Don Dolan Email & Phone Number

Oak Forest, IL, US

Greater Chicago Area

• Develop pricing models and pharmacy cost tracking tools
• Develop GEO Access models
• Provide detailed analysis and support for forecasting of pharmacy network costs
• Identify outlier cost issues
• Provide consultative support to network managers with legitimacy testing of rate proposals
• Develop provider compensation and fee schedules

Bolingbrook, IL

• Description: Create financial reports for all Presence Health hospitals. Develop programming changes to improve processes for internal financial reporting and analysis tools. Provide recommendations based on the.
• Compile and perform analysis on standardized weekly and monthly financial, quality, and productivity reporting for all Presence Health hospitals. Summarize findings from analysis in reports distributed to the.
• Develop new reports as needs are identified, to provide value to the organization. Assess frequency, redundancy, and value of reports and provide recommendations.
• Develop automated process improvement tools using MS Access, MS Visual Basic, or other programming tools to facilitate improvement initiatives related to financial reporting. Create instructions to allow other team.
• Provide recommendations and/or support documentation to leadership for operational improvements that will provide cost savings or increase revenue via data analysis and reporting.
• Identify and analyze trending and key variances in reporting while maintaining detailed knowledge of baseline numbers in the financial reports.

Greater Chicago Area

• Working on data warehouse development team, drove the process to collect and standardize data corporate application systems into the enterprise warehouse and mart environmentCoordinated with department leads and other.
• Developed project plans and user stories
• Drove the process to collect and standardize risk and quality score data into the enterprise warehouse and mart environment
• Served as subject matter expert with company applications and processes relating to member risk and condition profiling capabilities
• Created data dictionary and developed policy and procedure for ongoing maintenance

Greater Chicago Area

• Reporting to executive management, managed department which provided analytic services in support of all internal corporate functions as well as external reporting for Clients and Regulatory Compliance
• Built financial models to analyze the impact of benefit plan design changes, and determine employee cost share and contribution levels
• Provided savings and disruption analysis of Medical/Dental/PBM networks
• Interfaced with vendors on system modifications
• Integrated medical and pharmacy claim data
• Analyzed trends, variances, and outliers of financial and utilization information

Greater Chicago Area

• Provide analytic services in support of all internal corporate functions as well as extensive external government reporting
• Integrated information from McKesson’s Care Coordination Management System (CCMS) and TriZetto’s (QNXT) core administration solution, to provide comprehensive analysis
• Utilized Verisk’s Quality Reporter application for HEDIS reporting
• Working on ICD-9 to ICD-10 conversion team
• Compiled results from Health Risk Assessments
• Developed reporting solutions and provided analysis relating to Provider networks, Membership, Claim audits, and provider incentive programs

Greater Chicago Area

• Classified members according to health conditions and co-morbidities utilizing criteria from quality stewards including CDPS and NCQA
• Aggregated and analyzed healthcare data to show financial impact of care improvement opportunities
• Performed population health assessments based on usage patterns and develop reports to quantify results and measure ongoing progress
• Utilized medical and pharmaceutical claim data to perform compliance analysis and identify gaps in care
• Completed content assessment and validation on data files prior to being incorporated into the data warehouse
• Performed validation of data warehouse tables ensuring business rules were accurately applied during the ETL process

Greater Chicago Area

• Provided analytics and reporting relating to medical cost and utilization
• Perform content assessment on new data sources
• Designed data extracts utilizing SQL Server and Access databases

Greater Chicago Area

• Created Executive Dashboard reporting solutions that provided a concise view of critical metrics, along with full supporting detail for drill down analysis
• Analyzed and reported on revenue cycle processes including claim adjudication, A/R days, denials, bad debt and credit balances
• Performed data mining on identified negative trends and outliers

Greater Chicago Area

• Developed and tested reporting solutions covering areas of contract management, utilization, and clinical quality
• Developed physician pay for performance incentive reports
• Developed scorecards showing compliance with established clinical measures for various disease management programs and protocols
• Performed data profiling to validate accuracy and completeness of data
• Performed analysis in several areas including; contractual underpayment, physician productivity, cost, and utilization
• Coordinated prototype review, integration, system, and user acceptance testing

Greater Chicago Area

• Conducted analysis on a variety of complex financial issues, providing detail summaries, reports and recommendations.
• Calculated risk settlements for provider bonus totaling over $3 million dollars of reimbursement.
• Created utilization reports and analysis for early detection of high cost/high risk members.
• Provided profitability reports to aid in focused intervention of high medical loss ratio provider groups. First intervention resulted in identifying costly groups, resulting in improvement of one region’s MLR by 5 %.
• Performed data mapping and validation of the data warehouse.

Greater Chicago Area

• Evaluated current processes, determined information needs, and developed solutions for Decision Support and Quality departments.
• Performed data validation for installation of new reporting software package.
• Lead Data Analyst on National Healthcare Quality Accreditation Team (HEDIS)