• Review and research moderately complex business, operational, and technical challenges that require an in-depth evaluation of variable factors• Perform complex financial and economic analysis and model development• Plan, coordinate, and execute primary and secondary customer market projects• Manage and participate on large cross group projects and mentor less experienced staff• Collaborate and consult with peers, colleagues, external contractors, and managers to resolve issues and achieve goals

• Provided analytical insight and support for implementation of new programs, products and services • Lead operational systems and data pertaining to Risk Adjustment processes from internal and external sources resulting in the reimbursements from CMS • Created and contributed to HCC data submission and correction for plans through data collection, mining and analysis • Developed and conducted educational Excel courses for company staff to improve companywide efficiencies to more than 50 staff members and physicians

• Provided weekly and monthly performance reports to inform strategic planning • Designed metrics for Operational and Business Line reports for leadership • Forecasted and allocated 1,200 sales targets by customer for 5 Medicare business lines, including roll-up for 8 sales staff • Determined enrollment conversion rates for Leadership and Sales Staff at business line and customer level to track success • Initiated evaluation of membership repositories to establish standard business rules for reporting for 3 analytical teams • Developed and operationalized governance process for prioritization of data requests and report developmentProduced over 40 urgent Ad Hoc reports for Sales Department leadership and their sales staff • Awarded the “Strive to Thrive for the Star” in 2010 for excellence in reporting and customer service

• Provided utilization and claims data using SQL, Crystal Reports and Access to gauge out of network prevalence • Analyzed reimbursement data to match billing system rates and make changes in the database as needed • Responsible for quarterly financial and usage reports to Management for planning and analysis • Created and maintained 1,000-page Fee Schedule Resource Manual on an annual basis