Summary of Qualifications
I am a seasoned health information technology expert with a passion for building products that solve the most complex healthcare problems today. "Working the problem backwards" approach to building solutions has brought much success over 15+ years working in the industry.
Lead product teams focused on provider enablement solutions, including EMR interoperability capabilities, AI/ML, and enterprise analytics.
• Led the EMR clinical data acquisition strategy, connecting to thousands of providers through HL7 direction connection, Health Information Exchanges, and EMR connectivity (e.g. Epic, Athena, Allscripts).
• Directly supported HEDIS and CMS Stars clinical data requirements to close patient care gaps and risk gaps, including leveraging EMR clinical data to meet Electronic Clinical Data Systems (ECDS) current and future NCQA requirements.
• Automated longitudinal patient chart process to leverage EMR connectivity for risk adjustment chart review.
• Automated prior authorization and notice of admission provider processes from EMR to reduce the significant administrative burdens of payout authorization requests and responses.
• Automated hospital discharge notifications to primary care providers to enable timely follow up care and avoid costly hospital readmissions.
Automated delivery of patient care gap information to EMR point of care and population health tools to improve critical care gap closures.
Led product teams focused on complex network analytics development and system integration, including integration of patient data within EMRs.
• Managed the end-to-end deployment of complex network utilization analytics aimed at distinguishing high performing providers. Partnered with clinicians and statisticians to develop clinically and statistically sound measurements, documented technical specifications, and defined UI/UX requirements.
• Integrated patient data and insights to support network utilization strategy into EMRs (e.g. Athena, eCW) using Point of Care Assist®.
• Developed internal reporting analytic tools and dashboards to support population health management, value based care, and other network affordability initiatives.
Managed the end-to-end reporting of EMR clinical data and the overall impact to HEDIS & Star measure impacts enabling more effective prospective member care gap engagement.
• Partnered with leaders to develop clinical data roadmap to enhance reporting functionality within Optum Data Exchange (ODX), Single Data Repository (SDR), and Stars Data Mart (SDM).
• Sunset legacy dashboards and deployed new PowerBI dashboards that illustrated the journey of clinical data through various enterprise systems (e.g. HealthBI, ODX, SDR, SDM) and demonstrated impact to care gap closure.
Responsible for all areas of program management for high performing network measurement programs and affordability initiatives. Duties included hiring and training program resources, capital planning and delivery oversight, business and technical requirements, and program operations support.
• Managed program releases of network measurement programs including on-time delivery of new analytic capabilities, reporting tools, and integration of results into various systems/webportals.
• Design and delivered flagship relaunch of $5M program provider portal, partnering with UX designers and technical architects to design all UI and backend workflow processes, lead testing and validation efforts, and train all users prior to deployment.
Managed several aspects of network programs including business requirements and technical specifications, operational support, and program reporting.
· Managed complex population health analytics development, which included translating clinical and statistical requirements into technical specifications (i.e. data elements, table structures, ETL, clinical and statistical algorithms).
· Developed financial reporting that measured cost of care savings from preferred provider utilization metrics.
· Supported external program training and inquiries, including engagement with clinicians, statisticians, health experts, and regulators.
EMR and clinical interoperability
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