Summary
Overview
Work History
Education
Skills
Websites
Certification
Timeline
Generic

Andrew Daoheuang

Minneapolis,MN

Summary

Dedicated and experienced Doctor of Education (EdD) healthcare professional in Executive Leadership with strong skills in data evaluation, project management, and process improvement. Proven track record in driving results through effective collaboration and adaptability to evolving requirements. Expertise in leveraging analytical tools, problem-solving, and stakeholder communication to deliver impactful solutions. Known for reliability, strategic thinking, and focus on achieving organizational goals.

Overview

12
12
years of professional experience
1
1
Certification

Work History

Clinical Program Analyst

Prime Therapeutics
04.2024 - Current
  • Support RFP (Request for Proposals) implementation process by gathering information and requirements and communicating status updates to key business partners providing formulary drug alternatives of negative and excluded drugs to proposal writing team
  • Monitor and complete CPA shared inbox on RFP requests for alternatives, serviced for Blues Plans - Completed over 30 RFP requests as of January 2025
  • Partner with internal business partners to develop, generate, analyze, quality check, and coordinate delivery of client and internal program reporting that includes UM Savings, Compliance, Utilization data, Retrospective Drug Utilization Review (DUR), and adhoc requests for clients as needed
  • Gather and analyze formulary drug alternatives for excluded and negative impacted drugs for RFP files
  • Work with various internal departments to create and maintain client, member, and/or physician communications and templates, member disruption mailings, and utilization requests
  • Participate in fulfillment activities where applicable Develop and maintain business process flows and desktop procedures for designated functional area
  • Support clinical rules maintenance (GPI lists, other lists) and/or client invoicing for programs
  • Put together Quarterly P&T Books for Blue Cross Blue Shield Clients with updated drug information
  • Audit monthly drug lists for clients for changes according to client formulary ID before reporting to Clinical Account Manager or Clinical Account Director of client
  • Manage CPA (Clinical Program Analyst) One Note sections for assigned clients and team
  • Maintaining compliant and following HIPAA when working with sensitive member information

Revenue Cycle Business Analyst

North Memorial Health
01.2023 - 04.2024
  • Audit and analyze Provider and Facility contracting for the year with unit cost analysis for Hospital and Professional Billing with financial forecasting of reports for the month, quarter, and year with MCO (Managed Care Organization) and Drug Reporting when applicable
  • SME (Subject Matter Expert) for anything in billing department relating to organizational development
  • Collaborate with Business Office Manager to ensure organizational effectiveness with process changes
  • Manage contracts from different insurance payors and its reimbursement rates with financial models
  • Assist Finance department with Finance Forecasting, Revenue Cycle Forecasting, and Medical Expenses
  • Responsible for financial performance reporting, researching and aiding in processes to achieve optimize legitimate reimbursement for the organization that is being paid correctly per commercial contract or government contract by payors with target setting for upcoming quarters
  • Investigate and communicate with insurance companies on high dollar claims over $250,000 to pay
  • Perform quality checks on accounts with claim issues with investigating and reporting back to Manager
  • Create PDSA (Plan-Do-Study-Act) for the revenue cycle department and present it to colleagues
  • Provide leadership, coaching, training, and guidance to Hospital and Professional Billing team that includes billers and coders on denials, rejections, price increases, and market trends
  • Financial forecasting of organization's ROI with RCM for organization's success

DME Program Director

Olidia Medical Inc.
09.2021 - 01.2023
  • Utilize CRM (Customer Relationship Management) system that is operational, analytical, collaborative, and strategic for DME patients and services
  • SME (Subject Matter Expert) for anything medical supply related such as supplies, durable medical equipment, respiratory, incontinence, nutrition, etc.
  • Vendor management with medical supply companies around the state and nationwide such as McKesson, Cardinal Health, etc.
  • Focus on organizational development and change to make sure metrics are achieved for effectiveness
  • Marketing research of durable medical equipment supplies and products and analyzing local competitors
  • Contacted current customers to conduct satisfaction survey over phone and opportunities to improve
  • Use Microsoft Excel to manipulate XLS files and analyze data using Pivot Tables/VLOOKUP and develop and build SQL queries for DME data for Brightree EHR service
  • Monitor, analyze, and audit company operations to ensure business practices and employees comply with regulatory requirements of Centers for Medicare and Medicaid Services (CMS) and The Joint Commission (TJC) following MCO (Managed Care Organization) regulations
  • Recruit candidates for open positions and complete HR on-boarding and training schedule for new hire
  • Gather financial data (paid claims, denials, accounts receivable, revenue and etc.) for the Board of Directors plus responsible for analyzing for company's financial management process that includes track, identify, collect, and manage incoming payments of DME for current patients
  • Develop, plan, and implement clinical operations including ROI and KPI for financial side of business
  • Conduct annual performance reviews and probationary period performance reviews managing employees for the department

Sr. Pharmacy Technician/Project Manager

State of Minnesota
06.2019 - 09.2021
  • Responsible for collaborating alongside other Sr. Pharmacy Technicians in Revenue Cycle Management (RCM) to review, analyze, and audit financial data for different quarters within fiscal year
  • Use SQL to identify pharmaceutical drug data and patient information to gather information for pharmacy department and report back to pharmacy director findings from quarter/annual audits
  • Dispense and document Controlled Drugs (CII, CII, CIV, and CV) following DEA Regulations and Minnesota Board of Pharmacy guidelines with monthly inventory and quality assurance duties
  • Assigned as Project Manager for department training while creating SOP (Standard Operating Procedures) documents to provide to staff/management and presenting new SOPs in team meetings with training of new and current employees on new procedures and daily workflow
  • Use QS1/DocuTrack to enter in pharmacy data and bill patient's insurance or facility on formulary for covered prescriptions while working on claim adjudication and PBM services for pharmacy
  • SME (Subject Matter Expert) with pharmaceutical drug and medical supply ordering through McKesson and Cardinal Health as well as performing necessary quarter and annual changes for organizational development for pharmacy department within Veteran's Homes
  • Management of third-party vendors that are contracted through Minnesota Veterans Homes/State of Minnesota with drug reporting for Minnesota Board of Pharmacy and MCO (Managed Care Organization)
  • Extract data for fiscal year and quarters to analyze pharmacy rebates with drug purchasing and applying to ROI and using KPI as indicator on drug spending for Minnesota Veterans Homes ensuring department meets its part in meeting organizational effectiveness

Pharmacy Technician/Medication Scribe

Fairview Health Services
09.2015 - 11.2018
  • Billing and filling medication drug charges in Epic during patient admission and discharge
  • Implement Pyxis Machine project for the OR area of the Hospital and prepare drugs for Go-Live Date
  • Inquiring drug information from outside pharmacies due to discrepancies in Epic for patient profile
  • Use Epic to navigate electronic medical record of patient's medication orders and other information
  • Train new employees on policies and procedures and in different job duties in the pharmacy
  • Interview patients during pre-op process of their medication lists and schedule patients for their appointments before their procedure on the day of surgery at Fairview Southdale Hospital
  • Retail pharmacy duties researching insurance, data entry, prior authorizations, etc.

Pharmacy Technician 3 Lead Trainer

Alixa RX
10.2013 - 09.2016
  • Collaborated with other Lead Trainers within production and data entry team on daily tasks and operations
  • Filled prescriptions including oral, nebulizers, inhalers, creams, ointments, insulin, and vaccines plus creating sterile and non-sterile compounded drugs for nursing home residents
  • Process shipping labels to correct facility and assign appropriate courier to deliver packages/process returns
  • Training new technicians in dispensing medications and daily workflow of Alixa RX while leading current technicians
  • Ordering drugs and supplies through Cardinal Health and other drug wholesalers and inventory control

Education

Doctor of Education (EdD) - Executive Leadership, Organizational Development & Effectiveness

St. Mary's University of Minnesota
Minneapolis, MN
08.2025

Master's Degree of Science (MS) - Health Care Innovation

University of St. Thomas - Opus College of Business
Minneapolis, MN
08.2021

Bachelor of Science (BSc) - Human Services

Rasmussen University
Bloomington, MN
06.2020

Skills

  • Corporate and regulatory best practices
  • Quality assurance and auditing
  • Customer satisfaction
  • Critical thinking
  • Advanced analytical skills
  • Data interpretation, SQL
  • Microsoft Office
  • Pivot Tables, VLOOKUP
  • Healthcare Software Applications
  • Data mining
  • Healthcare cost trends
  • Health Insurance Companies
  • Payment Methodologies
  • Financial forecasting, KPI, ROI, Revenue Cycle
  • Interpersonal communication and Leadership skills
  • Organizational development and effectiveness
  • Strategic planning
  • Business process improvement

Websites

Certification

  • Six Sigma Certification - White Belt, The Council for Six Sigma Certification (CSSC), Certification #ewIn18Lfpv, Certification Date: 08/06/2023

Timeline

Clinical Program Analyst

Prime Therapeutics
04.2024 - Current

Revenue Cycle Business Analyst

North Memorial Health
01.2023 - 04.2024

DME Program Director

Olidia Medical Inc.
09.2021 - 01.2023

Sr. Pharmacy Technician/Project Manager

State of Minnesota
06.2019 - 09.2021

Pharmacy Technician/Medication Scribe

Fairview Health Services
09.2015 - 11.2018

Pharmacy Technician 3 Lead Trainer

Alixa RX
10.2013 - 09.2016

Master's Degree of Science (MS) - Health Care Innovation

University of St. Thomas - Opus College of Business

Doctor of Education (EdD) - Executive Leadership, Organizational Development & Effectiveness

St. Mary's University of Minnesota

Bachelor of Science (BSc) - Human Services

Rasmussen University

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