Tony Cox Email & Phone Number

• Conduct data collection for Healthcare Effectiveness Data and Information Set (HEDIS)/medical evaluation studies including data requests, analysis, evaluations, and reporting.
• Perform medical record reviews and chart abstraction to identify and evaluate source data.
• Conduct system analyses to locate and retrieve HEDIS and quality data from claims, pharmacy, financial, provider, member and other internal and external sources.
• In collaboration with Quality Improvement team, identify quality issues and root causes, develops interventions and supports implementation to facilitate improvement in provider compliance and HEDIS scores.
• Partner with colleagues internal to Family Health Network as well as external (provider/designated group contacts) in the evaluation, communication, outreach and support of non-compliant members, providers and groups.
• Coordinate the timely distribution, completion, and submission of approved HEDIS related documents to auditors and National Committee for Quality Assurance (NCQA) as aligned with Family Health Network calendar of HEDIS.

Greater Chicago Area

• Ability to assess and measure the process capability to capture and maintain the quality of data throughout all business and system processes.
• Monitored Uniform Data System (UDS) Measures for reporting trends and analysis.
• Analyzed data trends and create processes and policies to improve patient outcomes.
• Conducted data quality assessments and derive metrics for the data elements of most business value.
• Provided data recommendations and solutions to Chief Medical Officer to improve provider processes
• Discovered, documented, and analyzed data collection and data transformation processes to determine the cause of systematic errors or data quality improvement opportunities.

Chicago

• Conduct data collection for Healthcare Effectiveness Data and Information Set (HEDIS)/medical evaluation studies including data requests, analysis, evaluations, and reporting.
• Perform medical record reviews and chart abstraction to identify and evaluate source data.
• Conduct system analyses to locate and retrieve HEDIS and quality data from claims, pharmacy, financial, provider, member and other internal and external sources.
• In collaboration with Quality Improvement team, identify quality issues and root causes, develops interventions and supports implementation to facilitate improvement in provider compliance and HEDIS scores.
• Partner with colleagues internal to Family Health Network as well as external (provider/designated group contacts) in the evaluation, communication, outreach and support of non-compliant members, providers and groups.
• Coordinate the timely distribution, completion, and submission of approved HEDIS related documents to auditors and National Committee for Quality Assurance (NCQA) as aligned with Family Health Network calendar of HEDIS.

Chicago

• SAS programming, merging SAS Data Sets, developing SAS procedures, preparing data and SAS Formats.
• Develop, validate, and implement new or modified SAS and SPSS programs to load data from the source and create study specific datasets for analysis.
• Prepare statistical reports using SAS, SPSS, STATA, and Survey Documentation and Analysis (SDA) software after data extraction.
• Analyse data using SAS procedures PROC FREQ, PROC MEANS, PROC SUMMARY.
• Maintain programs in SAS and SPSS in a user support environment.
• Various data management skills: merging, reading raw data files, handling programming errors, accessing and managing data, appending, concatenating, interleaving data sets.