John Trombley Email & Phone Number

St Louis, Missouri, United States

Greater New York City Area

Working in the Customer & Operations group on healthcare transformation projects for State and Local governments.

Greater New York City Area

My responsibilities include staff training, data quality improvement and revenue cycle enhancement as it relates to managed care contracting, policy and legislation, A/R abatement, Medicaid and Medicare reimbursement among others. I act as a liaison between the various operational segments of the hospital and the managed care organizations in order to troubleshoot various issues relating to reimbursement.These new roles are in addition to my previous work as a Financial Analyst for SUNY.

Reporting directly to the Vice President of Managed Care and Clinical Business. I am primarily responsible for Managed Care contract rate and language negotiation, profit and loss analysis of contract performance as well as the resulting reporting and analysis requirements.Projects:Developed a database with custom automated reporting for length of stay analysis for the Department of Medicine. Reports allow department administrators to track key physician statistics. Database development included implementing a bench marking system for each physician based on national length of stay standards and custom Diagnosis Related Grouping (DRG) comparisons which allows managers to compare changes in physician volume, length of stay, case mix and revenue over time. Created business plan models and financial projections which aid the senior leadership in determining funding for future product line enhancement.Developed and implemented a tracking system for Medical Board and Credentialing departments. System tracks application processes to improve transparency in the new physician privileging process and health plan credentialing enrollment.

Provide data analysis and database support for the Brooklyn Healthcare Improvement Project. BHIP is a coalition of hospitals, health insurers, Community Based Health Organizations along with the Office of the President of the Borough of Brooklyn, tasked with informing the health planning process for a 15 zip code area in central and northern Brooklyn covering over 1.1 million lives. Project includes health research of statewide data sets and health plan encounter data focusing on emergency department utilization and admissions and readmissions for Ambulatory Care Sensitive Conditions. Built database to collect data from over 11,000 surveys from community provider canvassing as well as emergency department patient surveys.

Master'S Degree, Public Policy

Activities and Societies: Graduate Program of Health Administration and Policy

Bachelor Of Science (Bs), Chemical Engineering

Activities and Societies: Coach - Tappan Middle School Academic Games Team

Science & Arts

Activities and Societies: Academic Games