Frank Soto Email and Phone Number
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I am currently an operations associate applying my skills in Visual Basic, SQL, Business Objects and other data analysis tools to optimize everyday business practices and hopefully help shake up the health insurance industry with Oscar Health. Specialties: Microsoft Office Products, Applied Optimization, Statistical Analysis, Data Supply Chain Design, Data and file management, both electronic and paper based. Visual Basic, SQL Server, Business Objects, Discoverer, SPSS, and Tableau.While working in the data field, I've also picked up best practices for database management using data movement and optimization tools such as Access, SISS packages and other optimization tools to allow for quick and east use of data across many platforms. I have developed a team based on the above principles and skill sets, helping to improve the operations space and a myriad of ways all centered on data driven solutions.
Oscar Health
View- Website:
- hioscar.com
- Employees:
- 201
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Manager - Payment Integrity InsightsOscar Health Aug 2024 - PresentNew York, New York, UsPrimary Duties and ResponsibilitiesBe the subject matter expert for Payment Integrity (PI) operations through knowledge and expertise of PI solutions, PI data elements, and operational workflows.Manage a complex portfolio of initiatives and deliverables and proactively identify areas of opportunity to improve key performance indicators.Reporting and Analytics: Provide data and insight needs for the payment integrity space. Own and operate dashboards and reporting tools to allow for leadership to make informed decisions across pre-payment solutions, post-payment solutions, and overpayment recovery. Data Integration and Analysis: Collaborate closely with both the PI team and the Data Science team to understand business requirements and data needs. Pull, clean, and analyze complex datasets related to healthcare claims, payments, and financial performance.Project Management: Lead cross-functional projects that involve PI initiatives, data modeling, predictive analytics, and revenue cycle optimization. Coordinate timelines, deliverables, and resources effectively to ensure project success.Line-Level Leadership / Management: Act as Team Lead for responsibilities and management of day-to-day line-level staff in support of lockbox reconciliation and manual provider check collections.
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Operations AssociateOscar Health May 2022 - Aug 2024New York, New York, Us• Identify design opportunities in the Claims Post-Pay Overpayment space.• Set up process flows and write design requirements for Next Gen Engineering team.• Coordinate cross-functional teams to reach design and operation goals.• Lead initiatives with Optum on Post-Pay recoupment efforts.• Coach internal teams on proper post-pay claim review related to Optum findings.• Speak to trends, insight, and progress on high-risk projects during leadership touchpoints.• Act as subject matter expert in all things overpayment for the development of Next Gen systems and designs.
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Manager Subscriber Services Technical DeveloperBlue Cross And Blue Shield Of Illinois, Montana, New Mexico, Oklahoma & Texas Apr 2018 - May 2022Chicago, Il, UsResponsibilities• Produced white papers and business use documentation for newly developed business-critical systems.• Facilitate data transfers to various areas throughout the company using several ETL methods, SQL Server pulls, Power BI, Tableau, and ad hoc data extracts.• Monitor member engagement and develop insights on operational improvements suggested through member feedback including SQM and CAHPS surveys.• Correlate Provider reporting with ongoing issues and risks and develop action plans with network teams to remediate.• Weekly participate in several strategy meetings to help improve member sentiment and overall experience with HCSC.• Work regularly with compliance team to ensure all operation initiatives and activities are within in regulatory scope.• Coach both internal and external teams on proper documentation, measurement, and process improvement optimization.• Speak to trends and measurements as it relates to operational functionality.Accomplishments• Built initiative tracking utilized both internally and externally to assess effectiveness of operational improvement projects• Lead team to develop, test, and implement new effective customer service research and root cause analysis tools. • Helped lead System Transformation discussions combining multiple systems and databases into a single source for the Medicare lines of business. -
Senior Medicare Regulatory AnalystBlue Cross And Blue Shield Of Illinois, Montana, New Mexico, Oklahoma & Texas Oct 2015 - Apr 2018Chicago, Il, UsResponsibilities• Create weekly, monthly, and annual presentations on Medicare performance to oversight committee for call statistics, grievances, and government inquiries.• Lead weekly data and commentary prep for directors on current status of Medicare operations.• Managed up to 50 Databases and more than 100 tables and reports used for reporting needs.• Wrote and submitted various Process and Procedures to document new and improved strategies within the Medicare space.Accomplishments• Built PHI safe SharePoint environment for department to utilize to share data efficiently.• Completely revamped data transfer system from multiple vendors.• Rebuilt and managed multiple data entry systems used for critical customer service operations.• Developed forecasting models to better prepare customer service for changing trends with customer input.• Lead multiple initiative for quality and process improvement driven by SQM FCR and customer satisfaction scores. • Oversaw improvements in STARS, FCR, and CSAT ratings across government lines of business.
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Business Intelligence AnalystTaxact Dec 2014 - Jun 2015Dallas, Texas, UsResponsibilities• Assess project management goals under Agile methodology.• Facilitate data requests from business users and produce regular and ad hoc reporting.• Participate in a constant data restructuring and cleansing project.• Report directly to product development team status of new projects being trackedAccomplishments• Created word counting system for unstructured survey data.• Produced analysis portfolio in support of entering an emerging immigration tax market. • Designed and implemented a training course on Tableau data visualization. -
Business Strategy AnalystTaxact Sep 2014 - Dec 2014Dallas, Texas, UsAnalyzing data to identify business insight such as patterns, trends, and descriptive analytics that provide value to the Product team’s decision making process.Packaging of business insight to clearly articulate findings via succinct verbal and written communications (i.e. data visualization).Proactively facilitating and soliciting requirements from business users to clearly understand and articulate the business objectives of a given request.Packaging analysis work products via Excel, Powerpoint, and/or reporting tools to communicate output of data analysis.Socializing and presenting analysis work products to stakeholders.
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ConsultantBlue Cross And Blue Shield Of Illinois, Montana, New Mexico, Oklahoma & Texas Dec 2013 - Aug 2014Chicago, Il, UsI work with the Planning and Reporting department to produce accurate reports and analysis for everyday business use.
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Merchandise PlannerWinston Brands, Inc. Jul 2013 - Dec 2013Elk Grove Village, Il, UsWorking to create new merchandise planning processes through the use of my database and visual basic skills and talents. Also working with Executives to find most reliable way to make merchandise choices. -
Merchandise Planning Analyst ConsultantWalgreens Jan 2013 - Jul 2013Deerfield, Il, UsHired to perform assortment planning and recommendations for the newly acquired USA Drug stores. Moved on to report analysis and optimization within the same department using Visual Basic, SQL, Discoverer and Business Objects. -
InternCgn & Associates May 2012 - Aug 2012Chicago, Illinois, UsWorking with the Business Analytics on various projects. -
Pc Sales PersonBest Buy 2010 - 2011Richfield, Minnesota, UsSell computer and computer accessories as well as Geek Squad services to Best Buy customers. -
Alumni Office InternSaint Ignatius College Prep May 2010 - Aug 2010Chicago, Il, UsI help update the alumni database and any other clerical work for the rest of the office. -
Devlopment Office AssistantSaint Ignatius College Prep Dec 2009 - Jan 2010Chicago, Il, UsI did clerical work for the office of the Development.
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Office AssistantInternational Coatings Inc. May 2008 - Aug 2008I took calls and orders from clients around the nation, setup orders to be made and organized filing system to fit everyday needs. While there I created a spreadsheet to help create orders and give customers price ranges more quickly and efficiently. They use this spreadsheet to this day.
Frank Soto Skills
Frank Soto Education Details
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Bradley UniversityEconomics -
St. Ignatius College PrepHigh School/Secondary Diplomas And Certificates
Frequently Asked Questions about Frank Soto
What company does Frank Soto work for?
Frank Soto works for Oscar Health
What is Frank Soto's role at the current company?
Frank Soto's current role is Business Intelligence Leader | Operations Solutions Expert | Process Improvement Advocate.
What is Frank Soto's email address?
Frank Soto's email address is fr****@****csc.com
What is Frank Soto's direct phone number?
Frank Soto's direct phone number is +184767*****
What schools did Frank Soto attend?
Frank Soto attended Bradley University, St. Ignatius College Prep.
What are some of Frank Soto's interests?
Frank Soto has interest in Social Services, Writing, Data Analysis, Human Rights, Economic Empowerment, Video Editing, Education, Racquetball, Science And Technology, Business Optimization.
What skills is Frank Soto known for?
Frank Soto has skills like Microsoft Excel, Microsoft Word, Powerpoint, Program Management, Microsoft Office, Sql, Research, Economics, Data Analysis, Customer Service, Fundraising, Alumni Relations.
Who are Frank Soto's colleagues?
Frank Soto's colleagues are Sarah Leavitt, Richard Baumgartner, Chandrashekhar Bharatipudi, Nicole Katwan, Jessica Garfias, Benjamin Angle, Adarsh J.
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