Matthew Carr Email & Phone Number

Saint Louis, MO, US

• Manage Senior Product Managers and Analysts responsible for plan design, competitive intelligence, pricing, and demographic analysis. Provide mentorship and guidance to the team in designing and managing competitive.
• Lead and supervise a team involved in the design, development, and implementation of plan designs and portfolio development, competitive intelligence, pricing analysis, and market research.
• Co-own the department documentation of the Product Development Life Cycle.
• Coordinate with a dedicated Project Manager to document business processes, timelines, and presentations for new and existing Ambetter marketplace portfolios.
• Review product cycles to drive process improvement and enhance quality while seeking administrative efficiencies and positive member experiences.
• Supervise and lead a team responsible for collaborating with Product Strategy, Network Strategy, and Actuarial to guide product development, and managing overall strategy.

Saint Louis, MO, US

• Managed Product Analysts who were responsible for completing plan design, competitive intelligence, pricing, and demographic analysis for their assigned markets. Supported the team in mentorship and guidance for design.
• Worked in partnership with the Product Strategy Director to manage the Product Development team who is responsible for completing product design, competitive intelligence, pricing, and demographic analysis of our.
• Delivered end-to-end commercial solutions by participating and supervising staff in the design, development and implementation of benefits, competitive intelligence, pricing analysis, and market research.
• Co-owned the department documentation of the Product Development Life Cycle, coordinating with the dedicated Project Manager to document business process, timelines, and presentations new and existing Ambetter.
• Reviewed product cycle to drive process improvement and improve quality, and seeking administrative efficiencies and positive customer experience.

Saint Louis, MO, US

• Managed Product Analysts who are responsible for completing plan design, competitive intelligence, pricing, and demographic analysis for their assigned markets. Supported the design and management of competitive.
• Delivered end-to-end commercial solutions by participating and supervising staff in the design, development, implementation of benefits, competitive intelligence, pricing analysis, and market research.
• Collaborated with Manager, Product Development to manage the department documentation of the Product Development Life Cycle to document business processes, timelines, and presentations for new and existing Ambetter.
• Reviewed product cycle to drive process improvement and improve quality while seeking administrative efficiencies and positive customer experience.
• Served as product subject matter expert for assigned markets and product elements.
• Supported short and long term portfolios and growth planning.

Saint Louis, MO, US

• Supported the design and management of competitive product portfolios for our Marketplace Product Ambetter in Illinois, Indiana, Kansas, Michigan, Missouri, and New Hampshire. Developed and recommended improvements to.
• Managed large scale projects, e.g., HIOS ID Management, Plan Design & Pricing Tool, Cost Sharing Database, EDGE Server, and JSON File Management
• Served as product subject matter expert for assigned markets and product elements
• Supported short and long term portfolios and growth planning
• Ensured federal and state regulatory requirements were being met promptly for our Qualified Health Plan (QHP) documents, e.g., Plans & Benefits, Rx, and Crosswalk Templates
• Performed detailed audits of our internal and external product documentation to support product quality, e.g., Schedule of Benefits (SOB), Summary of Benefits and Coverage (SBC), HIOS Plan Preview, CMS IMP1A Testing.

Saint Louis, MO, US

• Provided analytical support to leadership to analyze and rate the performance of our Marketplace product Ambetter. Conducted qualitative and quantitative analysis on product performance, competitive position, product.
• Provided support for product initiatives, functions, and federal filings
• Conducted data analyses, reviewed and maintained product documentation, and completed QHP templates
• Performed detailed auditing of our product documentation and QHP templates
• Collaborated in product development strategy
• Served as product subject matter expertise for assigned projects

Saint Louis, MO, US

• Managed the IP Validation process and IBNR reporting for the Cenpatico Integrated Care line of business. Compiled and analyzed financial information for all other company lines of business, including Medicare.
• Developed integrated IP Validation reports, analyses, and IBNR financial forecasting
• Conducted weekly meetings with Utilization Management, Case Management, and executive leadership to review and rectify weekly IP Validation audits
• Created and analyzed scheduled reports to ensure financial information has been recorded correctly
• Identified trends and presented senior management with findings while making recommendations as needed

Saint Louis, MO, US

• Provided Health Net Access management with critical data to make accurate, timely, and informed business decisions. Created and maintained detailed analytical reports regarding NICU, EPSDT, OB and HEDIS lab data.
• Created graphs and provided analysis on NICU, low/very low birth weight, C-section & non C-section rates, emergent and non-emergent deliveries of members for Medical Management Committee Meetings
• Created and maintained reports and graphs used to analyze OB calls to pregnant members and EPSDT follow up calls
• Reviewed missing EPSDT forms from claims data and created tables summarizing findings
• Imported HEDIS lab data and created reports for Medicaid and Medicare Case Managers
• Assisted Case Managers with outbound correspondence and medical records requests

Phoenix, Arizona, US

• Managed complex data reporting and analysis used to supply management and contracted health insurance plans weekly and monthly figures.
• Managed contract payer incoming referrals, admissions, and discharges for Arizona Palliative Home Care (AZPHC)
• Planned, organized, and carried out monthly contract payer ICC meetings with the health insurance plans
• Worked with the Director of Clinical Services and Palliative Care Office Manager to manage and distribute data related to utilization, financials, and patient census
• Created and maintained contract payer reports
• Managed payer survey to ensure contractual needs were being met

Phoenix, AZ, US

• Planned, organized, and conducted recreation programs and activities with the adult and senior programs at the Paradise Valley Community Center.
• Issued facility reservations and program registrations using the City of Phoenix database
• Partnered with supervisors to hire, train, and direct contracted staff for center programs
• Trained colleagues to use ACTIVE/CLASS program maintenance and report printing
• Supervised contractual and part-time staff

Bachelor Of Applied Science, Health Innovation Cum Laude

Associate In Applied Science, Organizational Management With Distinction