Rutgers University Edward J. Bloustein School of Planning and Public Policy

Analyst - Value Based Initiatives

Responsibilities include:

● Collaborate with Quality Performance Improvement (QPI) stakeholders to analyze and report on key metrics for
NCQA's HEDIS, STARS-QRS, Quality Improvement, and NCQA Accreditation initiatives.
● Leverage Kubernetes scripting to manage and optimize code bases, enhancing technical operational efficiency.
● Oversee allocation of resources within the Clinical Analytics team, ensuring alignment with organizational priorities.
● Distill complex data into actionable insights accessible to non-technical stakeholders by employing compelling
storytelling techniques, thorough packaging, and dynamic presentation of findings.

Oscar Health

Analytics Associate, Clinical Analytics (HEDIS-STARS-QI)

Responsibilities included:

-	Liaising with organizational stakeholders for analytics and reporting on behalf of the Value Capture Analytics team around NCQA’s HEDIS programing
	
-	Building, refining, and tracking workflows to meet CMS submissions deadlines
	
-	Collecting and analyzing data to implement and monitor quality improvement initiatives to achieve positive CMS STAR outcomes
	
-	Supporting the development of strategies and collaborate with leadership using quantitative and qualitative data analytics to drive quality performance
	
-	Designing and operationalizing member engagement campaigns and monitoring their success
	
-	Establishing relationships with internal and external stakeholders to foster an increased understanding of the HEDIS process
	
-	Optimizing member health by increasing penetration of evidence-based preventative and chronic care measures by identifying quality care gaps and barriers

-       Reviewing and Refactoring standardized SQL algorithms for 3rd Party Vendor quality data submissions

HEDIS Analyst

Responsibilities included:

-	Working collaboratively with Contract Management to optimize VBP contract negotiations.

-	Recommending reporting enhancements based on VBP partner feedback and needs identified through existing reporting tools such as the 3M Health Information Systems Dashboard, internal Greenplum SQL databases, MicroStrategy, and PowerBI resources.

-	Serving as a liaison between IT and external vendors to effectively maintain alignment with overall Value Based Payment business strategies and amend technical issues

-	Supporting the execution of the business objectives to drive successful VBP relationships

-	Assisting in building and maintaining relationships with key individuals at assigned DSRIP PPS organizations and their underlying contracting entities.

Centene Corporation

Analyst - Value Based Initiatives - Fidelis Care

Responsibilities included:
- Developing ad-hoc reporting to conduct data analysis and validation

- Maintaining dashboard resources to monitor CMS HCC Risk Adjustment Program progression through AccuReports Risk Reporting. 

- Tracking Salesforce to monitor Rep-Provider interaction between the Provider Relations department.

- Implementing a Termed IPA Membership Reassignment Process to supplement the Network Tailoring Plan

- Evaluating the financial impact of Value Based Contracting requirements with key physician group partners.

- Collaborating with IPA management to standardize membership report specifications through IBM Cognos Analytics Reporting

- Consolidating and synthesizing reporting from Tableau sites and SAS databases for deck presentations with an emphasis on HEDIS and NCQA quality metrics.

- Leading corporate involvement with the Albany County Connections Project, including working group attendance and facilitating data submissions through the NYDOH Health Commerce System

- Working with key stakeholders to develop health analytic strategies towards provider group engagement
- Validating internal capitation models for Patient Centered Medical Home, Care Administration Fee, and PCP Assignment payments

Provider Relations Business Analyst - WellCare Health Plans of NY

Responsibilities include:
-Collaborating with the Data Analytics team to support and present strategy deck reporting for IPA and PR Representatives.  
-Participating in Data Cleansing initiatives within the Ancillary market to ensure a more efficient adequate network.

Provider Relations Intern - WellCare Health Plans of NY

Tasked with increasing patient flow within the Emergency Department, using LEAN techniques and other process improvement methods, under the supervision of the Vice President of Special Operations.

Responsibilities included:
-	Observing both patient and clinician workflows to collect baseline data.
-	Mapping work processes preformed in the Emergency Room using LEAN methodologies.
-	Identifying areas of improvement and potential future projects relating to increasing patient satisfaction.
-	 Creating an Emergency Department Dashboard in Excel for AllScript KPIs

Trinitas Regional Medical Center

Student Intern

Responsibilities included: 
-Reformatting graphs for executive presentations
-Processing clinical provider terminations and amendments
-Corresponding with Health Home representatives with daily updated member rosters
-Composing and coordinating monthly mailings to assigned Health Home members
-Documenting and charting the department's processes and workflows for its Business Continuity Plan
-Updating the Monthly HEDIS Measure Dashboard

MetroPlus Health Plan

Student Intern- Behavioral Health/HARP

Responsibilities included: 
- Assigning members to Health Homes through the Medicaid Analytics Performance Portal 
- Creating membership status reports
- Corresponding with potential candidates for a department vacancy
- Generating demographic summaries for the duplicate claims database

Responsible for: 
- Turning daily member utilization census data format into charts for analysis 
- Creating individualized worksheets for each contracted service provider.

Jonathan Dubin, MHA