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Yyyyyy x. yyyyyy

Results-Generating Leader Seeking Growth-oriented Analytics Role

Specializations in Analytics Education, Consulting & Strategic Data Visualization, Planning & Presentation

 

3132 Paseo Xxxxxx, XXXXXX xxxxxx (xxx-xxx-xxxx abc@xyz.com

 

Analytics Training / Development Team Building Multi-Process Optimization Executive Analytics Consulting

Assessments Multi-Project Management Visualization Presentations Quality Assurance Key Communications

Instructional Methodologies Design Instructional Evaluations Training Curriculum Development Website Design

Data Analysis / Interpretation Methodology / Criteria Development Strategic Analysis / Planning Trends Tracking

 

  • Top Performer who offers a record of proven career results, and who makes sound business decisions to reflect positively on operations in alignment with a company s vision, value, and goals to support optimal healthcare analytics.
  • Ambitious Self-Starter with experience in healthcare analytics and reporting on claims, membership, medical management, and provider data, as well as training and developing solutions-focused teams in attaining objectives.
  • Visionary Professional who leads results-generating training / development, team building, and multi-process optimization initiatives, and actively rises above challenges to drive winning outcomes in presenting reports and results.
  • Excellent Communicator who builds and sustains synergistic relationships with C-level executives, decision-makers, healthcare / business professionals, clients, and brokers; who excels in both autonomous and collaborative work environments; and who leads by example and with integrity to reach a common goal and deliver positive outcomes.

 

Career Highlights

 

  Routinely noted for outstanding performance, and received 2 job promotions within only 3 years.

  Noted as the pivotal driving force for the success of comprehensive training / development programs.

  Honored by CEO Pat Hemmingway Hall with a 3-year term on HCSC s Management Steering Committee.

  Recognized for job excellence with numerous awards, including an Achievement Award for Reporting Implementation Team, Spot Award for Management for successful webpage development project, and 3 additional Spot Awards for analytics and consulting on disparities, excellent leadership and results on a Behavioral Health Logic Standardization Project, and successful development of a PG team and improvements on reporting and processes.

 

Professional Synopsis

 

Blue Cross Blue Shield of Xxxxxx, Richardson, XXXXXX 2001 Present

 

Senior Manager Actuarial Systems (2016 Present)

  Capitalize on the opportunity to lead a forward-thinking reporting team in handling production reports for Provider / Network Analytics, including additionally providing analytical advisement to senior leadership to meet objectives.

  Serve as Reporting Business Lead on Provider Performance Model (PPM) with comprehensive responsibilities for report visualization, methodology of metric development, and section of reporting tool to achieve targeted goals.

 

  Strategically lead annual development of provider efficiency scores.

  Design and develop departmental processes / policies to enhance team effectiveness.

  Handle coding updates to department reports to accommodate ICD-9 and ICD-10 industry transition.

 

Manager Healthcare Analytics (2013 2015)

  Established an Analytics Department responsible for monitoring and reporting of Performance Guarantee metrics for Medical (Care) Management division, including providing analytical support for monitoring performance to Managed Care teams while serving as the official approver of standard Medical Management Performance Guarantee metrics.

  Expertly managed Medical Management satisfaction survey data housing and reporting, including facilitating database design, design and development of monthly tracking reports, certifications quality metrics, and PG reporting.

  Collaborated with Audit Services, Medical Management, Marketing / Sales, Operational Reporting, and Client Reporting leadership to attain objectives, and managed hired resources for critical project development and implementation.

 

  Delivered multiple comprehensive presentations to leadership on performance objectives.

  Improved metric accuracy by reviewing existing metric methodology and making enhancements.

  Developed metric criteria for new standard metrics on Medical Management products (i.e. MHA, Elite).

  Served as business lead on Performance Guarantee Monitoring / Tracking (PGMT) application and database project development tasked with defining requirements, designing scheme, and vision of design and functionality.

 

Yyyyyy x. yyyyyy Page Two (xxx-xxx-xxxx

 

Blue Cross Blue Shield of Xxxxxx, Richardson, XXXXXX (continued) 2001 Present

 

Senior Health Analytics Consultant (2008 2013)

  Utilized broad scope of industry knowledge toward serving as lead on metric logic realignment for client performance guarantees while directing a 9-member team in developing standard claims definitions of behavioral health data metrics and continuing to provide consultations on metrics as necessary throughout companywide areas.

  • Efficiently verified performance results of all HCSC wellness and care management programs through comprehensive evaluation of analysis and ad hoc reporting, and applied best management strategies in analyzing claims, care management, and behavioral health data projects, including data and trend analysis recommendations and key insight.

  Produced and performed data analysis on propensity of consumer lifestyles using PULSE, and Claritas PRIZM, and Market Scan data, with data utilized to identify and target populations for engagement and improve performance.

 

  Directed a team of 4 professionals in completing a data mapping project.

  Served as Interim Supervisor for 3 remote employees within a 6-month period.

  Expertly determined trends to generate analysis with critical recommendations.

  Expertly analyzed results of HEDIS metrics routinely for behavioral health business.

  Performed as Co-Chair of Staff Satisfaction Committee (Blue Pulse) within the division.

  Developed and designed process plans and flowcharts used to support top-notch projects.

  Successfully oversaw development of divisional website project and supervised 6 team members.

 

Senior Training & Communications Specialist (2004 -2008)

  Contributed sharp analytical abilities toward administering report training courses to broker / consultant community or clients / accounts and marketing representatives, including building and sustaining mutually beneficial communications between internal departments, clients, and brokers for training, demos, and on-site visits.

  Designed and delivered results-generating presentations and performed demonstrations to clients and executive-level staff on advanced reporting technology for sales proposals, along with administering training and strategic processes.

  Strategically steered evaluation of students proficiency through assessment tests, designed instructional methodologies, facilitated instructional evaluations, and developed training curriculum and communication methods.

 

  Personally assigned multi-user security on web-based reporting application.

  Successfully identified materials and necessities for training through surveys.

  Cost-effectively managed and allocated high-volume budget for training efforts.

  Recognized for job performance excellence with rapid improvement to specialist role.

  Optimized use of resources to achieve goals by planning and prioritizing team-based duties.

 

Client Analytics Consultant III (2001 2004)

  Expertly monitored trends and analytics of clients reporting portfolio by counseling brokers, clients, and executives, including documenting summary of data analysis, interpreting results, and evaluating standard statistical methods.

  Participated in marketing / sales executive and client / broker meetings to deliver comprehensive reports of clients performance, and further coordinated and presented clients benefit utilization summary per critical objectives.

 

  Successfully wrote and tested data modeling rules and led testing for data integrity.

  Proactively supported marketing executives and communications in developing ad-hoc reports.

  Served as the go-to primary trainer for online reporting application for internal marketing staff and clients.

 

Additional multiple Mathematics & Computer Science Teaching and professional Instructional Technology Specialist roles held prior to 2001 for Xxxxxx and Carrollton, XXXXXX employers; comprehensive experience details provided upon request.

 

Education, Professional Development & Technical Summary

 

Bachelor of Science in Mathematics Education (Honors Graduate) Grambling State University

Graduate-Level Economics Studies Xxxxxx Baptist University

 

Training Certifications Instructor / Facilitator Instructional Designer / Developer

Teaching Certifications Mathematics Computer Science Computer Literacy

 

Microsoft Office Suite (Word, Excel, PowerPoint, Access Advanced Levels) Visio Microsoft FrontPage TeamSite

SQL Management Studio SQL Server Teradata SSRS Business Objects Cognos Advantage Suite Adobe Captive

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