Eileen Duffy Email & Phone Number

Minneapolis, Minnesota, United States

• Sole responsibility for the overall management of the productivity system through the loading, mapping, auditing and processing of data, creating and running reports, and administering security levels within the system to maintain a stable production environment.• Trained and supported over 500 Financial Analysts, Managers, Directors, and Vice Presidents on complete functionality and report analysis of the productivity reporting system.• Acted as Business Analyst eliciting user requirements, system uses, changes, and enhancements.• Collaborated with Financial Analysts regarding target/budget changes and coordinated with IT resources to set up/troubleshoot feeder system data issues. • Produced scheduled financial reports, perform ad hoc queries and impromptu reports for executive management.• Facilitated workgroup meetings to establish control tables, policies and procedures, and resolve issues related to the implementation and use of the software.• Communicated status of system and reports, timelines, and resolutions of open issues.• Troubleshot and resolved issues for system end-users.• Managed relationship with software vendor including day to day system operations as well as additional contracts for special projects including upgrades.• Six Sigma Green Belt training.

Minneapolis, Minnesota, United States

• Led and facilitated the creation of managed care organization’s Strategy Map and Balanced Scorecard, Vision, Mission, and Values Statement.• Managed project workgroup to plan, implement, and bring to operation new line of business.• Designed the Requests for Proposals, evaluated vendors, and participated in contract negotiations for HEDIS software vendor and certified HEDIS auditor. Acted as key contact for these vendors.• Accountable for regulatory reporting including HEDIS and other State of MN contract requirements.• Directed Quality Management Department and Planning Evaluation and Performance Reporting Departments.• Managed and trained healthcare analyst staff.• Assisted with migration of existing reports from legacy system to new reports and cubes using Cognos tools.• Performed focus group sessions to identify reporting and data analysis needs for all areas of managed care operations.• Participated in rate negotiations with State of MN and attended Risk Adjustment User Group meetings.

Minneapolis, Minnesota, United States

• Prepared financial pro formas for capital expansion projects and capital equipment.• Performed analyses for and coordinated workgroup assigned to Revenue Capture projects.• Co-facilitated process improvement project to improve lab documentation required for Medicare reimbursement.• Provided financial and utilization analytical support to Oncology Service Line.• Assisted with market share analysis.• Developed database for Inpatient Admissions Department for measuring changes resulting from process improvement projects.• Prepared capacity analysis of critical care beds for growth planning.• Developed skills in TSI/Eclipsys Patient Level Reporting system.

Minneapolis, Minnesota, United States

• Analyzed revenue versus cost by ratecell for dual-eligible seniors, resulting in program restructuring and moving from loss to profit.• Performed analyses related to capitation rate negotiations with State of MN.• Analyzed financial impact of several high dollar vendor contracts and recommended improvements. Presented findings to Executive Director and Directors.• Audited payment of claims for fund assignment and led resulting process improvement efforts.• Computed rates for various HEDIS measures using Paradox and Access and reported results to State of MN. • Prepared market comparative report for internal stakeholders.• Compiled key data and statistics for managers and directors each month in Management Summary Report.• Calculated and reported Enrollment, Utilization, and Quality measures required by Department of Human Services and Department of Health.• Monitored Department of Human Services’ risk adjustment methodology and Adjusted Clinical Groups’ impact on capitation rates.• Led operations workgroup charged with designing and implementing state requirement for health plans to begin paying for 90 nursing home days.• Performed numerous ad hoc reports, queries, and analyses resulting in recommendations for decision making, strategic direction, and process improvement.

Master Of Arts - Ma, Business - Health Management (Health Administration)

Master Of Science - Ms, Risk Management And Insurance

Bachelor Of Science - Bs, Exercise Physiology

Bachelor Of Science - Bs, Nutrition Sciences