Marc Deleon Email & Phone Number

Hopewell, New Jersey, United States

Greater New York City Area

•Directs team of analysts which research issues and conduct root cause analysis for HEDIS measure improvement. •Implement processes and solutions based on data driven decision making. •Develop business processes and implement technology solutions to maximize HEDIS/Medicare star rates.•Directly supports the CMO and Community Medicine (CBCM) areas by conducting performance analysis on HEDIS accreditation and Medicare Star.•Oversee creation and maintenance of Medicare Star dashboard.•Accountable for tracking, analyzing and trending data. •Responsible for all commercial and Medicare submissions to NCQA.•Maintain and monitor HEDIS project plan to ensure that all deadlines are met.•Business owner and primary liaison between vendors and enterprise in order to provide technical solutions to HEDIS/Medicare Star enterprise projects.•Manage data mining activities with the goal of creating supplemental databases to be used for our HEDIS audit. •Primary HEDIS subject matter expert. Develop policy and procedures with the goal of maximizing HEDIS rates.•Work cross divisionally in various corporate work groups. •Investigate and resolve systems issues relating to the certified software used during the HEDIS audit.

Greater New York City Area

•Responsible for collecting, tracking, trending HEDIS data, and the management and implementation of the HEDIS data collection software. •Lead and participate in projects with internal and external entities aimed at improving our HEDIS rates. •Recommend solutions based on data analysis to increase business efficiency and improve existing processes. •Coach and mentor less experienced staff and assist in training of new staff.

Greater New York City Area

•Responsible for system technical activities in requirements gathering, testing, production support, and system configuration. •Provide day to day assistance to internal users for the implementation of functionality and processes that improve the performance of the system. •Manage and monitor projects and supports teams to ensure the availability of resources throughout the development and implementation of new systems

Greater New York City Area

•Accountable for managing and overseeing the processes related to clinical quality performance data. •Managed team of nurse reviewers conducting chart reviews for our HEDIS audits.•Ensure efficient collection of data for HEDIS, URAC, NCQA, focused audits, and special projects. •Responded to quality improvement mandates and assisted in the oversight and management of Quality Improvement initiatives in the provider service areas. Responsible for the management and implementation of the HEDIS data collection software.