• Responsible for production, documentation, and implementation of data processes for the Medicaid HEDIS engine used in annual NCQA accreditation and mandatory reporting to CA Department of Health Care Services.• Responsible for development of routine and ad hoc reports to support company-wide Quality initiatives and Provider Incentive Programs.• Responsible for development of Clinical and Operational metric dashboards via Power BI.(7/2021 – current position)

* Responsible for intake and fulfillment of requests for ad hoc reports, total cost of healthcare studies, risk score data, and large group claims encounter data. Customers include Sales/Account Management, Underwriting, Actuarial, and Analytics Reporting.* Performing and contributing as Business Analyst, Project Manager and Data Analyst for KP claims encounter and membership submission to Integrated Healthcare Association (IHA). Primary liaison working directly with IHA's third party vendor OnPoint.* Subject matter expert in several KP Claims and Membership systems.* Analyze claims in upstream systems including EPIC Resolute (Billing) and Clinical to source enhancements to large commercial group pricing.* Provided analytical support in major interdepartmental projects including: Fee Schedule Redesign and efforts to support compliance with Affordable Care Act (ACA), and other database development projects.* Expert in SQL (Oracle, Teradata, DB2, and T-SQL) and data presentation in Excel. Proficient in SAS Enterprise on Grid and Excel VBA.* Role as technical lead for department through use of SQL/SAS programming expertise and business knowledge.(7/2011 – 7/2021)

* Supervised staff of two analysts.* Led the development and production of Financial and Clinical Outcomes * Saved company from refunding performance guarantee fee risk by running, within the guidelines of contractual agreement with clients, multiple versions of Financial ROI and Clinical Outcomes. * Communicate results and verify expectations with Account Management team.(3/2008 – 7/2011)

* Designed and produced analyses of program outcomes (including Financial ROI, Clinical, and Operational metrics) at the client level. * Presented Outcomes Reports to account management and provided recommendations to enhance program services with the objective of impacting health outcomes more effectively.* Analyzed and document client contractual specifications.* Automation of data quality assurance. * Developed and maintained SAS programming code used in client ROI modeling.(11/2005 – 2/2008)

* Wrote Large Group New Sales quoting program in Excel with visual basic subroutines used to:* Enable user interactivity during runtime* Create broker rate exhibits in separate Excel files* Store/retrieve quote census and rating information in Access* Responsible for developing manual rate demographic factors: including age/gender/contract tier, area, other. * Developed experience rating module embedded in Mid-Large group rating program. * Regularly participate in meetings with Underwriting and Actuarial management.* Other responsibilities include pricing of custom (non-portfolio) benefit plans for large employer groups.* Created financial projection worksheets to analyze small group and individual plan profitability and calculate rate recommendations.

* Assisted in product pricing and development of standard financial and actuarial reports. * Maintained and programmed monthly incurred reserve worksheets.