University of Arizona

Western University of Health Sciences

Arizona State University

Boston University

Senior Manager at Blue Shield of California

Costa Mesa, California, United States

After seven months as a clinical program manager consultant, promoted to Senior Manager of the Healthcare Value Solutions and Cost of Healthcare Governance Team. The Healthcare Value Solutions team is responsible for identifying and evaluating initiatives that will help to improve the quality and affordability of care. The team researches various ideas that may come from either within the team or from other departments within the company to help determine the value in terms of healthcare cost and quality. The Cost of Healthcare Governance team is responsible for creating, maintaining, and enhancing the process that is used to by the entire company to implement cost of healthcare initiatives. The team maintains a tool and dashboard to monitor the progress of initiatives, and coordinates with various departments within the company to ensure that the progression of each initiative is smooth and efficient.

Blue Shield of California

Senior Manager

Analyzed clinical data, evaluated clinical evidence and industry program trends to develop business cases for programs that enhance member care, quality, and improve company’s stewardship of each member’s dollar. Successfully implemented and monitored initiatives, such as the urine drug and vitamin D testing medical policy. Supported more than $350 million in cost of healthcare targets for the department by researching industry sources such as Centers for Medicare and Medicaid Services (CMS) and Agency for Healthcare Research and Quality (AHRQ) and partnering with data analytics teams to identify outlier data trends of services and providers, synthesizing information into program opportunities, and designing programs with clinical and operational leaders.

Clinical Program Manager Consultant

Provide in-depth analytical support to the Quality Improvement Department through analyzing various measures and presenting and formatting critical information for senior management decision making. Work collaboratively with many departments to develop and produce reports in Statistical Analysis System (SAS) and Structured Query Language (SQL) that monitor Healthcare Effectiveness Data and Information Set (HEDIS), hospital and other clinical quality measures against quality benchmarks and performance indicators. Assess reports for adverse trends and assist quality improvement clinical program managers in program design, implementation, and evaluation. Enhance and redesign processes to automate various reports for the clinical program managers, present components of report and provide technical assistance to key stakeholders, and direct SAS contractors in determining how to automate the reporting processes.

Health Care Data Analysis Consultant/Lead

Managed interns participating in a summer internship at the company. Designed the internship program to facilitate the learning of analytical skills and SAS programming. Used SAS to analyze the Healthcare Effectiveness Data and Information Set (HEDIS) measures and synthesized results in written reports and presentations for the states of California, Georgia, Hawaii, Illinois, and Virginia. Evaluated health data in California to program maps of areas with disparities to help determine areas as targets for intervention. Wrote and designed methodologies for analyzing various types of data, and creating different deliverables, such as reports and presentations.

Health Services Advisory Group

Healthcare Data Analyst/Project Manager

Responsible for supervising visits between children, who are victims of divorce and separation, and their parents. The children have often been exposed to drugs/alcohol, domestic violence, child abuse situations, or fear of abduction. Observed, monitored, and wrote summaries regarding parent/child interactions each week. Wrote conclusion reports to send to the courts for each case.

F.A.C.E.S

Volunteer

Analyzed trends in the managed long-term health care sector to create profiles of health plans for marketing purposes. Designed marketing tools, such as PowerPoint presentations, brochures and call scripts, to utilize when contacting health plans for marketing healthcare software. Analyzed healthcare software to assess for potential changes, redesigns, and additions. Developed focus group questions for healthcare providers, patients, and health plan staff to determine needs and desires. Served as main liaison between health care plans and the company to facilitate business relationships.

Cyrus XP

Healthcare Analyst

Analyzed the Healthcare Effectiveness Data and Information Set (HEDIS) measures and produced results for the state of Arkansas. Conducted reviews of Medicare-Medicaid health plan readiness for compliance to specific State-Specific Readiness Review Plans in the forms of desk reviews, site visits, and remote systems testing. Functional areas of assessment included confidentiality, enrollee protections, enrollee and provider communications, financial soundness, monitoring of first-tier downstream and related entities, organizational structure and staffing, performance and quality improvement, provider credentialing, utilization management, assessment, care coordination, provider network, systems, and enrollment.

Healthcare Data Analyst

Screened and enrolled eligible adolescent Latina girls into GirlSmart, a project designed to teach young women about various health topics including nutrition, exercise, and safe sexual practices. Designed databases to collect and track patients seen in the Teen Pregnancy Clinic. Assisted in registering the participants on the website, and maintaining contact to ensure participation and completion of all modules. Analyzed results and summarized findings to publish in articles to be submitted to various health journals.

Research Coordinator

Teach young players the basics of the sport of badminton. Serve as a role model in terms of sportsmanship.

Arizona Badminton Center

Badminton Coach

Conducted preliminary research with patients and their parents in using an electronic kiosk system to self-triage in the pediatric emergency department by enrolling, videotaping, and analyzing the dyads. Enrolled more than 400 patients who were randomized to control or kiosk groups, approaching patients using English or Spanish. Obtained consent, determined discrepancies between self-triage with the kiosk, standard triage, and reported data, conducted satisfaction surveys, collected and analyzed all data. Summarized study protocol and design in abstract that was submitted to the Pediatric Academic Societies. Compiled study data, analyzed, and composed findings in a manuscript that was submitted to, and published in, Pediatric Emergency Care.

Maricopa Medical Center

Study Coordinator

Monitored real-time emergency department data to screen, interview, and enroll participants in septic shock, myocardial infarction, MRSA, suicide, traumatic brain injury, and COPD studies. Worked with suicidal patients to educate them on available resources and possible treatment plans. Conceptualized and designed public health educational opportunities and clinical interventions for patients facing major hardships such as lack of health insurance and complex socioeconomic situations. Analyzed, reviewed, and summarized various data for hospital studies, including intravascular changes and optical nerves. Provided statistical support for studies conducted in the emergency department of the hospital. Through identifying symptoms, diagnoses, and characteristics associated with these conditions, ascertained clinical knowledge and increased desire to work more closely with patients. Assisted in abscess incision and drainage procedures, treated infected wounds, assessed cellulitis, and prepared blood work and cultures for lab testing.

Planned and led Organic Chemistry student review sessions to address difficult concepts from class lectures, homework, and exams. Through learning to listen and clarify student concerns, gained understanding of distinct learning methods and individualized teaching methods accordingly. Applied subject knowledge to develop creative solutions and gain confidence in knowledge of subject. Evaluated the effectiveness of sessions through the implementation and interpretation of student surveys.

Arizona State University West

Supplemental Instruction Leader

Mentored and tutored foster children in this organization that facilitates opportunities to help alleviate emotional hardships and improve lives through various programs. Planned educational and recreational activities. Guided and encouraged children through difficult emotional problems to provide consistency and positive experiences. Collaborated with group home staff to discuss best methods for counseling the kids and determine appropriate activities. Prepared weekly math lessons, met with tutees to explain concepts, assigned and graded daily homework, and steered tutees through problem areas to reach grade-appropriate standards.

Provided a safe haven for pediatric patients to escape from their pain, illnesses, and treatments through playing games, doing crafts, and reading books. Tended to children to allow parents and families the opportunity to take a break. Exhibited great deal of caution with patient information to reinforce importance of confidentiality. Received and renewed CPR training and certification to escort patients throughout hospital.

Evaluated various components of state health department quality strategies, including health plan performance measures and data quality measures. Performed validation of performance improvement projects and wrote reports to help inform health plans of ways to provide quality health care to Medicaid patients. Conducted technical assistance with health plans for any questions and/or concerns regarding statistical testing and/or performance improvement project validations. Performed statistical tests and analyses to assess health plan network adequacy and nursing home rates.

Formulated research questions and analyzed statistical data on various chronic diseases, their indicators and risk and protective factors using Statistical Analysis Software (SAS). Identified population-based disease burden and risk factor surveillance trends and characteristics. Prepared and presented summary reports with analytical results, trends, impacts, and indications for prevention and control of obesity and other chronic diseases for a variety of audiences, including health professionals, legislators, and the general public. Established documentation procedures for all analyses and written reports. Used Geographic Information Systems (GIS) to illustrate various correlations and relationships between data. Linked analytical surveillance data to program evaluation measures. Conducted program evaluation activities in collaboration with program surveillance and management staff and community partners. Developed evaluation tools on selected interventions. Collected and analyzed data to determine if interventions have achieved stated objectives. Assisted in writing progress reports, grants and journal publications. Consulted and collaborated with program management, contracted evaluators and community partners.

Arizona Department of Health Services

Epidemiologist/Evaluator

Collected, organized, and reported data for a state osteoporosis directory using Microsoft Access and Word.

Big Sister, Big Sister Association of Greater Boston

Data Specialist

Administered surveys to teenagers for eligibility for alcohol and marijuana study. Conducted Brief Negotiated Interviews with patients about their substance use, and followed up with the patients afterward.

Community Youth Outreach Worker

Health Services Advisory Group, Inc. (HSAG)

Screened, interviewed, and enrolled patients in the emergency department who were qualified to participate in a health and safety study.

Research Assistant

Assisted in events with girls who have special attention and care needs.

Customized and designed a weight management program for adolescents and parents that included activities such as exercise sessions and nutrition classes. Planned and conducted a patient focus group to evaluate needs and perceptions, and utilized results to direct future activities. Formulated evaluation plans that included collection, organization, and analysis of data. Designed and instructed a nutrition class curriculum tailored to overweight adolescent girls of varying cultures. Oversaw a DVD advertising project intended to promote indoor physical activity for families. Developed Spanish and English BMI worksheets for patients and physicians to utilize in weight management counseling.

South End Community Health Center

Program Coordinator

Developed educational curriculum to train and teach local families on proper hygiene procedures, importance of clean food and water, and usage of mosquito nets. Engaged in clinical rotations with Spanish-speaking physicians in primary care clinics and general hospitals to compare the urban and rural healthcare systems of Ecuador. Aided in performing Cesarean sections without proper equipment and less than ideal hygienic practices. Examined children and families with complicated tropical diseases like Chagas and malaria, and formulated potential public health solutions.

Hospital Napoleon Davila Cordova

Clinical Assistant

Developed and implemented health education plans for various populations, including Spanish-speakers. Translated medical information for physicians and patients. Performed clinical tasks, including blood draws and urine samples.

Kai-Ning Khor

Kai-Ning Khor