Business Analytics

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Position
Business Analytics
Location Confidential
No
Location
Southeast USA
Willing to Relocate
Yes
Industry
Financial-Insurance
Function
TECHNOLOGY(IT/EDP/MIS/Communications)
Compensation
$150,000 to $300,000

Resume Summary
Data Scientist with strong analytic, client relationship and business strategy skills. Increased return on investment and quality at several organizations. Masters degrees in Decision Sciences (Analytics & Data Science) and Finance.

Resume Body      BUSINESS ANALYTICS

xG HEALTH SOLUTIONS
Director Healthcare Analytics, 2013 to 2014
Spun off this for-profit company from Geisinger Health Plan to take our clinical and analytical initiatives nationwide based on our success with employers, providers, and ACOs.

" Identified health care savings opportunities for a large employer and implemented strategic clinical initiatives that reduced admissions by 35%, readmissions by 40%, ED visits by 5%, High Tech Radiology by ~30%; Reduction of Inpatient utilization saved $34 PMPM = $4.8 million annually; Identified and referred average of 140 patients per month to Care Management
" Launched a MSSP Accountable Care Organization; Identified over $1 million in initial savings opportunities; established patient centered medical home sites; supported Population Health Management initiatives with analytical and clinical reporting
" Served on executive committee for largest convener group in the CMMI Bundled Payments for Care Improvement Initiative; co-created an innovative gain share model

GEISINGER HEALTH PLAN
Director Accountable Care Organizations & Business Opportunities, 2011 to 2013
Expanded this innovation health care organization into three new territories and added ~40,000 commercial members. Results from our clinical and analytical initiatives were so successful that we created the new company, xG Health Solutions, to take our initiatives nationwide.

" Identified health care savings opportunities for a large employer and surpassed target with a savings of $500,000 in the first year; Reduced admissions by 15%, readmissions by 50%, ED visits by 25%, High Tech Radiology by 12%
" Supported innovative Population Health Management initiatives such as patient-centered medical homes which increased patient contact and closed gaps in care
" Launched and supported a Pioneer Accountable Care Organization with ~14,000 beneficiaries which became one of the top performing Pioneer ACOs in the first performance year

ALERE
Vice President Health Intelligence, 2006 to 2009
Recruited to Matria Healthcare (~$370 million in revenue) by the CEO to interface with clients on complex analytical issues, preserve revenue and integrate accounts from a large acquisition. Matria was acquired by Alere for approximately $1 billion.
" Led a team of actuaries to evaluate the economic, behavioral, and clinical quality impact of population health and disease management programs
" Managed financial risk in client contracts

IPSOS LOYALTY
Director, 2005 to 2006
" Led marketing research and customer loyalty projects for international clients
" Turned around a key international account by developing an interactive website reporting real-time market research results, within a few days and on budget. The client was so pleased that the account went from facing peril to being a reference to future clients.
AETNA
Economics Manager, 1999 to 2004
Designed and implemented strategic initiatives for the Southeast Region (approx. $5.2 billion revenue in 2004) of this Fortune 100 company. Several of my initiatives were recognized as best practices and adopted company-wide. Promoted several times.

The net result was an increase in profit margin by 18% between 2000 and 2002.
Exceeded profit margin targets by 4% in 2003 and by 6% in 2004.

Developed an innovative profiling model to measure physicians performance based upon the severity adjusted efficiency, quality, and cost of care. This revolutionized relationships with physicians by enabling the company to implement pay-for-performance contracts. Physicians were motivated to increase quality. Worked in a matrix environment across all departments to implement the project.

CAREDATA.COM
Product Manager, 1997 to 1998
Joined this fifteen year old health care information company as they went public and began acquisitions of young growth companies. This fast paced environment required managing expectations of both customers and shareholders on a daily basis. The products focused on predictive models of health care utilization, cost and quality.
" Launched a state-of-the-art software product without funding
" Generated new business leads and assisted sales teams in closing deals
" Led product development and created marketing tools

COOPERS & LYBRAND LLP
Consultant, 1992 to 1997
Built a management consulting practice focusing on the health care industry.
" Reduced annual health care expenses by 15% for a Fortune 100 company
" Recommended improvements to quality measures, including HEDIS
" Guest speaker at conferences on physician network accessibility
" Highest productivity in department for five consecutive years

EDUCATION
" Master of Science in Decision Sciences, Georgia State University, 2003
" Master of Science in Finance, Georgia State University, 2001
" Bachelor of Arts in Mathematics, West Virginia University
" 110 Credits, Society of Actuaries

TECHNICAL SKILLS
SAS, SQL, Python, SAP Crystal Reports, @Risk. Multivariate statistics, predictive modeling, risk analysis, regression, time series, optimization, segmentation, Agile project management.

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