Deirdre Dooley
Data Analyst II at Buckeye Health Plan- Claim this Profile
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Bio
Dustin Matthew Burt „Dee is bright, creative, and remarkably hardworking. She often had an out-of-the-box solution to greatly improve work that was handed off to her. Dee also created a database that automated a remarkably complicated process--we still use this database to this day.
Dustin Matthew Burt „Dee is bright, creative, and remarkably hardworking. She often had an out-of-the-box solution to greatly improve work that was handed off to her. Dee also created a database that automated a remarkably complicated process--we still use this database to this day.
Dustin Matthew Burt „Dee is bright, creative, and remarkably hardworking. She often had an out-of-the-box solution to greatly improve work that was handed off to her. Dee also created a database that automated a remarkably complicated process--we still use this database to this day.
Dustin Matthew Burt „Dee is bright, creative, and remarkably hardworking. She often had an out-of-the-box solution to greatly improve work that was handed off to her. Dee also created a database that automated a remarkably complicated process--we still use this database to this day.
Experience
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Buckeye Health Plan
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United States
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Hospitals and Health Care
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100 - 200 Employee
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Data Analyst II
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Mai 2020 - –Heute
Responsible for meeting analytical data needs, handling complex data requests, operational reporting and automation for Provider Data Management. Current tools are SSMS, SSIS, Visual Studio w/ SSDT, Access and Excel. Responsible for meeting analytical data needs, handling complex data requests, operational reporting and automation for Provider Data Management. Current tools are SSMS, SSIS, Visual Studio w/ SSDT, Access and Excel.
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OPERS
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United States
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Government Administration
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300 - 400 Employee
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Health Care Data Analyst
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Jan. 2014 - Nov. 2019
Responsible for the oversight of the OPERS health care data warehouse and the development, implementation, and operation of a reporting structure that identifies, measures, and impacts the drivers of health care quality and cost. Also responsible for developing and managing the business functions associated with the Health Care eligibility processes between OPERS IT, OPERS’ Health Care vendors and the Data Warehouse. OPERS provides healthcare for Ohio Public Employee retirees, survivors and family members. Weniger anzeigen
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Lead Medical Data Analyst
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Apr. 2010 - Jan. 2014
Provide analytical support to Physician Hospital Organization maintaining quality improvement initiatives and pay for performance programs. Play an integral role in implementation of a Patient Registry purchased from a third party vendor, serving as the hub of the PHO’s clinical integration strategy; assessing business needs, data sources and configuration requirements. Also provided critical support for NCQA recognition efforts for Patient Centered Medical Home and Diabetes Recognition Program. Extensive use of MS Access to build custom databases to support pay for performance programs as well as to perform financial analyses to ensure that physicians are rewarded according to program design. Use of multiple data warehouses to extract claims data for analysis using SQL based query tools. Weniger anzeigen
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Medical Mgt Analyst|Business Analyst II
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März 2007 - Apr. 2010
Provide analytical support to Finance and Medical Management to develop focused management reports and trend information to improve medical management across the Plan and provide interface between end users and data resources. Develop and manage projects designed to improve effectiveness and efficiency of medical management processes using database and data analysis software. Extensive use of MS Access to query the Operational Data Store (ODS) and Enterprise Data Warehouse (EDW) to extract claims data for tracking, trending and analysis. Weniger anzeigen
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Sales Associate
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Jan. 2007 - März 2007
Part of the Voyager Software Suite sales team making contact with health plans and HMO’s that manage Medicare Advantage programs. The software deals with Risk-Adjusted Reimbursement methodologies and Medicare Part D. Requires a working knowledge of Medicare and Managed Care principles as well as technical knowledge regarding data analysis and reporting. This position also requires excellent communication skills and organizational skills. Part of the Voyager Software Suite sales team making contact with health plans and HMO’s that manage Medicare Advantage programs. The software deals with Risk-Adjusted Reimbursement methodologies and Medicare Part D. Requires a working knowledge of Medicare and Managed Care principles as well as technical knowledge regarding data analysis and reporting. This position also requires excellent communication skills and organizational skills.
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Business Systems Analyst
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Juli 2006 - Nov. 2006
MetaVance Implementation Team: Configuration of an integrated claims administration suite focusing on Provider (team lead), Pricing and Benefits. Interpreted in the business requirements as described in the client’s explanation of coverage documents and provider contracts and translated them into the technical requirements of the claims administration system to adjudicate claims according to those specifications. MetaVance Implementation Team: Configuration of an integrated claims administration suite focusing on Provider (team lead), Pricing and Benefits. Interpreted in the business requirements as described in the client’s explanation of coverage documents and provider contracts and translated them into the technical requirements of the claims administration system to adjudicate claims according to those specifications.
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Health Care Cost Specialist II
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März 2002 - Juli 2006
Applied managed care principles to medical bills for third party liability claims to maximize benefits for injured claimants for auto insurance and workers’ compensation. Evaluated medical bills against reasonable and customary standards or PPO contracts using CPT procedure codes and ICD-9 diagnosis codes. Performed key leadership roles as part of new software release Test Team, the Audit Team Pilot Program and the Key From Image implementation team. Contributed to the training manual and training new users. Weniger anzeigen
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Site Supervisor
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Okt. 2001 - Jan. 2002
Supervised correspondence service for Medical Information Management Department at The Ohio State University Medical Center. Ensured timely completion of requests for release of medical information in compliance with the state and federal laws and policies and internal procedures using comprehensive knowledge of regulatory requirements for Release of PHI. Directly supervised six employees. Management Clinical Affiliation – Medicaid Managed Care Plans, Ohio Dept. of Job & Family Svcs (4 - 5/2001) Compiled data for Federal Medicaid Regulation Compliance Review on ICD-9 and CPT codes related to sterilization, abortion and hysterectomy; designed project-planning document for meetings on Medicaid; compiled information for Health Plan Case Management Incentive Project including ICD-9 diagnosis codes for children with special healthcare needs; developed a spreadsheet for contrasting Ohio Health Department hospital data with data from participating managed care plans. Internship. Management Clinical Affiliation – Provider Information Management United Health Care (3 - 4/2001) Updated provider databases; conducted employee satisfaction surveys using a self-designed instrument; developed productivity standards; performed a study on telephone-usage abuses. Internship. Clinical Affiliation – JamesCare for Life MusicCare Project Weniger anzeigen
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Education
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1998 - 2001
The Ohio State University
Bachelor of Science, Health Information Management and Systems
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