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Flexible and resourceful analytics professional whose management philosophy is to lead from the front. Ready and able to forge a wide variety of experience and knowledge into a precision instrument focused on delivering high quality information products. Broadly educated with eight years of medical industry analytics experience together with five years in progressively higher military leadership positions. Accustomed to presenting complex topics to a variety of stakeholders; from high level summaries suitable for executive decision making to meticulously detailed technical specifications for program teams.Advanced knowledge of provider contracting methodologies especially regarding health plan cost containment strategies, and a strong knowledge of health care delivery systems. Significant experience in Pharmacy in the past two years.
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Director, Audit ServicesMockenhauptPortland, Or, Us -
Director, Audit ServicesMockenhaupt May 2022 - PresentPortland, Oregon, United StatesResponsible for PBM audit practice, collaborating with other audit activities and data analytics solutions. Coordinating RFP and contract development process for medical, pharmacy, dental, and vision benefits. Presenting audit results and other analyses to clients. -
Director Of Pricing & AnalyticsMedone Aug 2020 - May 2022Portland, Oregon, United StatesMedOne Pharmacy Benefit Solutions (MedOne) is a national, full-service, transparent pharmacy benefit administrator (PBM) headquartered in Dubuque, Iowa. MedOne is committed to building solutions with the most current technologies available in the marketplace. As the Director of Pricing & Analytics, I am a strategic team member who helps win new clients and keep existing business by creating competitive financial proposals. I also develop internal and external reports, and analyze the business environment to produce benchmarks and identify areas of improvement throughout the organization. -
Director Of Audit ServicesDeepview Solutions, Inc. Dec 2016 - Aug 2020Portland, OregonManagement of resources and personnel in support of DeepView's pharmacy benefit audit program. DeepView audits have aided groups in recovering over 50 million dollars in penalties. -
Senior AnalystDeepview Solutions, Inc. Feb 2015 - Nov 2016Portland, OregonProduced and automated production of Pharmacy Benefit Audit products that have aided groups in recovering 35 million dollars in audit penalties.Gathered RFP information and processed disruption reports for Pharmacy Benefit Marketings.Additional data analysis and peer-review tasks on an ad hoc basis.
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Consulting Research Analyst AssociateCambia Health Solutions Jun 2014 - Jan 2015Portland, OregonPrimarily focused on coordination and analysis of contractor work regarding Medicare and Commercial risk corridors and data reporting.Enhanced marketplace competitiveness and built competitive advantage through a greater understanding of competitors and the health care environment.Produced C-level reports on the progress of the Revenue Management Program. Wrote SAS-SQL code for packaging of Edge Server data for the risk adjustment program.Developed predictive risk-adjustment model and coordinated with other teams to develop Revenue Management metrics and reporting standards. -
Market AnalystModa Health May 2012 - May 2014Produced business analyses and calculated impacts of contractual changes for contracted health systems covering over $800,000,000 in total commercial reimbursement.Developed and maintained reimbursement models for IPPS, OPPS, RBRVS methodologies with the addition of specialized modeling of pay for performance and specialty rates when applicable.Managed research in support of contractual service guarantees, RFP submissions, NCQA and other quality programs. Supported corporate strategic planning research and other information products on an ad hoc basis..
Eric Riley Skills
Eric Riley Education Details
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Applied Mathematics
Frequently Asked Questions about Eric Riley
What company does Eric Riley work for?
Eric Riley works for Mockenhaupt
What is Eric Riley's role at the current company?
Eric Riley's current role is Director, Audit Services.
What is Eric Riley's email address?
Eric Riley's email address is er****@****ehs.com
What is Eric Riley's direct phone number?
Eric Riley's direct phone number is +150344*****
What schools did Eric Riley attend?
Eric Riley attended Portland State University, Colorado State University.
What skills is Eric Riley known for?
Eric Riley has skills like Data Analysis, Analysis, Analytics, Microsoft Office, Competitive Analysis, Market Research, Market Analysis, Healthcare, Forecasting, Business Intelligence, Microsoft Excel, Marketing Research.
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Eric Riley
Visalia, Ca4gmail.com, 4-creeks.com, cghmc.com, cghmc.com4 +191676XXXXX
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Eric Riley
New York City Metropolitan Area5nyu.edu, cuny.edu, gc.cuny.edu, pcdc.org, morganstanley.com3 +121225XXXXX
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Eric Riley
Interim Chief Information Officer At Workers' Compensation Insurance Rating BureauUnited States1wcirb.com2 (844) 5XXXXXXX
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4astrazeneca.com, buckeyemail.osu.edu, polyone.com, merck.com
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