Senior Business Analyst
Northwell Health - Accountable Care Analytics
• Healthcare Claims Analytics focusing on Membership, Attribution,Provider Performance monitoring, PMPM, Gap Care, HEDIS, PaymentIntegrity Analysis etc.• Payer Data Warehousing, well versed with data from Empire, Aetna,CareConnect, United Healthcare, Healthfirst, 1199, Medicare ShareSavings Program, MEDAR, CCJR & CMS Research Data.• HCC & LACE score logic, HIE notification, comorbidities assignment.Value-Based Payments.Implemented metrics and dashboards, monitoring Reimbursementpatterns, Account Receivables Trends, Departmental Trends. Analyzingtrends and reporting to management on the causes for the shift in trendsand suggesting measures to counteract trends. • Evaluate daily cash flows trends and ensuring the revenue stays close to 100% of the goal.• Improved existing process of production of Dashboards, increasingefficiency by 50%, saving 15 days of man-hours/days.• Conducting audits & providing auditors with physician billing data in aformat that is easily reconcilable with the financial ledgers. • Train coworkers on existing technologies and new technologies, therebyincreasing the efficiency of the department. Worked on the transition to a newbilling system (GECB, SORIAN), especially with the reporting system.