Timothy Mandell

For the Voice of the Member (operations focus)– member journey and complaints review use case's of Qualtrics XM;

• Perform all services found in the 'Research Analyst' role in the previous contract with USAA with additional efforts to improve data quality.
• Performed gap analysis between existing systems or processes and desired state, identifying areas for improvement or enhancement.
• Developed and maintained relationships with Qualtrics SaaS teams for technical support and UI improvements.
• Mentored local personnel on best practices and protocols to maximize productivity and drive team maturity.
• Fostered culture of continuous improvement, encouraging team feedback and implementing process enhancements around reusable code.
• Prioritized bug fixes, technical debt, and enhancements based on user impact, maintaining high levels of customer satisfaction.
• Collaborated with engineering teams on technical feasibility assessments, resulting in realistic scope definition for transitioning automated ETL's sourced from on premises to those residing on AWS in S3.
• Facilitated communication between development teams and stakeholders, ensuring clear understanding of requirements and expectations as found in Epic's, Feature's, and Story's.
• Empowered employees to take ownership of their responsibilities, leading to increased accountability and improved performance outcomes.

• Attached to the New Account's and Upgrade Implementation team; managed and prioritized the product backlog for data on boarding and integration steps for automated use case, ensuring alignment with both business goals and SaaS technical requirements in a complex reporting environment for topics like Revenue Cycle, Risk Management, Patient Care, Practice Management, Fraud Review, with data sourced from EDI (835, 837), HL7, XML, and flat file extracts from clients.
• Collaborated daily with development teams to assure timely completion of stories/ tasks/ QA/ UAT to effectively reduce time to Go-Live
• Provided technical guidance to junior team members, fostering a culture of continuous learning and innovation in the organization.
• Utilize Erwin for database design, modeling, and governance on net new use cases and no standard files
• Designed internal process improvements to automate file quality review tasks, shortening data delivery times from days to minutes.
• Collaborated with system architects, design analysts and others to understand business and industry requirements.

For the Voice of the Member (VOM VOC) (operations focus) – user journey/ complaints review;

• Established strong working relationships with stakeholders, fostering collaboration and effective communication around data initiatives.
• Collaborated with stakeholders to identify business needs to align and upload data sources, such as; Qualtrics surveys, chat, 3p satisfaction surveys, call transcripts, and other sources as requested from on premises sources to SaaS via ad hoc uploads and/or technical execution
• Conducted discovery sessions with stakeholders to gather requirements and define clear iteration objectives for system improvements ensuring alignment with product vision and business vision
• Developed comprehensive roadmaps and clearly defined requirements to guide product development by the technical teams and ensure alignment with business objectives.
• Managed implementation of new features by outlining plans and specifications such as how, where, and when each component would work.
• Collaborated with engineering teams on technical feasibility assessments, resulting in realistic scope definition for projects.
• Actively participated in team meetings to share knowledge, exchange ideas, address challenges, and collaborate on potential solutions.
• Managed backlog prioritization, ensuring alignment with business goals and stakeholder expectations.
• Facilitated communication between development teams and stakeholders, ensuring clear understanding of requirements and expectations.
• Proactively identified risks associated with project timelines or deliverables, implementing mitigation strategies when necessary.
• Worked closely with technology enablement partners to design, create and deploy data management and governance processes.
• Supported Data Stewards data security review processes evidencing that services were properly secured and handled based on sensitivity and regulatory requirements as supported in the Information Sharing Agreement Charter
• Mapped data between source systems and warehouses.
  Monitored and managed data cleansing requirements and data conversion initiatives.
• Performed gap analysis between existing systems or processes and desired state, identifying areas for improvement or enhancement.
• Supported migration projects by cleansing and validating datasets prior to integration into new systems.
• Conducted data analysis to identify trends, patterns, and anomalies to diagnose production issues, determined root causes, and worked with stakeholders to resolve discrepancies for system corrections and improved customer experience utilizing Python, SQL, Excel and Tableau.
• Established and managed key performance indicators to measure and improve processes, systems and data.
  Assured data compliance management verifying data was retained and purged appropriately by 3p SaaS in accordance with contract SLA / SLO and business agreements
• Provided polished and timely client communication and responsive follow-through on all issues, actions, and escalations
• Generated ad-hoc reports to evaluate specific business requirements for text Analytic and visualization within Clarabridge using CX Studio and CX Designer.
• Developed and implemented best-practice methodologies and SOP's across a variety of use cases and industry verticals to include content that educated users on how to fully utilize the platform and understand what to expect from the product road-map

For Medicare Risk adjustment, Medicaid Risk adjustment (John Hopkins and CPDS models), and ACA Risk Adjustment;

• Applied technical and business knowledge to gather complex business requirements to support business operations creating databases, reports, executive summaries, and executed submissions to Government sponsored programs utilizing the required delivery method and validating responses
• Coordinated with IT teams to design and implement custom applications tailored to specific business needs, such as RAC reviews, resulting in increased efficiency and effectiveness of workflows.
• Worked with cross functional teams; local IT project support, off shore IT, and SME’s to complete project requirements in a timely/ budget friendly manner often wrapping multiple goals into single projects to maximize outcomes, reduce budget constraints and shorten development time frames supporting the business requirements.
• Conducted thorough root-cause analysis on complex data issues, proposing practical solutions that align with business objectives.
• Streamlined reporting procedures by creating user-friendly dashboards for easy access to key performance indicators.
• Enhanced team collaboration by providing clear communication of complex findings through visualizations and reports.
• Facilitated cross-functional collaboration and workshops for better decision-making through the development of comprehensive data visualization tools.
• Standardized metadata management across systems for improved consistency in reporting and analytics.
  Improved internal knowledge sharing by developing comprehensive documentation outlining standard operating procedures for various tasks.
• Provided technical guidance to junior team members, fostering a culture of continuous learning and innovation in the organization.
• Reviewed/validated; data mining, SQL query statements/processes, data systems, data interface, work flows, and data warehouses to identify appropriate data interactions connections and structure to support business requirements.
• Reviewed/validated; data mining, SQL query statements/processes, data systems, data interface, work flows, and data warehouses to identify appropriate data interactions connections and structure to support business requirements.
• Migrated numerous legacy systems by automating ETL tasks and procedures to SAS web resulting in significant improvements for processing speed, dashboard updates, and conversions, without compromising on accuracy or integrity. Techniques included; query optimization, indexing strategies, and overall architecture design.
• Consolidations and improvements saved the company over $3 million dollars by removing some third party contracts and reduced time to provide reports.

• Was responsible for providing the following for twelve facilities each with two to three service lines - Assisted in accounting cost reports and audit support reconciling with financial statements per Medicare and Medicaid policies, procedures and regulatory requirements by preparing supporting documents for the data administrator to accurately pull financial and human resources information to compile it into a singular Excel report format
• This annually came to fifty two unique financial reports with fifteen of the reports to be audited per regulatory requirements
• Maintained credentialing for all facility service lines assuring client relationships with no disruption of funds for services provided and allowing budgeting incomes to remain steady
• Created database tables ensuring the proper valuing of invoices based on provider type using the Medicare programs; policies, procedures and regulatory requirements for payments
• Operated Hyperion Financial Reporting Repository: A cubed based reporting interface, retrieving information for ad-hoc statistical reports and analyses
• Reconciled reports for accounting abnormalities and working with key staff to correct those issues
• Worked with collections group to notate discrepancies in lag triangles (IBNR) actual versus accrued
• Other duties included; setting privileges, managing report interface and coordination with the systems administrator to assure application up time and routine operations
• Prepared information and training materials for supervisors on Government Policy Memos that effected annual and daily business practices
• These materials routinely included Return On Investment breakouts to identify potential risks and areas of opportunity
• Updated report mapping increased facility reimbursement by $500K annually.

• Operated and automated Access databases, retrieving information for statistical reports and analyses reviewing work flow policies created for practice management system and procedures that adhere to employee rating based on metrics KPI outlined by best practices
• Verified rating/metrics schemes with various staff elements to ensure accuracy
• Oversaw; insurance data tables; payment posting, refunds insurance and private collections of twelve full time employees and two departments
• Assured position classification, employee development, management- employee relations, incentive awards and career management through review, mentor-ship and referral
• Prepared information and training materials based industry standards to support policy memos
• Responded to inquiries on the status of proposed, pending, and approved claims to insurance providers and customer bills
• Assisted in administering the companies incentive program through statistical reports and employee review process
• Provided Administrative assistance to the Administrative Officer responsible for human resources by assuring pertinent employee information requested was up to date and accurate
• Improved employee moral accelerated KPI's to highest levels since tracking began and increased collections by 15%.