Stella Ej Yoon Email & Phone Number

New Mexico, United States

- Manage team and give guidance, performance review and feedback to team members.- Generate data and anlysis for member/ provider initiatives. - Streamline, generate, review and manage standard and nonstandard supplemental data for increasing HEDIS/CMS STAR compliance rate. - HEDIS 2019-2022 Roadmap manage, review and update. - Review, update and submit for CMS PLD, NYS Birth file and NYS PCMH.

New York

- Manipulate large databases to summarize Quality of Care performance to be reviewed by senior leadership. Recurring and ad-hoc reports include but not limited to : Provider incentive, Medicare STAR dashboard, Gaps-in-Care database, Non-recommended service provider list, Behavior health provider, Provider audit, HEDIS medical record reviewdatabase- Creating data of HEDIS project with external vendors (MedXM, MagellanRX, ExamOne, Silverlink and Pfizer) and inter-departments for member and provider outreach. - Developed a training manual for the department’s new team members and gave training to overdozens of new team members using the manual. The training manual comprehensivelyincludes company wide/department specific information and practical programming/coding/skills for SAS/ACCESS/Excel.- Built the streamline of projects and programs for the automation of data process in SAS Enterprise Guide and Microsoft ACCESS/Excel (Macro, Vlookup and advanced formula). Made operational process documents for easy transition to team member.

New York, Ny

- Mine medical and pharmacy claims data to capture utilization which is counted for quality metrics scores : Uncovered total of 3,844 Breast Cancer Screening, Diabetes Care, Rheumatoid Arthritis Care,Dental Care and HIV care utilization for HEDIS2016 which were not initially captured instructured process- Collaborate with internal and external stakeholders to plan and evaluate Quality Improvementinitiatives such as target population identification, health outcomes and economics research- Perform quality assurance for data analyses processes for self as well as others- CMS Audit: Prepared QIA documentation for chronic condition measures( CDC, CBP, PBH, ART, SPR and PCE). Conducted rate comparison between performance years or provider groups using statistical testing and perform target population analysis. - Medicare Part C measure: Developed initiatives and work plan, support data for member and provider initiatives and report to Health Status Improvement Committee. Performed measure research and analysis for Star Assignment Measures. - HEDIS/QARR measure: Performed measure research for rate improvement by mining claim/RX claim data by utilizing SAS EG, R and Access DB. - Developed chronic member database for Health Navigator program, provider group outreach and initiatives. The logic includes member’s chronic condition, CMS triple weighted Medicare Star measure and Special Needs Plan.- Collaboration with Health Navigators for member and provider initiatives. - Provided statistical testing and analysis for Quality Improvement projects and Case Management programs.

Melville, Ny

- HEDIS/QARR/CMS Star: Improved compliance rate through HEDIS/QARR/CMS reports file conversion from various vendors and medical groups to standard report file. - Medicare Part C measure: Developed initiatives and work plan, supported data for member and provider initiatives and report to Health Status Improvement Committee. Performed measure research for CMS Star Measures. - Medicare Part D measure: Support initiatives for member and provider for compliance rate improvement. Generate rate, report and statistical trending from daily, weekly pharmacy claim and monthly pharmacy vendor reports. - ESAWS: research and analyze claims, member, RX and provider data using ESAWS - a HIPPA compliant relational database.- Managed Long Term Care: Participated in Performance Improvement Project (PIP) and conduct statistical testing and analysis for Uniform Assessment System – NY (UAS-NY) data. - Developed chronic member database for Health Navigator program, provider group outreach and initiatives. The logic includes member’s chronic condition, CMS triple weighted Medicare Star measure and Special Needs Plan.- Generated NCQA Accreditation requirement report of Quality Management and Improvement - Cultural Need of members (QI 4A).- Provided statistical testing and analysis for Quality Improvement projects and Case Management programs. - Compiled data to support Quality Improvement initiatives including targeted mailings and call campaigns.- Generated daily, weekly, monthly, quarterly and yearly reports for Quality Management, Pharmacy, Quality Risk and Quality Review department. - Perform Quality Assurance for HEDIS/QARR rate improvement and care performance to member.- Reported plan performance rates such as local market comparison index (NCQA Quality Compass data), Warboards (Inovalon QSI/QSHR data) and Medicare Part D patient safety rate grid.

Yangju, Gyeonggi-Do, Korea

- Instructor of 6th and 5th grade students. - School Manager of National Education Information System (NEIS). - Awarded School Prize in Kyunggido Office of Education for the NEIS system model school.

Yangju, Gyeonggi-Do, Korea

- Instructor for 5th, 4th and 1st grade students. Awarded two Excellent Teacher Prizes in Dongduchon Yangju Office of Education and in Federation of Teachers’ Association. - School Library Manager. Awarded 2 times award in Dongduchon Yangju Office of Education. - Girl Scout Instructor for three years. Awarded an Excellent Instructor Prize.

Master Of Science, Applied Mathematics And Statistics

Master Of Education, Korean Education

Bachelor Of Education, Social Studies