As a healthcare data analyst, I helped the company with organizing data from clients and processing information needed.
As a healthcare data analyst, I helped the company with organizing data from clients and processing information needed.
- Healthcare Data Analyst at HealthMark Group
- Hostess/Busser and server at Dodies Cajun Diner
- Sales Associate at Aeropostale
3 months at this Job
- High school or equivalent
- None - general studies
• Liaised with external stakeholders as a healthcare data subject matter expert on Eligibility guidelines and Electronic Data Interchange (EDI) protocol for clients.
• Researched and consulted to improve healthcare data integrity and ensure excellent service delivery.
• Developed analytics to track engagement, resolved data enrollment issues on a daily basis while consulting with clients on healthcare data needs.
• Completed data entry requirements for finalizing new enrollment information as well as for changes and/or terminations and provided data-driven recommendations and solutions to clients.
• Corresponded with external stakeholders on outward-facing data initiatives, like provider data reports, to provide basic technical assistance and solicit feedback.
• Monitored daily status reports assessing output for developing trends potentially impacting service levels.
• Participated in requirements and design reviews to thoroughly ensure comprehensive testing scenarios are performed.
• Created and maintained high quality documents and adhered to quality standards set by Management.
• Designed and executed clear and organized written procedures to support workflow processes and query design to allow replication of work.
- HEALTHCARE DATA ANALYST at CVS HEALTH
- DATA QUALITY AUDITOR/FACILITY RATE ANALYST at HEALTH SMART BENEFIT SOLUTIONS
- TECHNICAL CLAIMS AUDITOR at COVENTRY HEALTH CARE
- PHARMACY BENEFITS MANAGEMENT SPECIALIST at MEDCO HEALTH SOLUTIONS, INC
1 year, 8 months at this Job
- CMA - Medical Assisting
- Associate of Applied Science - Healthcare
Provides credentialing expertise to Medicaid & Medicare providers and groups to ensure payment for services
• Works with providers, hospitals, managed care companies and networks to prepare for and respond to accreditation surveys for the Accreditation Commission for Healthcare (ACHC), the National Committee for Quality Assurance, State Standards and other organizations.
• Provides consultative assistance to providers, hospitals, physicians and managed care organizations in the areas of quality improvement and credentialing.
• Performs primary verification as Central Verification Organization.
• Investigates claims processes and adherence to guidelines and standards.
• Develop HIPAA and compliance programs including ongoing provision of audits and compliance measures.
• Responsible for corporate or management oversight of the organization.
• Oversee the services and supports provided to individuals with Developmental Disabilities
• Assist multiple Medicaid & Medicare providers in the analysis of requirements to ensure a smooth and successful implementation.
• Responsible for the development and documentation of functional requirements for residents and employee reviews.
• Conduct functional assessments and Quality Improvement Audits
• Redesigned and implemented processes to credential and recredentialed over 600 providers in multiple states in less than six months.
• Revised the quality improvement program and work plan to conform with NCQA standards resulting in Full Accreditation.
• Compiled the data and reporting functions for multiple providers statewide.
• Ensured the continuity of quality care within cost containment framework.
• Applied Quality Management concept and program to the Medicare and Medicaid products.
• Revised department management roles and responsibilities for cost savings.
• As the lead analyst for multiple management teams, created positive corporate culture to repair the provider and hospital community image.
• Decentralized provider and hospital education department resulting in 96% compliance with JCAHO, CARF, ACHC and State Standards for competency and continuing education.
• Train Human Resources Managers and Administrative Staff in Compliance
• Conducted financial feasibility studies: debt financing, analysis of a provider agency for acquisition.
• Developed profile of the healthcare market for regional partners.
• Created databases for analysis and comparison.
• Contribute to technical performance analysis and enhancement.
• Monitor the process toward achievement of goals in the ISP, and make recommendations for modifications to the ISP as appropriate.
• Initiate and facilitate resident and employee's requirements, and reviews.
• Design, read and use interface specifications
• Responsible for ensuring that Redundancy and Backup System provide the highest level of data security and availability.
• Designing, developing and maintaining technical and interface specifications
• Designing and conducting user acceptance testing.
• Train and consult with States, Counties, single and multi-state providers, families, self-advocates, and anyone else using Therap Electronic Documentation Systems on an Oracle Platform.
• Work with Health Information Exchanges and other interoperability vendors looking to exchange data.
• Interact with users and Therap customer support in person, via computer, at conferences and over the phone.
• Work both independently and remotely and as part of a diverse and dynamic national and multi-national organization. SR. DATA ANALYST/PROJECT MANAGER (404) 719-9549 |Cell [email protected] https://www.linkedin.com/in/rhondacrockett
- Healthcare Data Analyst/Project Manager at THE QI TEAM, LLC
- Healthcare Data Analyst/Project Manager at COMMUNITY CARE HOMES, INC
- DIRECTOR/HR Manager at GA COMMUNITY LIVING FACILITIES, LLC
- Oracle DBA at ACCENTURE (BELLSOUTH)
6 years, 3 months at this Job
- Project Management Certification
- Certified Training - Business Administration
Leading healthcare projects and epidemiological research for pharmaceuticals and Medicare/Medicaid
• Predicting healthcare outcomes and costs related to CMS Bundled Payments Initiative (BPCI Advanced), updating monthly data for hospitals participating in programs and creating dashboards for data visualization
• Analyzing health care data and insurance databases for risk factors, predictions and trends for pharmaceutical projects and healthcare organizations using SAS
• Assisting in projects related to investigative analyses of trends, insurance risks and cost management
• Writing white papers for work done as a part of risk management strategy and healthcare research MASTERS THESIS Center for Firefighter Injuries and Research Trends Linking safety climate and antecedents to safety behaviors to organizational and safety outcomes in fire service and EMS based on survey scores
• Performing PATH Analysis of longitudinal data from fire departments to link injury trends with safety culture among firefighters and paramedics using R
• Exploratory data analysis and regression analyses to assess linkage between turnover, job satisfaction, employee engagement and morale
• Extensive literature review of related risk factors associated with line-of-duty injuries and outcomes
- HEALTHCARE DATA ANALYST at Milliman
- RESEARCH ASSISTANT at Center for Firefighter Injuries and Research Trends
- EPIDEMIOLOGY, & EVALUATION (FIRE) FELLOW at FIRE SERVICE INJURY RESEARCH
- RESEARCH ASSISTANT at New England Cryogenic Center
7 months at this Job
- M.P.H. - Epidemiology and Biostatistics
- B.S. - Biology
• Creation and maintenance of programs used for data entry, data management, data validation, statistical report generation, and program validation.
• Work as the key data analyst for the Value, Incentives, and Quality Reporting (VIQR) Programs founded by Centers for Medicare & Medicaid Services (CMS). Monitor and evaluate national wide hospitals and healthcare providers. Produce quarterly reports, analytic tools and interactive dashboards by using SAS/SQL and Tableau.
• Work with Medicare claim data in the CMS Oracle database for Inpatient/Outpatient data validation, trend and comparative analysis.
• Apply ArcGIS and visualize up-to-date healthcare or medical information on digital maps.
• Plan data collection methods for specific projects, and determine the types and sizes of sample groups to be used. Apply statistical models to data sets as needed including sampling and risk adjustment methodologies for both quantitative as well as qualitative analysis.
• Identify relationships and trends in data, as well as any factors that could affect the results of research.
• Support the organizational efforts in the development of documentation methods and reporting tools to track the progress of projects/initiatives, in order to meet all the deliverables.
• Support the organizational efforts to operate within a continuous quality improvement model.
• Generate SAS based well-defined reports by using PROC REPORT, PROC TABULATE and develop SAS macro/SQL code to program data manipulation, TLFs and report production.
- Healthcare Data Analyst at Oklahoma Foundation for Medical Quality
- Associate Biostatistical Research Analyst at BlueCross BlueShield of Tennessee
- Biostatistician at Kentucky Injury Prevention and Research Center, University of Kentucky
- Teaching Assistant at Department of Statistics, University of Kentucky
7 years, 2 months at this Job
- M.S. - Statistics
- M.S. - Chemistry
- B.S. - Chemistry
Able to assist supervisors, provider services analysts, and other end-users to maintain a technical working relationship with the access database developers. ♦ Comfortable addressing and presenting to senior leadership on key finding of discrepancies with provider information through project implementations. ♦ Expert level knowledge in Microsoft Excel and Word. Works mainly out of several Microsoft Access Databases. ♦ Assist in the design and development of databases, reporting tools, and business processes along with creating /updating desktops to implement the process. ♦ Assists with training and mentoring new Healthcare / Data Analysts, and Provider Network Coordinators on new processes. ♦ Responsible for the timely completion of projects, and daily work assignments (ie; quarterly / monthly rosters, reported inaccuracies / daily changes, FAP's, self-audits, etc.) ♦ Analyze data, trends, validation of info for anomalies for operational impacts and needed actions to update provider demographics. ♦ Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources. ♦ Ensure compliance with federal and state deliverable reporting requirements as SB 137 by performing data quality audits and analysis
- Healthcare / Data Analyst at Health Net Inc
- CASE MANAGEMENT ASSISTANT II- CASE MANAGEMENT DEPARTMENT at Health Net Inc.
- CUSTOMER SERVICE REP I, II & III at Health Net Inc.
1 year, 1 month at this Job
- Bachelors of Science - Health Administration C/O
Creating accurate and meaningful reports for departmental and management decision-making
using Tableau, R, and MS Excel.
• Working on the quality incentive programs including Meaningful Use(MU), PQRS, Managed Care Incentive Programs (HEDIS) and other regulatory, quality and pay for performance initiatives for Penn State Health Medical Group and Hospital.
• Providing utilization and outcome analysis, trends and other reports involving claims and membership data to identify and track members for disease and case management, incentive and rewards program.
• Leading and managing the automation of data feed project using Toad to support productivity and return on investment programs by closing maximum patient gaps in care.
• Working knowledge of Cerner including Power Chart, Healthe registries, Heathe Intent, Healthe Analytics and various payer portals like Data Link, Optum, Navinet, Theon, and Conifer.
• Preparing, verifying and maintaining clear and user-friendly dashboards which contain frequently requested data and reports to share with the provider representatives to improve member health, improve member satisfaction and reduce medical costs.
• Serving as a technical resource in developing specific questions while determining the appropriate analysis methodology, performing analysis and strategy development.
• Developed a process to track funds, quality programs progress, meeting minutes and communications.
• Assisting with provider registrations, attestations and maintaining an active participation list throughout the calendar year.
- Healthcare Data Analyst at Penn State Hershey Medical
- Business Office Analytical Intern at St. David's Healthcare
- intern at Data Analytic
- Graduate Research Assistant at Texas State University
1 year at this Job
- Master of Healthcare Administration - Healthcare Administration
- Bachelor of Dental Surgery - Dental Surgery
While assigned the Advanced Analytics team, was responsible for the data validation of the IBM Watson's Explorys ETL process utilizing MS Excel, MS Access and MS SQL. Performed root cause analysis of data mapping issues. Identified multiple tools to extract and report IBM Hadoop data. Additionally was responsible for the data validation of the IBM Watson's Explorys ACO and HEDIS reporting capabilities. Identified reporting anomalies and validated corrections to these anomalies. Reverse engineered the IBM Watson's Explorys application into MS SQL tables to provide current and accurate Database Model diagrams utilizing MS Visio. Developed SQL queries to perform monthly Data Profiling analysis of IBM Watson's Explorys data to St. Joseph's Meditech, Allscripts, Allscripts Home Health and IDX data sources. Developed requirements for daily monitoring of the Explorys Hadoop database for accuracy and completeness of St. Joseph's data. Develop a QuickBase data base to track development and production support issues associated with the IBM Watson's Explorys database and reports. Developed a QuickBase database to track the Vendor and User Department relationships associated with Third Party data files produced by SSRS/COGNOS report processes. Developed a prototype ACO set of reports utilizing data extracts from the Explorys Hadoop database, MS Excel flat files and a MS Access database. This prototype identified data mapping issues specific to the Allscripts tables which were addressed by IBM Watson's Explorys team. Performed user acceptance testing of Third Party data files being converted from MS SSRS processing to IBM COGNOS processing. Coordinated End User and Vendor acceptance testing of the same Third Party data files.
- Healthcare Data Analyst / Contractor at Providence - St. Joseph's Health
- Healthcare Data Analyst / Contractor at Blue Shield of California
- Business Analysis / Consultant at Optum Insight
- Application Consultant at Simpluris, Inc
4 years at this Job
- BS - Public Administration
- MS in Organizational Leadership - Leadership
• Collect, enter and gather health data
• Create and validate health records
• Evaluate and preprocess raw information
• Enter claims into computer using ICD-10 and CPT codes
• Verify and authenticate medical claims
• Performs data analysis and visualization
• Liaise with patients, insurance and service providers
• Design, monitor and evaluate health programs
• Drafts action plans, prepare budget and writes technical reports
• Responsible for store, retrieve, and maintain health information
• Ensures security, privacy and confidentiality of health information.
• Designs form/template for data capture and documentation purposes.
• Communicates and disseminates health information to appropriate agencies.
• Coordinates and supervises health programs
• Serves as key health management team member for healthcare units
- Healthcare Data Analyst at Ghana Health Service
- Medical Laboratory Technologist-Intern at Holy Family Hospital
7 years, 8 months at this Job
- Bachelor's - Medical Laboratory Technology
- Associate - Health Information Management
- High school or equivalent - Science
- Healthcare Data Analyst at Children's Specialized Hospital
- Customer Service Representative at TD Bank
- Research Assistant at Mid-Jersey Chamber of Commerce
- Manager at Destiny 12 Theaters
3 years, 2 months at this Job
- Bachelor's degree in Economics - Economics