Nate Lucena Email & Phone Number

Greater St. Louis

Greater St. Louis

Greater St. Louis

Chief of Staff/Advisor for head Quality Executive, coordinating day-to-day operations and strategic initiatives across all functional areas of Quality Improvement and Operations, including:o Strategic Planningo Annual Operating Plano Monthly Budget Trackingo Integration Management ActivitiesLeadership over department Project Management Office, managing and deploying a team of resources on critical projects across the department, including:o Performance governance for Medicaid, Marketplace, and Medicare LOBso Produce Executive Performance Updateso Strategic internal and external communicationsLeadership over department Vendor Management Office with accountability for driving HEDIS Improvement via innovative and efficient care gap closure across numerous national vendors and campaigns, including:o Budget and Forecastingo Contracting and Program Design/Implementationo Performance Management and ImprovementLed development of enterprise Quality Improvement KPIs across partner business units to drive improvement toward enterprise goals, including Pharmacy, Enterprise Operations, Sales, Claims ConfigurationImplementation and change management oversight of multi-phase shift to Shared Service Operating ModelLed development of strategic analytic tools and competitive landscape analytics to drive Improvement strategies

Greater St. Louis

Chief of Staff/Advisor for head Quality Executive, coordinating day-to-day operations and strategic initiatives across all functional areas of Quality Improvement and Operations

St. Louis, Mo, United States

Integrated existing data strategy, data science, and business analysis teams under Centene Quality Analytics umbrella to facilitate innovative analytics and reporting for all corporate Quality Improvement activities, including Medicare Stars, Marketplace Quality Rating System, NCQA Health Plan Rating System, state Medicaid Pay for Quality programs, and all ad hoc reporting and analytic needs Led migration from Excel-based enterprise Quality ratings scorecards to on-demand browser-based automated reporting.Analyzed multi-year trends in performance and utilized statistics and machine learning to build data-driven enterprise and line of business-specific CAHPS improvement strategy, including: o Developed analytic roadmap to tie industry/contract-level CAHPS results to real time, impactable operational and customer service metrics for strategic focus to improve performance on Stars-critical CAHPS measures o Performed supplemental analytics using mock CAHPS data to identify CAHPS domains and member characteristics that predict Rating of the Health Plan and Rating of Health Care Quality o Led development and implementation of model to predict dissatisfied customers across all lines of business, resulting in a 40% reduction in customer grievances in controlled experiment study Led development and implementation of Declining Health Model to proactively identify members for outreach who may self-report declining physical or mental health on Health Outcome Survey Developed a robust pipeline for identifying health outcome disparities and assessing the impact of disparity reduction initiatives based on race, language, urban/rural, with planned expansion to other social determinants of health Serve as subject matter expert and reviewer for quality performance data, strategy, and tools for new business proposals and re-procurements of existing business

Greater St. Louis Area

• Built and expanded new team from the ground up including staffing proposal, development of job descriptions, hiring decisions, and all onboarding/training procedures • Responsible for managing the development and delivery of innovative and actionable reporting and analytics for quality improvement initiatives at a large managed care organization, including:• Complex data mining and modeling of claims and encounter, HEDIS, CAHPS, and operational data to identify barriers and drivers of performance for Medicaid, Medicare, and Healthcare Exchange lines of business• Predictive modeling of factors influencing member-level compliance on critical HEDIS measures using big data techniques and machine learning• On-demand, holistic member clinical prioritization tool marrying performance goals, member-level predictive modeling, and forecasted end-of-year performance • Led development of automated time-series forecasting pipeline to predict end-of-year performance for clinical metrics• Served as analytics and quality data subject matter expert/thought leader for development of:• Self-service data access layer between distributed storage (Hadoop) and web-based data views (Denodo) to outline requirements, supervise UAT, and guide architecture and development work to meet business needs• Enterprise-wide consolidation of data sources for outreach to members and predictive modeling of ‘next best actions’ to improve health outcomes for members• Internal consultant for complex analytics and strategic insights across clinical and member experience domains

Greater St. Louis Area

• Established a statistical modeling and predictive analytics program for the Medicare Stars line of business, working closely with the Senior Director of Medicare Stars and the cross-functional Stars team to leverage industry and corporate data to drive performance improvement in clinical health outcomes, medication adherence, member satisfaction, and health plan operations.• Worked with key stakeholders across quality improvement, medical management, IT, call center, and business intelligence teams to identify areas of at-risk performance, translate business needs into research questions, identify appropriate data sources, and deliver reliable and valid conclusions to drive decision making• Utilized longitudinal modeling to innovatively identify real-time drivers of member dissatisfaction• Developed and implemented a member stratification pilot program to prevent hospitalizations by dynamically monitoring risk score information across time deliver targeted case management outreach. Partnered with IT team to oversee the automation and production of member stratification modeling and reporting.Developed flexible and interactive dashboard reporting to provide high level insights into relevant data with drill down capabilities for scenario building, population filtering, and member-level details on health outcomes

St. Louis

Greater St. Louis Area

•Worked collaboratively with teams of consultants to provide consulting services to local companies in the biotech sector, including growth-stage drug development and early-stage biomedical device startup companies. Duties included business plan development, competitor analysis, identification of regulatory pathways and partnership opportunities, market size and segmentation, and potential exit opportunities.

Greater St. Louis Area

•Worked collaboratively with a committee of faculty and staff members to develop curriculum and secure sustained funding for a new, university-wide training initiative aimed at improving inclusivity in classrooms, office spaces, and residence halls for members of marginalized groups.•Served as lead for training program assessment, including design of a pre-post self-report training survey, data entry, data analysis, and data-driven curriculum revisions.•Generated easy-to-understand data graphics and reports of results for funding proposals, progress reports, and team meetings. •Implemented program branding strategy.•Created dynamic visual presentations of curriculum tailored for faculty or staff departments for use during training session.•Produced graphic designs for publications, business cards, and informational handouts. •Facilitated over 20 training sessions across a wide range of professional and academic departments.

Greater St. Louis Area

•Planned and executed experimental research on cognitive and brain aging using varied methodologies including both laboratory- and online-based cognitive, psychometric, and survey data collection.•Extensive collaboration with colleagues across research laboratories and centers, including the Knight Alzheimer’s Disease Research Center and the Rehabilitation Institute•Developed data cleaning, storage, and analysis pipelines for new and existing data sets•Analyzed data and interpreted statistical results using latent factor modeling, multiple regression, mediation/moderation analysis, and path analysis using SPSS, SAS, MPlus, and Microsoft Excel; additional experience with R, MatLab, and Stata.•Executed data query/acquisition from large, international datasets for statistical modeling of neuroanatomical, cognitive, and lifestyle data related to the aging process.•Translated and disseminated complex research findings that contributed to understanding of relationships between aging memory systems in the brain and cognitive performance.

Raleigh-Durham, North Carolina Area

•Provided data collection, data governance, and data analytic support to primary investigators, postdoctoral associates, and researchers across multiple institutions and centers in experimental research studies of cognitive and neural development in schizophrenia and autism.•Developed, documented, and implemented quality control procedures for data collection, data entry, data cleaning, and analysis to insure organization and integrity of large datasets. •Processed and formatted incoming raw data from multiple data collection platforms for input into standard statistical analysis packages•Managed cognitive and neuroimaging datasets and fulfilled data requests from collaborators on large, multi-site projects.•Queried databases to merge primary key-matched data sets into single files for analysis•Performed descriptive and multivariate statistical analyses of psychometric and neuroimaging data using SPSS, Excel, SAS, and MatLab toolboxes.•Provided support with the preparation of reports, publications, and presentations.

Master Of Arts (M.A.)

Master Of Arts (M.A.)

Bachelor'S Degree