Grace Woo Email & Phone Number

Oversee creation and management of large data sets to support analysis and reporting of program and provider performance. Providers participate in a large in-office assessment program, whose goal is to ensure that their patients receive a complete and comprehensive health assessment at least once a year, and all care opportunities, including suspected risk-adjusting conditions and HEDIS measures, are addressed. Responsibility for calculation and administration of provider administrative and incentive payments, as well as invoicing of program fees.

Las Vegas, Nevada Area

I provide client situation analysis for a client with 2.4 million members. This includes receiving requests for information or reports, identifying business requirements, using subject matter expertise, creating a conceptual solution, obtaining the necessary information directly or in coordination with other functional areas; creating or modifying reports as necessary, providing quality assurance checks, and delivering the end product along with analysis and interpretation. The requests usually pertain to risk adjustment activity at a point in time or over time, RAF trending, and evaluation of effectiveness of programs or pilot projects. The results may be used for strategic planning, to explain a given outcome, or to compare against expected outcomes.

Las Vegas, Nevada Area

Responsible for leading a team of analysts in providing decision support, complex analysis, and reporting to support clinical data quality, quality improvement activities, disease management, HEDIS, program evaluations, provider profiling, and Medicare and Medicaid operations and submissions. Oversaw collection of encounter data from capitated providers and verification of quality and completeness of data. Oversaw numerous survey projects for various companies and departments, ensuring sound methodological design, sampling, data collection, processing, analysis and reporting. Oversaw the development, implementation and distribution of disease management reports and maintenance of disease management registries for the health plan. Oversaw the process of health risk screening to identify high risk senior members at enrollment and meet regulatory requirements.

Las Vegas, Nevada Area

Accountable for accurate and timely enrollment and disenrollment of Medicare and Medicaid members to meet Federal and State regulatory requirements. Worked with vendor and operational staff to define requirements for a customized Medicare Enrollment system, designed testing scenarios and tested releases, developed new operational procedures and business rules to utilize the new system, and trained staff on the new system and procedures. Oversaw the requirements definition, building, and implementation of several tracking applications needed to facilitate the Medicare enrollment, disenrollment, and reconciliation processes. Identified root causes of problems in the new enrollment process; implemented solutions by identifying bugs or making enhancements requests of enrollment system/tracking applications, coming up with workaround or alternative work flows, and/or training staff in proper use of systems. Accountable for the overall planning and direction of internal surveys to support business decisions and regulatory/accreditation requirements. Managed the Health Risk Screening Department to ensure compliance with CMS requirements.

Las Vegas, Nevada Area

Accountable for the overall planning and direction of internal surveys to support business decisions and regulatory/accreditation requirements. Specified requirements for a survey application, capable of handling a variety of survey projects, identifying a random sample or population of respondents based on survey needs, tracking the responses received, tracking survey supplies ordered and used, and other functionality. Defined enhancement requests and tested releases. Managed Health Risk Screening Department to ensure compliance with CMS requirements. Specified requirements for identifying new Medicare enrollees and current Medicare members needing an annual screen; specified custom module in case management system for collecting screening information and triggering specific actions based on those responses; specified enhancements and tested new releases and modifications. Developed policies, procedures and performance standards. Led major projects requiring high-level analytical, statistical and writing skills. Oversaw the development and implementation of health risk appraisals for the commercial membership to enhance revenue potential and support Sales efforts. Led ongoing effort to monitor provider performance, including design and implementation of a provider incentive program.

Las Vegas, Nevada Area

Oversaw the design and implementation of an integrated case management system that spans 15 subsidiaries and departments within Sierra Health Services, Inc. Facilitated meetings with stakeholders regarding how the system should be designed and used; worked with vendor on detailed specifications for customized functionality; wrote the user manual with respect to all SHS customizations and business rules; created testing scripts and oversaw testing of initial release; prepared/distributed project status reports and meeting minutes; coordinated with Corporate Information Systems department; supervised Clinical Application Support Staff.

Las Vegas, Nevada Area

Supervised staff to ensure accurate and timely compilation, auditing, and reporting of survey data. Conducted statistical analyses, organized survey data in meaningful reports, presented data to committees. Advised internal and external customers on survey methodology and design of survey instruments. Created and maintained databases to pull data from a variety of sources and systems for surveys, disease management programs and preventive health interventions. Supervised staff in answering data requests related to members and their health care utilization.

Las Vegas, Nevada Area

Planned, budgeted, and managed survey projects from inception to final report. Hired, trained, and supervised graduate and undergraduate students in survey methodology. Trained personnel in interviewing techniques. Established procedures for managing and controlling data collection. Advised clients on survey methodology, designed survey instruments, conducted statistical analyses, and wrote final reports. Programmed survey instruments in Computer Assisted Telephone Interviewing system and in scannable format for self-administered surveys. Produced survey research center mission statement and annual reports for university administrators.

Oswego, New York

Taught undergraduate courses in Research Methods, Health Psychology, and Psychology & Gender. Conducted data analyses for research projects and wrote papers for conference presentations and publications. Supervised two students for their honors projects. Served on departmental committees.

Ma, Phd, Social Psychology (Minor Health Psychology)

Ba, Psychology