BANAFSHE (SHEA) YOUNG
Sahuarita,AZ
Summary
Analytical and strategic thinker known for high productivity levels and the ability to efficiently complete tasks, ensuring accuracy and timely delivery of projects.
Proficient in preparing financial statements, monitoring controls and completing closings. Highly detail-oriented, proactive, and diligent. Excel at communication, problem-solving, and adaptability, making complex financial concepts understandable and actionable for diverse audiences.
Overview
10
10
years of professional experience
Work History
Financial/Decision Support Manager
Carondelet Medical Group And Abrazo Medical Group
Tucson, AZ
02.2021 - Current
- Prepare a daily financial dashboard for providers, practice managers, and senior leadership to evaluate current performance and track improvement.
- Prepare detailed reports on the financial status for providers.
- Discuss wRVU productivity and quality performance with providers.
- Prepare RFPEs for providers' onboarding.
- Generate and distribute standard reports from Athena on schedule, using Excel and other reporting software.
- Analyze data to identify opportunities for improving support levels.
- Identify opportunities for process improvements within the Medical Groups (Carondelet Medical Group and Abrazo Medical Group).
- Analyze trends in financial performance to identify areas for improvement.
- Evaluate complex financial information from multiple sources to make sound recommendations.
- Develop financial analysis reports and presentations by applying acquired financial principles.
- Collaborate with other departments to ensure that accurate budgeting and forecasting processes are followed.
- Evaluate new business opportunities, and conduct feasibility studies to assess financial viability.
- Determine and track budget expenses with accuracy and transparency.
- Coordinate with cross-functional teams to gather financial data and insights for comprehensive reports.
- Perform quantitative analysis of historical data to identify patterns or anomalies in the dataset.
Analyst, Decision Support
Carondelet Medical Group
07.2018 - 02.2021
- Prepare and set monthly financial goals for all primary and specialty providers within TPR.
- Respond to requests for data by determining the user's needs, collecting, organizing, and analyzing data, and providing accurate and complete reports and information.
- Participate in the annual budgeting process and periodic financial forecasts.
- Track health plan and government receivables, and reconcile receipts.
- Prepare productivity and quality payment distribution for participating physicians, and submit for approval and processing.
- Data analysis to assist in delivering optimal healthcare management and decision-making.
- Design and produce timely and meaningful analysis and data interpretation regarding large healthcare-related datasets to assist TPR in understanding and monitoring performance, breaking down key drivers, and identifying new opportunities.
- Interpret data accurately, and produce clear and comprehensive written analyses, dashboards, graphs, tables, etc.
- Work closely with participating health plans to coordinate HEDIS measures and quality incentive programs within the clinics.
- Manage the Carondelet Quality Team to actively work on HEDIS reports to drive the quality of care in the community through the communication of gaps in care to providers and staff.
- Manage the Carondelet Quality Team to review and complete health quality patient assessment forms (HQPAF) for different health plans through chart reviews.
- Develop patient care screening tools, including policies and procedures for the implementation of the tools at the point of care.
- Develop and implement provider-level education on the use of HQPAFs for improved documentation and coding.
- Develop and maintain master HQPAF trackers for participating health plans to assess trends and barriers, to ensure maximum incentive return.
- Conduct regular audits of the Carondelet Quality Team's performance against standards, and ensure compliance with delegation requirements from health plans.
Network Operations Administrator
Cigna-HealthSpring
07.2015 - 11.2017
- Responsible for general oversight of provider network financials, including monthly action plans, reviews, and verification for all participating medical groups and providers within Pima County.
- Built relationships that nurture provider partnerships and seek broader, value-based business opportunities to support the local market strategy.
- Responsible for network development, including physician contracting, physician network relationships, physician network communication, and physician recruitment.
- Collaborated with the contracting team to provide a liaison for Medicare Advantage contracting initiatives, evaluating proposed language, rate exhibits, and other terms for accuracy.
- Directly worked with the Chief Operating Officer, Medical Director, Sales, Marketing, Finance, Billing, Coding, Health Services, Contracting, and Legal to accomplish objectives.
- Provided guidance on strategic plans, vision, and action plan development for the network.
- Participated in network and company meetings, including the physician board of directors, quality management, financial/bonus, operations, and committee.
- Responsible for maintaining compliance with CMS and company policies and guidelines.
- Assisted in the STARS and clinical metrics data collection, and designed a plan for enhanced provider engagement in quality initiatives.
- I participated in and conducted the monthly financial review with senior leadership.
- Created and managed initiatives that improve total medical costs and quality.
- Assisted in resolving elevated and complex provider service complaints.
- Researched problems and negotiated with internal, external partners, and customers to resolve highly complex and/or escalated issues.
- Managed key provider relationships and was accountable for critical interfaces with providers and business staff.
Education
BACHELORS OF BUSINESS - FINANCE
UNIVERSITY OF PHOENIX
03.2010
General Studies in Business -
UNIVERSITY OF ARIZONA
01.2009
Skills
- Attention to detail
- Strong proficiency with MS Excel, Word & PowerPoint
- Outlook
- Leadership
- Data Management
- Data mining
- Problem-Solving and resolution
- Collaboration
- Excellent communication skills
- Adaptability
- Excellent decision making
- Analytical skills
- Incident reporting
- Forecasting
- Teamwork
- High degree of independence
- Flexibility
- Initiative
- Commitment
- Highly effective in working with physicians
Affiliations
- Hiking
- Traveling
- Painting
- Volunteering
Languages
Farsi
Native/ Bilingual
Timeline
Financial/Decision Support Manager
Carondelet Medical Group And Abrazo Medical Group
02.2021 - Current
Analyst, Decision Support
Carondelet Medical Group
07.2018 - 02.2021
Network Operations Administrator
Cigna-HealthSpring
07.2015 - 11.2017
BACHELORS OF BUSINESS - FINANCE
UNIVERSITY OF PHOENIX
General Studies in Business -
UNIVERSITY OF ARIZONA
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