Deepak Mathur Email & Phone Number

New York, Ny, Us

New York City Metropolitan Area

• Oversaw strategic direction for NY MLTC Health Plan, focusing on Health Plan analytics and Claims Department management, managing $3.5M budget and leading 6 direct and 11 indirect reports within the New York market and Medicaid/Medicare sectors.• Responsible for developing roadmaps for FIDE, HIDE, and MAP lines of business, beyond managing MLTC, ensuring comprehensive reporting and strategic planning.• Spearheaded system design, financial planning, reporting, and encounter data analytics across all Medicaid lines of business using analytical tools such as SAS, Excel, Tableau, and PowerBI, enhancing data-driven decision-making processes.• Led successful transition of encounter data reporting from EDPS to OSDS, streamlining data processes and improving reporting accuracy and efficiency.• Implemented new policies and procedures to enhance data accuracy, timeliness, mining, structures, and efficiencies, significantly boosting the credibility and confidence in departmental outputs.• Strengthened relationships with network delegated vendors, improving processes for claims data submissions and enhancing claims auditing capabilities, contributing to improved operational effectiveness.• Played a pivotal role in the seamless acquisition of Integra Managed Care by Empire Blue Cross Blue Shield.

New Hyde Park, New York, United States

• Established and expanded the analytics and claims departments at Integra Managed Care, initially starting as a sole contributor and growing the team to include 6 direct and 9 indirect reports, to support organizational needs in the New York Medicaid market.• Identified and filled the critical need for a dedicated data analytics and reporting department, transitioning these responsibilities from IT to a specialized analytics team, enhancing operational efficiency and performance.• Directed the strategic vision for Health Plan analytics and Claims Department oversight at Integra Managed Care, managing a $3M budget and improving the organization's data management and reporting capabilities.• Achieved over $100K in savings for Integra in 2019 by implementing cost-effective processes that transitioned providers from paper to electronic claims submissions, reducing claims administrative costs.• Significantly increased regulatory compliance APD encountered data acceptance rates from 88% in 2016 to 99% in 2023, through strategic prioritization, integration, and insightful analysis of processes and resources.• Exceeded all regulatory compliance and reporting requirements set by the Department of Health, as evidenced by surpassing Performance Improvement Scorecard Metrics, utilizing analytical tools such as SAS, Excel, Tableau, and PowerBI.• Developed and launched an Integra Executive Dashboard, featuring over 80 company-wide metrics and KPIs, enhancing decision making and performance monitoring across the organization with automated metrics updated with a 1-month lag.• Led MLTC Health Plan as the only health plan in New York City not to incur penalties for New York State Department of Health Performance Improvement Scorecard metrics and MMCOR to EIS Reconciliation.• Increased New York State Department of Health regulatory compliance APD encountered data acceptance rates from 88% in 2016 to 99% in 2023 by working with cross-functional teams.

• Founded and developed a dedicated data analytics and reporting department from the ground up, transitioning this crucial function from IT to a specialized team, which led to a 500% departmental growth over 12 years. • Managed $2.5-3M budget and led a team of 15 direct and 7 indirect reports, enhancing organizational efficiency and performance.• Successfully aligned the organization's goals with client needs by establishing a department that met various organizational needs, including the CHOICE Health Plan's comprehensive analytical support for retrospective and prospective reporting, utilization, cost, quality analytics, and regulatory reporting.• Bridged the gap between business and IT departments by creating a hybrid analyst role, merging business acumen with IT skills, which reduced reliance on a single department and improved operational effectiveness through the implementation of new internal controls, policies, and workflows.• Led CHOICE Health Plan through 6 years of CMS-sponsored Medicare Data Validation Audits with an outstanding 97% or higher overall rating each year, demonstrating exceptional regulatory compliance and data management capabilities.• Innovated reporting and automation strategies in response to changes in Medicaid Managed Long Term Care (MLTC) product regulations by NY State Department of Health, improving submission accuracy and driving increase of Medicaid product premiums.• Spearheaded the creation of new reporting strategies and enhanced oversight of over 15 delegated vendors, elevating the department's credibility and fostering better integrated health plan products. • Took on a leadership role in Business Intelligence and development initiatives, including the aggregation of all data sources under one environment and managing the RFP process for BI vendor and tool selection.

•Develop, create, maintain and enhance Health Care Economics metric reporting tools using COGNOS Powerplay for Oxford’s Intranet.•Conduct trend analysis on utilization and financial metrics such as PMPM, Unit Cost, Average Cost, etc.•Work closely with matrix partners (Financial, Pricing, Medical Management, Special Investigation Unit) to develop data and analytical capabilities to perform analyses on quality improvement and medical cost savings strategiesoStatistical analyses mainly conducting using PC SAS BASE and SAS STAT version 8.2 and SAS on UNIX server.

Develop, create, maintain and enhance Medical Management metric reporting tools using COGNOS Powerplay, either for the web or on PCWork closely with matrix partners (Systems, Market Research, Financial, Pricing, Regional Medical Economics) to develop data and analytical capabilities to perform analyses on quality improvement and medical cost savings strategiesDirect and conduct program assessment in support of Medical Management including managing and performing statistical and methodological analysisStatistical analyses mainly conducting using PC SAS BASE and SAS STAT version 8.2Participate in the development of metrics, structure of studies, benchmark initiatives, and data collection methodologiesEstablish position as an expert to support health plan measurement and effectiveness, and health services improvement initiativesServe as a focal point for communications and coordination of regional medical economics staffPerform routine and ad hoc analysis as it relates to medical cost analysis - Medical Decision Support Unit, medical management trending and health plan processesResponsible for the work and daily operations of three analysts.

•Coordinate daily activities associated with specific Health Care Quality Improvement Projects (HCQIP)•Project team leader for HCQIP projects. Responsibilities include: creating and maintaining timelines, initiating and maintaining communications with external collaborators, oversee all team members to ensure members are performing tasks in a efficient and timely manner, maintaining team dynamics between members•Identify and implement methods for improving HCQIP project process•Provide oversight to abstraction process e.g. tool development, abstractor training and deployment, and Internal Quality Control/Inter-Rater Reliability•Create presentations for internal and external audiences•Assist in the development of educational materials for health care providers and Medicare beneficiaries, reports for various health care providers, and other publications such as abstracts and manuscripts•Co-Chair of Connecticut Influenza and Pneumococcal Coalition•Perform duties of a Health Information Analyst in conjunction with duties of Project Coordinator

Research data for Community Health AssessmentPresent written reports based on data analysisReport presentation and community outreachData formatting and creating chartsAttend meetings and focus groups

Master Of Public Health - Mph, Biostatistics, 3.9

Master Of Business Administration - Mba, Healthcare, 3.9

Mha, Healthcare Administration, 3.9

Bs, Biomedical Education, 3.5