Experience

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  Maryland Health Services Cost Review Commission (HSCRC)

  • United States
  • Government Administration
  • 1 - 100 Employee

  • Chief of Revenue and Compliance

    • Nov 2022 - Present

    Setting rate for Maryland hospitals using the Global Budget Revenue system and applying and implementing rate setting methodologies into the rate setting processDesign rate adjustment models and assist in the development of rate setting automation toolsMonitor the charging practices of all hospitals and ensure hospitals are in compliance with HSCRC regulations Supporting and reviewing the calculations of the annual updates to hospital global budgets, as well as unit rates and rate corridorsAssisting in the review and evaluation of Commission initiated or hospital submitted rate reviewsAssist in training analysts and answer technical questionsPerform analysis on Total Cost of Care data and provide updates to stakeholders on Model performance

  • Rates Analyst II

    • Jun 2015 - Apr 2023

    Implentation of HSCRC Global Budget Revenue (GBR) and Total Patient Revenue (TPR) rate setting methodologies for hospitals.•Evaluation and analysis of monthly unit rate and revenue target compliance; development and implementation of technical changes and modifications to the GBR and TPR to incorporate Commission approved policy changes•The review and analysis of partial rate applications; and assist in performing the review of Full Rate Applications filed with, or initiated by, the Commission.•Develop recommendations for HSCRC on the structure of payment models which include: Balance Updates, Guardrails for Model Performance, Market Share and Initial and Future Models

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  Group Benefit Services

  • Hunt Valley, Maryland

  • Self-Funded Underwriter

    • May 2014 - Aug 2014
    • Hunt Valley, Maryland

    • Calculates standard and non-standard renewal and prospective employer group rates in accordance with regional rating rules and federal and state regulations. Consult and work with the state insurance laws and regulations and/or legislation.• Develop and maintain relationships with brokers. Assi...

• 

  CareFirst BlueCross BlueShield

  • Owings Mills, Maryland

  • Underwriter

    • 2011 - May 2014
    • Owings Mills, Maryland

    • Calculates standard and non-standard renewal and prospective employer group rates in accordance with regional rating rules and federal and state regulations. Consult and work with the state insurance laws and regulations and/or legislation.• Gathers and examines appropriate documentation and da...