Mark Pelkey, Mba Email & Phone Number

Plymouth, MI

Twinsburg, OH

Greater Atlanta Area

• Managed and assisted with development and troubleshooting in reporting for Disease Management programs for Blue Cross Blue Shield of North Carolina and several other clients. Types of reports produced included weekly.
• Developed reporting for several Biopharma clients on their patient drug therapy programs using SLQ Server queries. Managed reporting responsibilities for as many as 10-12 programs concurrently. Types of reports.
• Maintained consistent high quality and accuracy of information given in reports delivered, with a > 95% record of meeting or exceeding deliverable deadlines.

Greater Atlanta Area

• Managed and assisted with development and troubleshooting in reporting for Disease Management programs for Blue Cross Blue Shield of North Carolina and several other clients. Types of reports produced included weekly.
• Developed reporting for several Biopharma clients on their patient drug therapy programs using SLQ Server queries. Managed reporting responsibilities for as many as 10-12 programs concurrently. Types of reports.
• Maintained consistent high quality and accuracy of information given in reports delivered, with a > 95% record of meeting or exceeding deliverable deadlines.

Marietta, GA

• Assisted with new client implementations, as well as provided a support function to ensure that data is complete, correct and of high quality and required reporting deliverables to each client can be met. Technologies.
• Performed analysis of contracted vendor medical and pharmacy claims data, ensuring the presence and quality of essential data elements necessary for Matria (Alere) to translate into standard code for use in their.
• Improved data matching accuracy of several crosswalks that were built for translating a client's file feed with the Matria standard file format. For one of the largest clients, Metlife, I made updates to the crosswalk.

Atlanta, GA

Analyzed healthcare provider demographic, contracting and paid claims information. Responsibilities varied from production of contracted provider directories to analysis of healthcare products offered by providers. Additionally, performed in-depth analysis of medical claims data by market, product or provider. Technologies used included MS Access, MS.

Greater Atlanta Area

• Managed and reported on statistical information regarding selected Atlanta area healthcare provider networks, based on specialty.
• Generated standard reporting packages on monthly or quarterly basis, as well as interpretation of data as it pertains to cost trending views by provider, CPT/ICD9 billing or population group.
• Analysis and presentation of aggregate medical claims information and network financial performance before board representatives. Technologies used included MS Access, MS Excel, MS Word, MS PowerPoint, Cognos Impromptu.
• Through careful analysis, identified an outlier provider that performed an abnormal amount of diagnostic testing, which resulted in an overall very high pmpm cost for the provider network. The board used this.
• Created and implemented new reporting package for presentation at monthly meetings which proved to be far more understandable and actionable for the committee memebers.

Greater Atlanta Area

• Managed and coordinated participating provider network issues such as requests for contracting, credentialing, fee schedule rates and information.
• Delivered accurate and actionable claims data reporting to client human resource managers and network board members. Technologies used included MS Excel, MS Word, MS PowerPoint and Harvard Graphics.
• Designed and implemented new profit sharing paradigm for participating physicians which resulted in greater satisfaction and enhanced participation rates in the network by about 25%.

Master Of Business Administration - Mba, Busines Administration/Information Systems Management, 3.55

Diploma, College Preparatory

Activities and Societies: Sports (Football, Track, Wrestling)

B.S. Social Science, Multidisciplinary Studies Pre-Law

Mba, Business With Information Systems Concentration

Master Of Business Administration (Mba), Management Information Systems, General, 3.55

Bachelor Of Science - Bs, Social Science Multidisciplinary Studies - Pre-Law, 2.9

Activities and Societies: North Complex Student Judiciary Committee