Ji Kim Email & Phone Number

Los Angeles, Ca, Us

Los Angeles, Ca, Us

Us

Clinical Performance / Affordability: • $55M in medical affordability savings through actionable analytics for Medical Management and Network Management Team• Ensured effective resource allocation through development of predictive analytics to identification and stratification of high risk members enabling clinical teams to target intervention efforts• Supported development of Medical Management intervention initiatives and quantify effectiveness/success through application of regression, statistical and analytics methods such as match control study (AB testing), difference in difference analysis• Managed physician performance through development of physician benchmark and scorecard • Owned accountability for Nephrology Value Based analytics resulting in 20% reduction in admissions• Supported quality initiatives through identification of members with quality gapsData Management:• Effectively presented analytics findings to diverse audiences; leadership team, clinical and network operations, physicians, and regional conferences• Improved overall reporting and dissemination of analytics through creation of interactive Tableau, SSRS and Reporting Portal• Developed and maintain Health Care Economics data warehouse; established reliable data transfer from vendors and internal teams; developed normalized data structure, data models, and unified data cube such that analytics and reporting can be performed quickly and accuratelyFinancial Management: • Work with Finance Planning & Analysis to support management of nearly $1B in medical spend through medical costs trend analytics and financial forecasting; Key to success being robust provider and IPA level insights geared to targeted intervention• Supported physician, hospital, and health plan contracting efforts by assessing the impact of proposed contract• Develop more accurate and efficient method to estimate inpatient cost through development SAS based regression/statistical models (i.e. IBNR)

Indianapolis, Indiana, Us

Fortune 50 company and the largest for profit managed health care company in the Blue Cross/Blue Shield Association covering 1 in 9 Americans with more than 37,000 employees.Head of the Revenue Analytics team with 25 analyst generating $100M in revenue enhancement. Directed Medicare and Medicaid Care Management Analytics, Medicaid Premium Integrity, Medicaid Risk Adjustment, and Commercial ACA Risk Adjustment Analytics. • Generated $80M in enhanced revenue for Medicaid Risk Adjustment by developing innovative data driven suspecting and targeting analytics for 19 state plans covering 5M Medicaid members and implementing the analytics through vendor management and coordination with plans. • Validated $250M in revenue for Commercial ACA Risk Adjustment through data, statistical, financial, and evaluation analytics verifying vendor effectiveness.• Improved the health of 5M Medicaid and 500K Medicare members through data, statistical, suspecting, segmentation, evaluation, predictive analytics and providing strategic and consulting support to case and care management initiatives. • Validated and quantified care management outreach effectiveness to ensure efficient resource allocation by performing financial and statistical evaluation. • Directed multiple enterprise strategic initiatives big data initiatives, text analytics, population clinical profile, enterprise risk adjustment by coordinating with leadership and cross functional teams. • Generated $20M in cost savings and revenue enhancements by identifying Medicaid members whose medical conditions were not aligned with their benefits.

Independent consulting firm specializing in economic, financial, data and statistical analysis to provide business intelligence solutions and litigation support to diverse clients.Directed overall office management, business development, project management, analytics, and client relationship management.• Refuted plaintiff’s claims of damages leading to favorable settlement in wage and hour class action suit through data and statistical analysis using disparate data, security card swipes, computer log-in, cell phone, parking swipe, time and motion study, Kronos, and payroll records.• Produced 70% reduction in cost related to annual audit of AR transactions for major health care provider by developing customized sampling tool and methodology.

Orange, Ca, Us

Established in 1903, has 350 offices and 4,000 employees providing dental services to 2M patients a yearReporting directly to the CEO, built the Business Intelligence Department – hired, trained, and mentored 14 analysts. Directed enterprise data governance, analytics, development of KPI, financial and business performance reporting such that the company operated under single source of truth • Supported company sale to private equity investors by producing accurate, reliable, and timely reporting of financials and other KPI, and Ad Hoc analysis as requested including analytics to estimate potential liability to settle on-going class action litigation• Created and implemented new reporting infrastructure by utilizing more real time interactive Tableau reports leading greater report adoption and improving operational performance• Enhanced annual $20M real estate investment strategy by developing predictive analytics using Experian Demographic and Dunn & Bradstreet data and SAS to identify and predict locations with highest patient concentration and greatest potential for expansion• Developed one-to-one analytics by utilizing multiple data sources including Experian demographics data to improve effectiveness of $6M marketing expenditure• Performed analysis of dental office efficiency and wait time to improve overall patient satisfaction • Estimated profitability of appointment made by tracking appointments from call center to patents in dental offices• Supported financing of individual loans and collection through analysis of collection / default rate based on FICO score and other financial indicators

Chicago, Il, Us

Publicly traded firm with 40 offices, 2,500 employees, and $785M in revenue as of 2011 Teamed to manage the Los Angeles office, including conducting performance evaluations, participating in promotion and compensation decisions. Led recruiting and hiring efforts, managing project staffing, mentoring, training, hiring staff and leading business development efforts. Served as Navigant’s lead statistician, data and analytics expert serving as technical advisor to diverse teams.• Generated $1M in revenue through lead generation, proposal development, participating in client presentations, project planning, developing of analytics, and directing analytics teams • Refuted $12M in alleged damages in health care litigation involving more than two dozen providers leading to favorable settlement by testifying as an expert and supervising analytics• Built and managed teams overseeing data analytics, statistical modeling and predictive modeling analysis for diverse array of clients such as State of Texas – Health Care Provider Network Adequacy Assessment, ACS – Student Loan Servicing, Countrywide – Home Loan Default Analysis, Sompo Insurance, Apple – Music, Bratz – Retail marketing, FedEx – shipping, Target – retailPresentation Experience• “Keyword Searches: Have We Lost Our Way?”, ABA Third Annual National Institute on E-Discovery, faculty / expert panel• “Reducing Review Costs Through Statistical Sampling”, Legal Tech Conference, expert panel• “Statistics for Lawyers” developed and taught the continuing legal education (CLE) class.• “Statistical Analysis and Regression Techniques”, developed and taught the 2 day statistics course to Navigant Consultants• “SAS Programming Workshop”, developed and taught over six week period SAS programming course to professional consulting staff• Deposition in the case of Capital Medical Center, et al., vs. State of Washington, Department of Social Health Services, February 14, 2008

Worldwide, Oo

Deloitte & Touche LLP is the largest professional services firm and one of the Big 4 accounting firms with 286,000 employees worldwide. Manager for Financial Advisory Services / Economics, Statistics, and Data Consulting group. Led project teams supporting strategy, litigation, and consulting projects for diverse clients including many Fortune 500 companies. Supported the mentoring and development of associates.• Testified as data, statistical, and healthcare payment expert on a dispute representing the State of Washington refuting claims of alleged unpaid Medicaid payments to regional services network. Directed project management, client relationship, development and execution of the analytics • Identified $100M in Medicaid fraud through by utilizing data analytics and statistical methodologies to investigate alleged improper certification in a fraud investigation. Directed overall project • Developed and taught several in-house Continuing Professional Education (CPE) classes including MS Excel, MS Access, financial modeling, statistics, and statistical sampling

Gb

PricewaterhouseCoopers LLP (PwC) is the second largest professional services firm and one of the Big 4 Accounting Firms with 236,000 employees and operates in 154 countries.Manager for Financial Advisory Services / Economics, Statistics, and Data Consulting group. Led project teams supporting strategy, litigation, and consulting projects and providing technical expertise in Financial Audit and Tax Consulting group for diverse clients including many Fortune 500 companies.• Produced settlement that was 30% of the original claim in large multi-plaintiff Medicaid Health Care litigation involving over 50 providers, impacting 167,000 patients, and $100M in alleged damages by leading the analytics team performing data and statistical analysis • Lead project manager overseeing large portfolio of litigation projects and assisted the tax group in developing AMRT (alternative method of reporting tax), resulting in significant cost savings. Statistical sampling and extrapolation analysis was used in place of complete census audit

Arthur Andersen was one of the “Big Five” accounting firms and as of 2002 had over 85,000 employees worldwide and $9.3B in revenue. Manager for Economic, Financial, and Data Consulting group. Managed portfolio of litigation, audit, tax, and business management projects involving fortune 500 clients and annual billings of over $1 million. Provided statistical and data analysis expertise across service lines including business consulting, tax and the audit practice. • Created effective one-to-one marketing for major retail store by performing data-mining and statistical predictive analysis utilizing disparate data including Alteryx demographics data• Generated financial savings of $95M with the Unclaimed Property Team through development and application of statistical sampling method to estimate unclaimed property more efficiently and accurately. Savings is an improvement of 80% compared initial exposure

In 1994, one of the largest distributor of after-market motorcycle products based out of Fort Worth, TX with two offices in Europe in The Hague, Netherlands and Cologne, Germany. • Provided customer service in German by organizing and conducting client visits across Germany, and resolving customer issues • Organized exhibit at the at the Internationale Fahrrad und Motorrad Ausstellung in Cologne attracting 200,000 visitors (IFMA – International Bicycle and Motorcycle Convention)

Non-profit organization dedicated to international training and personnel development with emphasis on practical experience, exchange and foreign language programs for professionals and business leaders from around the world. http://www.cdg.de/

Master'S Degree, Economics

Bachelor’S Degree, Economics

Bachelor’S Degree, German Language And Literature

Education Abroad, Economics. German