct-to-Employer contracts. • Implemented a standard Data Acquisition and transformation process (Eligibility and MD/RX Claims) for all contractual claims based outcomes that freed up resources for other departments• Reduced outcome completion time from 4+ weeks to less than 2 weeks by proactively monitoring and reviewing member and claims data for quality assurance • Oversaw the creation and completion of the Return on Investment analysis including financial, utilization, and clinical metrics for the total population and disease management products (30+ customers) using multiple methodologies (Durational, Episode Treatment Groups (ETG), Plausibility, Johns Hopkins)• Provided subject matter expertise to account teams to support outcomes results• Created and processed all incentive data files for colleague and dependents based on participation in the Healthways Wellness ProgramWorked closely with Science and Value department to prepare quarterly data files for complex outcomes matching methodology (Coarsened Exact Matching) for one of the largest Healthways contracts Show less

Member of an Account Team that supported all the reporting and data requirements of the largest Health plan customer for Healthways. • Oversaw the tracking and processing of all data files (membership, medical, pharmacy, lab and utilization) • Managed the reporting for a specified book of business• Reviewed the analysis and preparation of outcomes and additional metrics using healthcare claims data and other operational data to show value back to customer• Collaborated with… Show more Member of an Account Team that supported all the reporting and data requirements of the largest Health plan customer for Healthways. • Oversaw the tracking and processing of all data files (membership, medical, pharmacy, lab and utilization) • Managed the reporting for a specified book of business• Reviewed the analysis and preparation of outcomes and additional metrics using healthcare claims data and other operational data to show value back to customer• Collaborated with account team regarding operational and financial reporting• Assisted with both internal and external customers regarding any data file changes associated with product offering Show less

Responsible for all financial reporting and billing for a specific book of business with $15M in annual revenue.• Completed the creation and development of specific performance measures including clinical, financial, and operational • Provided support for any new customer implementation including migration of customers to new software platform• Analyzed large amounts of data including membership, medical/pharmacy and lab data for quality control• Presented financial reports… Show more Responsible for all financial reporting and billing for a specific book of business with $15M in annual revenue.• Completed the creation and development of specific performance measures including clinical, financial, and operational • Provided support for any new customer implementation including migration of customers to new software platform• Analyzed large amounts of data including membership, medical/pharmacy and lab data for quality control• Presented financial reports related to key performance indicators as well as performance guarantees to customer and third party consultant• Reviewed all financial reporting including the monthly billing process and annual outcomes • Oversaw the annual reconciliation with customer specifically to membership and medical/pharmacy claims Show less

Member of an account team that supported a specific book of business within the Health Plan market.• Provided financial and analytical support to both internal and external account teams of multiple customers• Created and reviewed monthly billing process for financial accuracy• Analyzed large amounts of data including membership, medical/pharmacy, and lab data for quality control• Created and produced monthly tracking reports of performance guarantees that allowed for… Show more Member of an account team that supported a specific book of business within the Health Plan market.• Provided financial and analytical support to both internal and external account teams of multiple customers• Created and reviewed monthly billing process for financial accuracy• Analyzed large amounts of data including membership, medical/pharmacy, and lab data for quality control• Created and produced monthly tracking reports of performance guarantees that allowed for operational adjustments to program that created bonus revenue of $1 million Show less

Member of an account team that supported a specific book of business within the Health Plan market.• Produced monthly billing and reconciliation reports for multiple customers• Reviewed the quality of claims data setsSupported the internal and external account team as well as additional departments

Member of the Finance team that was responsible for all client reporting, contract pricing, margin analysis, and annual budgets. • Supervised a team of Financial Analysts in completion of monthly and quarterly reports• Managed the compilation of annual budgets for over 180 individual locations• Responsible for pricing all new and current business for the Occupational Health Division• Assisted in the feasibility process for prospective clients within the Primary Care and… Show more Member of the Finance team that was responsible for all client reporting, contract pricing, margin analysis, and annual budgets. • Supervised a team of Financial Analysts in completion of monthly and quarterly reports• Managed the compilation of annual budgets for over 180 individual locations• Responsible for pricing all new and current business for the Occupational Health Division• Assisted in the feasibility process for prospective clients within the Primary Care and Pharmacy divisionAnalyzed large amounts of claims data to compile all annual reports for current Primary Care and Pharmacy clients Show less