David Nance Email & Phone Number

Franklin, Tn

Franklin, Tn

Primary responsibility is to participate in healthcare economics activities including providing support and guidance to Sales, Product Development, Network Management and Account Management to facilitate network development, new sales and revenue growth.-Build, lead and manage a highly competent healthcare economics team.-Work with IT and data warehousing counterparts to develop and design deliverables to support the healthcare economics team and customer reporting needs.-Conduct baseline and trend analyses for targeted medical cost categories, geographies and segments.-Apply actuarial concepts and tools to enhance understanding of utilization and cost trends across networks, products and geography. -Validate findings against established benchmarks.-Create and deliver results in an accurate and timely manner to both internal and external customers.-Effectively communicate results to key stakeholders and policy makers. Communication of results includes clean and well-organized presentations to reflect analytic methods utilized, key decision points with sufficient detail to support comprehension and replication of the analysis.-Provide additional analyses that support sales and product development by being able to manipulate and analyze claims data to perform IBNR calculations, provider network overlap, fee schedule pricing, trend mitigation and population mix-shifts. -Relate analytic findings to business questions and objectives. This includes learning to integrate information from multiple sources, discern implications for future analysis and identify opportunities for enhancing the integrity of data results.-Work with prospective client claims data and establish metrics and trends.

Primary responsibility is to participate in healthcare economics activities including providing support and guidance to Sales, Product Development, Network Management and Account Management to facilitate network development, new sales and revenue growth.-Build, lead and manage a highly competent healthcare economics team.-Work with IT and data warehousing counterparts to develop and design deliverables to support the healthcare economics team and customer reporting needs.-Conduct baseline and trend analyses for targeted medical cost categories, geographies and segments.-Apply actuarial concepts and tools to enhance understanding of utilization and cost trends across networks, products and geography. -Validate findings against established benchmarks.-Create and deliver results in an accurate and timely manner to both internal and external customers.-Effectively communicate results to key stakeholders and policy makers. Communication of results includes clean and well-organized presentations to reflect analytic methods utilized, key decision points with sufficient detail to support comprehension and replication of the analysis.-Provide additional analyses that support sales and product development by being able to manipulate and analyze claims data to perform IBNR calculations, provider network overlap, fee schedule pricing, trend mitigation and population mix-shifts. -Relate analytic findings to business questions and objectives. This includes learning to integrate information from multiple sources, discern implications for future analysis and identify opportunities for enhancing the integrity of data results.-Work with prospective client claims data and establish metrics and trends.

Franklin, Tn

-Develop overall business relationships with assigned accounts-Establish and improve positive strategic relationships with client executives and respective consultants-Resolve customer-facing issues including resolution of technical or customer service problems-Conduct formal periodic review meetings to assess performance, identify opportunities or threats and discuss new ideas and solutions-Develop and communicate strategic plans for assigned accounts to ensure retention and satisfaction-Analyze and interpret contract data-Review, analyze and present data and reports needed to satisfy the customer-Lead implementation efforts to ensure consistency and success of implementations

-Manage a team of healthcare analysts supporting the western region of the healthplan market-Serve as subject matter expert for account teams in analyzing and interpreting data and reports-Work with healthcare analysts and their account teams to balance workload while ensuring accurate and timely delivery of reports-Create forums for sharing of best practices in an effort to drive new levels of efficiency and consistency across the market-Develop and communicate knowledge of evolving measurement methodologies

-Participated on account team managing $24 million in revenue for healthplan and employer group accounts-Coordinate internal and external colleagues and processes necessary to provide financial, utilization, clinical and other reporting according to the terms of the contract-Lead the process of producing and analyzing reports with an end result of presenting findings to the customer-Work with the account team and operations in identifying and producing reports helpful in increasing effectiveness in our programs-Manage monthly revenue close process to ensure appropriate revenue recognition

-Produce financial, clinical and utilization outcomes for assigned accounts according to contractual requirements using appropriate tools-Partner with account team members to analyze, validate and report outcomes-Support account team by participating in customer meetings where outcomes are presented and operational issues are discussed-Establish effective working relationships with Healthways and customer colleagues to ensure the accuracy and timeliness of outcomes

-Compile the monthly network statistics for the healthplan-Produce a variety of reports for Provider Services, Provider Data Management, Contracting and Sales using Access, SQL and Excel -Coordinate the production of member and provider directories for a four-state region of CIGNA Healthcare-Manage matrix partners to ensure timeliness and accuracy of both printed directories and the online directory