Diligent healthcare analyst with solid background in providing strategic advice and support. Proven track record of implementing solutions that enhance operational efficiency and stakeholder satisfaction. Demonstrated expertise in analytical thinking and effective communication.
Overview
15
15
years of professional experience
Work History
Senior Analytics Advisor, ACA Financial Risk
Cigna
10.2020 - 07.2021
$4.5M savings identified in 2024 due to overpayments from contracted rate errors found during trend analysis; instrumental in setting up a workgroup to review audit processes
Collaborate with matrix partners to prepare and present data-driven insights to senior leadership and local market executives
Designed and maintain Rx trend report for pharmacy director and market managers
Participate in clinical performance workgroup focusing on ED reduction
Analytic projects include high-risk pregnancy, substance use co-morbid conditions, high-cost MSK implants
Monthly claims trend and medical loss ratio analysis to identify changes in market risk, guide product enhancements, and clinical initiatives
Business Analytics Advisor, ACA Contract Analytics
Cigna
10.2017 - 10.2020
Collaborated with cross functional team concentrating resources for ACA expansion into new states
Developed and maintained total medical cost report comparing ACA and commercial products by market
Analysis of Medicare RBRVS by state and TIN
Analysis of CMS data to calculate base rates for ACA expansion
Analysis of utilization trends for provider contract modeling
Ad-hoc reporting and data reconciliation as needed
Business Analytics Advisor, Collaborative Care
Cigna
07.2016 - 10.2017
Responsible for annual collaborative care fee-for-value reconciliations for Mid-Atlantic market
Collaborated with market matrix team to support Medical Executives with disease management initiatives
Produced and presented quarterly reports to collaborative care partners, including total medical cost and utilization trends
Produced ad-hoc reports based on inquiries from collaborative care partners and market matrix team
Director of Operations
HCA, Virginia Care Partners
07.2016 - 10.2017
Developed strategic initiatives to move network toward increased fee-for-value shared savings opportunities
Responsible for financial activities, including preparing and presenting annual projections and budget to Board of Managers and Division executive team
Prepared for and actively participated in monthly Board of Managers meetings and quarterly JOC meetings with insurance companies
Prepared presentations for Performance Committee and facilitated discussions regarding network and practice performance, action plans, and cost data
Led analytics efforts to support operations and planning, including development of evidence based measure, cost, and utilization scorecard for network and provider groups
Collaborated with Clinical Director and vendor to develop protocols in software to enhance transitions of care workflow for care management team
Identified and resolved payer conflicts with vendor data.
Manager, Financial Information Technology
HCA
03.2011 - 07.2015
Created and maintained web-based tool to consolidate reporting of routine capital for 17 hospitals, including user reporting requirements
Collaborated with cross functional team to standardize development of BI tools, including SharePoint 2012, Excel 2013 Power Pivot and Power View
Collaborated with Business Development Executive team to develop SQL database and BI tools using Virginia Health Information annual licensure survey data
Financial Information Technology Analyst
HCA
01.2007 - 03.2011
Database administrator for Net Revenue tool and developed reports based on user requirements.
Maintained annual budget workbooks and supported financial departments for 17 hospitals.
Education
Master of Business Administration -
Strayer University
Richmond, VA
06.2014
Bachelor of Science - Database Technology
Strayer University
Henrico, VA
06.2005
Skills
Quantitative & Qualitative Analysis
Complex Problem Resolution
Collaboration
Written Communication
SQL
Tableau
SAS Enterprise
Mural
MS Office Suite
SSIS / SSRS
Timeline
Senior Analytics Advisor, ACA Financial Risk
Cigna
10.2020 - 07.2021
Business Analytics Advisor, ACA Contract Analytics