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Megan P. Status: Offline
Cartersville, United States
100% Job Success
Top Rated

Healthcare Analytics Expert

• Experience in enterprise data delivery, maintaining data integrity & managing data models. 11 years’ experience in quality data analysis, data interpretation & data integrity processes analyzing large data sets utilizing statistical programs. • 11 years of experience in healthcare provider data reporting & analytics applying BI tools. • Superb customer service and relationship-building capabilities, including the ability to work with different departments and translate technical specifications from customer requests to database programming requirements. • Experience with SQL, VBA, JAVA, SAS, HTML, CSS and XML. • Expertise in benchmarking, quality of care metrics, waste analytics, provider attribution, specialty drugs paid through the medical benefit & financial performance reconciliations. • Experience reporting out of proprietary BI applications from multiple vendors, including McKesson, HDMS, Microstrategy, SAP Business Objects, Truven Health Analytics & Cerner. • Expertise reporting on quality metrics, including HEDIS & Medicare STARS. • Experience creating delivery structure to satisfy NCQA PCMH accreditation requirements. • Expert-level understanding of Truven Health Analytics Medical Episode Grouper (MEG) & Diagnostic Cost Grouper (DxCG) methodologies. Familiarity with ETGs, as well as MARA & ERG risk scoring methodologies. • Paid medical claims data SME • Vigilant & proactive compliance with HIPAA. Familiarity with SOX compliance. • Experience with process improvement tools, including process maps, flow charts, statistical process charts, value stream maps, etc. • Experience using project management tools (e.g. Gantt charts, PERT charts). • Familiarity with current trends in the healthcare industry, including ACOs, HDHPs, HSAs, MACRA, etc. • Advanced proficiency in Microsoft Office Suite. • Broad knowledge of leading healthcare analytics industry best practices, including expertise assessing performance & monitoring outcomes. 10 years’ experience in quality data analysis, data interpretation & data integrity processes analyzing large data sets utilizing statistical programs. • 5 years of high-level analytic consulting experience, designing, producing & presenting reports to multiple clients driving improved health care and cost & quality outcomes. Consulting experience included presenting analytic deliverables to senior-level executives in benefits and health & wellness departments. • 2 years of experience collaborating with leaders across a university health system, including the health system CFO, hospital CEOs, the board of directors, Director of PCP practices, Director of specialist physician practices, physician leaders, community health provider leaders, etc. • Strong interpersonal & customer service skills, including the ability to clearly communicate, both verbally and in written format. 2 years of experience in direct management role. • 3 years of experience with analytic proposal scoping, project management and account management activities, including meeting contractual performance guarantees, managing all communication, coordinating analytic resources for projects and hosting meetings.
Work history
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Skills

Skills

  • Medical Informatics
  • Administrative Support
  • Medical Records Research
  • Healthcare Interoperability
  • Healthcare Common Procedure Coding System
  • Medical Condition Coding
  • Medical Billing & Coding
  • Medical Procedure Coding
  • Healthcare Management

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