John Roper Jr.

· Query and examine payer claims, clinical encounters, health quality data, EMR, and HIE data to identify financial and clinical quality trends, recognize patterns, examine data outliers, and investigate data inconsistencies.

· Create monthly and quarterly reports that highlight key performance indicators of the clinically integrated network of physicians and hospitals.

· Create claim, encounter, and EMR based clinical performance metrics that quantify providers performance over time.

· Conduct QA and data integrity checks of internal reports, external reports, database tables, queries, and programs.

· Implement automotive warranty products into the company’s universal system using SAS, SQL, Salesforce, VBA, IBM AS400, and Oracle CPQ.

· Automate repetitive processes using SAS, VBA, and Excel Macros.

· Troubleshoot, identify, and correct product errors when end users identify programming bugs.

· Maintain and update SQL server databases that house health care claims, pharmacy data, clinical encounters, attributed membership information and provider information.

· Create complex queries that join claims data to membership and provider information used to do utilization and expense analysis for HFS and CMS annual reports and audits.

· CAHPS outreach data analysis for Medicare members to improve star rating for Medicare plans.

· HEDIS quality measure support.

· Create board books for the Board of Directors that provides summaries of the company’s monthly membership, network utilization, high-cost members, and other key performance indicators.