David Brueggeman Email & Phone Number

Cincinnati, Oh, Us

Mclean, Virginia, Us

• Under the Healthcare Strategy and Finance teams, led and leading work with national, regional, and local provider health systems; national/regional health plans and provider sponsored health plans (PSHPs); and government entities.• Client areas of focus and project work include: - Managed care strategy, including overall strategy and specific payer negotiation support, rate benchmarking, chargemaster strategy, contracting language support, payment model development (including value based reimbursement), and price transparency strategy - Financial strategy, including revenue/cost trend analytics, model development, long range financial planning, build/buy decisioning, and revenue cycle optimization - Market strategy, including service area definition, competitive analysis, partnership evaluations, product development, and service line expansions - IT and Analytics strategy, including infrastructure evaluation, organizational design, key indicator identification, and communication strategies - Operational improvement, including process evaluation and streamlining, organizational design, and robotic process automation (RPA) opportunity identification and implementation. - Emerging issue response, including COVID related FEMA Public Assistance tracking and project worksheet development - Regulatory interpretation and response, including Price Transparency, Advanced EOB, No Surprises Act, and IPPS/OPPS rules.• Internal areas of focus and project work include: - Managed Care Solutions product development, including strategy and acting as Business Owner with Agile team - Mentoring and Leadership training

Mclean, Virginia, Us

Chicago, Il, Us

• Acquired by Guidehouse in October, 2019• Worked in the Healthcare Value Transformation team which works at the nexus of provider, payer, and government interactions.• See Guidehouse entry for responsibilites

Dayton, Oh, Us

• Built two new teams with focuses on Medical Economics and Financial Information Management, and lead two existing teams with focuses on Corporate Financial Analysis (including Pharmacy Analytics) and Provider Contracting Analysis while maintaining responsibility for both the Marketplace/Medicare Advantage and Reserving Actuarial teams.• Created innovation framework for new business opportunities and existing business enhancements, prepopulating with over 50 significant opportunities in new business, consumer experience, payment innovations, benefit designs, and other areas.• Began project to standardize base data throughout the organization, including both business glossaries and data lineage.• Identified and drove new policy initiatives for the Medicaid and Marketplace product lines, including regulation/rule interpretation and subject matter expert commentary to ACAP, AHIP, and Leavitt Partners.• Lead product design efforts for both Marketplace and MA programs.• Completed Networx Modeler implementation project to greatly increase the capabilities of the Provider Contracting team.• Acted as holistic Finance “Product Owner” and streamlined interactions with dedicated 12 member Agile based IT team for reporting and automation activities under the Financial Information Management guise.• Lead dashboard design efforts increasing information availability and informed decision making.• Created framework for discussing analytic roles throughout the organization.• Championed new Finance organizational structure to align with business needs.

Dayton, Oh, Us

• Hired, trained and managing multiple teams of analysts with focuses on pricing products, benefit design and documentation, fee schedule development, and medical economics. • Developed two team members into managerial positions.• Managed actuarial assumptions, benefit design, and bid pricing for Health Insurance Exchange in four states, Dual Eligible Demonstration in one state, and Medicare Advantage bids in three states. • Reviewed and commented on state Medicaid rates, acting as CareSource representative in meetings for 4 states.• Lead creation of and chaired Member Benefits Advisory Committee and Workgroup.• Developed contracting targets and advised on value based reimbursement strategies including membership in both Contract Strategy and Value Based Reimbursement Governance Committees.• Worked with Ohio Department of Medicaid (ODM) on Enhanced Ambulatory Patient Grouping (EAPG) implementation• Advised Government Relations team on potential solutions during 2017 Exchange CSR crisis.• Redesigned incurred but not received (IBNR) model to include several additional mathematical projection models and improved both visual presentation and preparation time.• Identified need for and designed process to support proprietary fee schedules.• Managed team identifying and executing $80 million in claims based and clinical edits based savings.• Selected to high performance manager-to-director development team resulting in the ideation of a knowledge management framework and solution.

Dayton, Oh, Us

• Hired, trained and managed team of five analysts with focuses on medical economics, contract analysis and modeling, medical and pharmaceutical claims analysis, and project financial guidance in the Ohio and Kentucky lines of business, including Medicaid and Medicare D-SNP products.• Developed three team members into managerial positions.• Co-lead implementation of All Patient Refined Diagnostic Related Grouping (APR-DRG) payment for inpatient claims, including historical claims analysis, claims pricing and medical management prior authorization tools.• Lead implementation of Primary Care Rate Increase project to incorporate changes required by the Affordable Care Act.• Selected to 7 member Strategic Think Tank working on 5 year strategic plan which lead to creation of Life Services product line extension focusing on the social determinants of health.• Provided financial leadership for ICD 10 conversion project including gap analysis, financial neutrality, and impact identification.• Identified and tracked $65 million in medical cost savings initiatives in CY 2013 and $100 million in CY 2014. • Co-lead D-SNP bid creation and submission team, including benefit design, supporting documentation, and actuarial coordination.• One of two identified project leaders in Finance designating Enterprise Data Warehouse data needs, certifying data, and designing Microstrategy-based dashboards.• Provided internal consulting and project guidance for both ROI and project timing.• Instituted story driven approach to analysis, pushing analysts to theorize based on logical assumptions and initial data and then test. • Revamped presentation style to create cohesive look and feel to presented reporting.• Ensured all repetitive reporting was documented utilizing standard templates.• Provided support and backup to actuarial analysis manager, including assumptions for the capitation rate setting process, IBNR, IBNP, and medical cost projections.

Dayton, Oh, Us

• Created and presented numerous operational, financial, and planning reports for senior executives and staff.• Mined data from Facets using SAS Enterprise Guide (EG).• Acted as financial representative on HEDIS Oversight Committee.• Created Encounter Quality Initiative Reports for the state.• Analyzed proposed contracts and fee schedule changes for medical providers.• Evaluated vendor responses to Requests for Proposals (RFPs).• Streamlined Medical Cost Reporting and overhauled graphical representations.• Prepared Incurred P&L statements.• Created flexible models for program ROI evaluation.• Championed data sharing initiatives between the Decision Support and Financial Planning & Analysis teams.• Beta tested Teradata-based Enterprise Data Warehouse.• Streamlined SNP Plan to Plan reconciliation process.• Overhauled internal Finance website increasing traffic exponentially.• Acted as resident Excel expert.• Created and compiled Excel and SAS EG training materials.

Chanhassen, Mn, Us

Instructed members on both basic and advanced techniques in rock climbing. Inspected and maintained equipment. Trained new personnel.

Created and presented numerous operational, financial, and planning reports for senior executives and staff.Mined data from both Allscripts Practice Management and EHR programs.Designed and reported metrics for Six Sigma quality initiatives.Prepared proformas for entering new lines of business.Analyzed reimbursements and recommended price changes.Responsible for the design and management of database for E&M Coderight product (a tool for correct physician coding).Manage data collection for medical quality programs including nationally ranked hypertension and diabetic programs. Acted as a liaison with Bridges to Excellence program.Designed database to support accounting reconciliation process.Acted as resident Access and Excel expert.Created and taught training class for Microsoft Outlook.

Us

Responsible for design, implementation, and continuing operations of all aspects of Internet and telephone banking systems. Impemented and administered database mining software. Trained staff on use of Microsoft Office. - Coordinated, designed, implemented, and administered Digital Insight Internet Banking and Intervoice Voice Response Unit systems, including Check Imaging and Checkfree Bill Pay features. Beta tested new releases. Managed Help Desk activities.- Developed all policies and procedures related to the above.Implemented and administered Hummingbird Data Warehouse.- Created user-specified ad-hoc reports relating to all aspects of the bank including financial reporting, operational analysis, and compliance by using Hummingbird (SQL), Microsoft Access, and Microsoft Excel programs.- Provided written and oral analysis of economic trends as well as internal issues.- Created and lead training program for Microsoft Project, Microsoft Excel, and Hummingbird.- Managed aspects of data integration relating to multiple acquisitions.

Us

Us

Us

Responsible for day-to-day operations including money management and troubleshooting. Train and schedule staff. Coordinate all aspects of catered events. Developed employee manual defining rules and regulations for the company. Redesigned scheduling process increasing both managerial and employee satisfaction.

Coordinated operations of hotel staff to meet varied needs of guests. Established excellent rapport with local businesses to obtain requested services for hotel patrons.

Responsible for weekly payroll for 30 employees. Maintained accounts payable, generated monthly expense reports, and compiled expense projections. Assisted construction crews on site as necessary. Aided in planning and implementing upgrade of computer system.

Tallahassee, Fl, Us

Reviewed and scored applications, recalculating GPAs, reviewing supplemental criteria, and making admissions decisions based on standardized scales. Maintained statistical data for senior management. Completed special projects as assigned.

Master Of Business Administration (M.B.A.), Finance, Marketing

Dual Bs: Finance, With Economics Minor; And Mutinational Business Operations, Fields Of Study: Finance, Economics, Organizational Behavior, Logistics, Computer Science, Mis