Experience

DataGration Consulting & Associates Incorporated

• United States
• Information Technology & Services
• 1 - 100 Employee

• Founder & CEO

  • Jan 2020 - Present

  Here at DataGration Consulting Group we believe that: Data + Integration = Business Insights Our leadership team is headed by Founder and CEO, Gary A. Preston. With over 15 years of analytical experience within many different industries. From creating, developing, and leading analytic divisions for Multi-Billion-dollar companies, to enterprising start up ventures. We understand your needs. With a sharp prowess for creative solutions both operationally and analytically, we are destined to achieve success. Show less



Advantasure

• United States
• IT Services and IT Consulting
• 400 - 500 Employee

• Manager, Analytics

  • Jan 2017 - Jan 2020

  Established KPI reporting and dashboards to be used by upper management. Manage resources to ensure client standard deliverables as well as ADHOC requests are completed timely. Create targeting analysis of all incoming client prospects, by using geographical/membership data provided by the clients or public CMS provided data. Develop value proposition model of projected revenue stemming from Medicare Risk adjustment products. Executing value case study analytics for existing product profitability, efficiency, and effectiveness within the market. Generating client performance presentations for existing clients using CMS Risk Score Methodologies and models, to display program benefits and client ROI. Create enterprise wide valuation-based methodology for Advantasure Medicare Risk Adjustment Product portfolio. Show less



Data Driven Delivery Systems

• Director, Reporting and Analytics Eastern Region

  • Aug 2014 - Dec 2016

  Built internal reporting and analytical division infrastructure from staffing/hiring through the recommendation and procurement of all software, and business intelligence (BI) tools needed. Delivered and developed client performance presentations based on program results to external stakeholders and business partners. Provided COO with analytical support to ensure business continuity and insightful decision making. Developed methodologies, dashboards, and models for current valuations and revenue projections for all clients using Medicare risk adjustment methodologies. Delivered timely and accurate monthly, quarterly, and annual management reports for Board of Directors and all senior staff. Responsible for client implementation, monthly deliverables, and day to day interactions/relations. Led and facilitated a cross divisional workgroup with IT and operations units to ensure requirements are met for all systemic enhancements. Supported senior staff in developing potential business opportunities, process improvements, and product offerings based on research and industry trends. Show less



Healthfirst

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Healthcare Analyst, Finance Analysis

  • Feb 2012 - Aug 2014

  • Monitor and develop internal processes to implement and transition from current Medicare RAPS process to the future state, CMS Encounter Data Submission System, while ensuring compliance with all CMS guidelines. • Conduct Monthly analysis of RAPS submissions files to measure success of Third-Party vendors as well as ROI of services provided. • Conduct parallel analysis of Medicare recipients’ risk scores using RAPS systems versus EDS system to ensure consistency. • Manage the relationship between Third Party vendors, contracted to conduct chart review analysis for Medicare Risk adjustment. • Enhance internal encounter submission policies and procedures to optimize system performance in order to implement latest CMS regulations and HIPAA data compliance Show less



Horizon Blue Cross Blue Shield of New Jersey

• United States
• Insurance
• 700 & Above Employee

• Business Analyst III

  • May 2011 - Feb 2012

  •Responsible for conducting research and analysis for stakeholders with the goal of recommending and implementing a new enrollment/claims platform. •Developed forecasting tools using current technology/systems to translate business requirements and assist IT with the development of technical specifications. •Led and participated in internal and external project workgroup(s) and presentations.•Recommend solutions based on data analysis to increase business efficiency and improve existing processes. Show less

• Business Analyst I

  • Oct 2010 - May 2011

  •Created ad hoc reports using SQL queries and complex databases to support the needs of stakeholders and departmental heads.•Analyzed divisional workflows and processes to ensure departmental efficiencies while also identifying points of improvement, and potential opportunities for automation through robot technology.•Analyzed, Trended, and Forecasted complex data sets in order to achieve optimization of internal/external resources.•Delegated, Trained, and Managed temporary staff in order to achieve Enterprise Data Integrity Initiatives.Prepared a suite of monthly reports for the use in decision making processes by senior management Show less

• Business Analyst I

  • Jun 2008 - Oct 2010

  •Analyzed and performed root cause analysis on the error trends identified from focus audits.•Performed analysis necessary to document system problems and recommended viable solutions through the creation of Business Requirement Documents (BRD).•Assisted with the implementation and creation of an internal reconciliation process which produced a 99.7% first pass success rate.•Identified and interpreted regulatory standards set by CMS to ensure Part-D Compliance.