Experience

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  MetroPlus Health Plan

  • Research Analyst

    • Sep 2011 - Present

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  AETNA HEATHCARE

  • Actuarial Consultant

    • Jun 2003 - Feb 2011

    Involved with middle market group insurance pricing. Prepared rate filings for the Kansas City and St. Louis markets to make sure to stay incompliance. Prepared and analyzed a monthly report to demonstrate the Actual Claim report and the Reserve allocation in the region markets. This report showed a comparison of the plan versus actual performance in the region by market and segments. Contributed to a reduction in medical cost ratio as a result of thorough analysis of the High Claim Database and Report. This report increased the accuracy of the reserve setting. Selected to perform ad hoc analyses of high claims that lead to reduced expense to the company. Participated in trend and forecasting analyses on quarterly bases. Participated in varied analytical studies that provided in-depth analysis for the Leadership Team.

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  CIGNA Healthcare

  • HEALTHCARE Consultant

    • Sep 1999 - Jun 2003

    Held a key role in the development of a Disease Management Database (Well Aware Program) that revealed the cost benefit analysis of the program. Assisted in the creation, development, build up, strategy and specifications necessary for an accurate assessment of the Disease Management Program. Assisted in developing business specifications for the Medical Cost Forecasting model.Helped in the design, test, and maintenance of the Medical Information and Decision Support Unit database, which is the data source for trend analysis, forecasting, and ad hoc report.

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  OXFORD HEALTH PLAN

  • Actuarial Associate

    • Oct 1995 - Sep 1999

    Prepared rate filings for the New York market commercial products.Analyzed hospital and physician contracts to measure impact on medical cost.Analyzed rating impact of demographics, area, and trend to set pricing action initiatives.Worked closely with Legal and Underwriting departments to ensure compliance with Department of Insurance regulations and policies.Developed, maintained, and updated rate models for the Underwriting Department.

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  POMEGRANATE INCORPORATED

  • Co-Owner

    • Oct 1991 - Jan 1995

    Started a small successful business. Hired and managed eight employees. Oversaw all of the finances