Patrick Frankle Email & Phone Number

Orange County, California, United States

Lead the DSS analytics group, budgeting and forecasting of medical expense, and various analyses involving utilization and unit cost.

Irvine, Ca

Lead and develop a team of eight analysts responsible for: Population health analytics, financial modeling of clinical programs, regulatory reporting, provider and health plan contract modeling, cost and revenue trend analysis, reserve position (IBNR) and forecasting support, and all ad hoc reporting across the various company using SQL data sources (e.g. claims, clinical management, provider credentialing, electronic medical records, and health plan provided data such as rx fills and shared-risk claims).

This position manages a small team of analysts engaged in activities that support managed care capitation and fee-for-service contract renewal, identify trends and opportunities, and otherwise provide senior leadership with research and ad hoc analyses.

Utilization and network analysis for the California medical and pharmacy benefits. Develop and analyze underwriting solutions from the detail results of predictive risk modeling. Using in-depth knowledge of Health Net systems, troubleshoot issues that generate large financial problems and/or reporting problems.

Lead Pacific region (CA, OR, WA) Healthcare Economics & Pricing team. Developed tools and standards for measuring unit cost changes for hospital and physician providers. Managed the staff that performed the analyses on unit cost change. Led the region's planning process for annual network recontracting. Instituted and managed fee schedule administration for the region. Developed and managed Medical Utilization reporting in support of Pacific region's Medical Director.

Head of hospital and capitated medical group contract analysis for Southern California. Trained and supervised a staff of five financial analysts. Previous positions at Health Net were in Actuarial and Clinical Pharmacy Programs.

Mba

Master of Business Administration

Ba, Economics

Bachelor of Arts, Economics