Kirk Shanks Email & Phone Number

Kirsha, LLC is a healthcare risk adjustment solutions provider specializing in MAPD risk adjustment consulting, financial analysis, operational analysis, and data management.

New York, NY, US

In this role I was able to reach a number of career highlights. I mimicked the HHS-OIG audits for targeted reviews of specific diagnosis codes for a large regional MAPD health plan. I served as interim risk adjustment program supervisor while advising an at-risk MSO on a complete risk adjustment program redesign. This MSO was near financial default, and we.

Work closely with Medicare Advantage and Part D health plans to manage risk adjustment factor (RAF) product development and accurately calculate how much money clients will receive from the government.Routinely define RAF performance reports and work closely with and educate client leadership, implementing programs and making recommendations. Create all.

Fort Lauderdale, FL, US

I was responsible for the execution and oversight of risk adjustment consulting services for both managed care and provider practice clients. With demonstrated and proven success within Medicare Advantage and Commercial Exchange risk adjustment program operations, I provide Gorman Health Group (GHG) clients with a broad range of consulting services related.

Princeton, New Jersey, US

I was responsible for owning and driving Indegene's product strategy for healthcare analytics products (e.g. risk adjustment) in the payer space. My other responsibilities include:- Leading client conversations and participating in pitches along with the sales team and providing subject matter expertise for the Medicare, HIX, and Medicaid marketplace..

Columbus, Ohio, US

Plan, organize, monitor, supervise, and maximize opportunities related to revenue streams using analytics to identify trends and opportunities for improvement. Calculate revenue projections and ROI, working with vendors. Ensure compliance with Centers for Medicare and Medicaid Services (CMS), Ohio Department of Insurance, and other regulatory agencies..

Tampa, Florida, US

Hired as an actuarial analyst and promoted in 2007. Managed the full scope of data projects that included Medicare Part D reconciliations, Medicare CMS-HCC, CMS-RxHCC risk adjustment models, Retiree Drug Subsidy (RDS) program, Medicare MA-PD bids, and Medicare 5% Limited Data Set.Worked closely with clients, typically CFOs and CEOs as the company's primary.

While pursuing graduate degree in actuarial science, received a mathematics assistantship that covered tuition costs in exchange for working in the mathematics lab for 10 hours a week.

Seattle, WA, US

Developed databases that enabled beneficiaries' claims data to be uploaded and transformed it into clean, usable data sets that people could put into Excel spreadsheets and easily manipulate. Estimated incurred but not reported claims revenue (IBNR) using reserve models.* Developed training materials for an underwriting manual that company sold to health.

Atlanta, GA, US

Completed one year toward Ph.D. in Mathematics.

Houston, Texas, US

While completing undergraduate degree, designed internal websites tied into Access databases. * Gained recognition as an internal subject matter expert on creating internal websites to manage projects.

Led a staff of 70 to 100 employees as one of 4 managers.

Master Of Actuarial Science, Actuarial Science

Bachelor Of Science, Mathematics

Other; Certificate In Entrepreneurship Essentials