Assists the Manager in analyzing and validating managed care claims and comp grids against provider contracts, member eligibility, benefit grids, and authorization data to ensure VNSNY CHOICE pays our Providers appropriately and VNSNY CHOICE contains cost.
June 23, 2022
Tests the integrity of utilization and payment data across plans and functions.
December 27, 2022
Design and develop data queries through SAS and other tools to create models for analyzing business opportunities and interpreting key drivers of health care trends .
January 24, 2023
Attends meetings with analytics teams, product teams, operations, and allied departments to communicate status of investigative projects and identify new areas of opportunity or priorities.
February 14, 2023
Create summarized reports for leadership.
February 15, 2023
Serves as a key resource to finance teams by providing data / analytical support, mentoring, guidance and technical expertise.
February 24, 2023
Provide additional analyses that support New Sales and Product Development by being able to manipulate and analyze claims data to perform IBNR calculations, Provider Network Overlap, Fee Schedule Pricing, trend mitigation and population mix-shifts.
March 30, 2023
