Experience

Correctional Health Partners

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Manager, Business Operations

  • Jul 2018 - Present

  Supports Vice President of Business Operations in matters related to budgeting, financial and analytical reporting and analysis, * Manage proposal budget development, key indicator reporting, client contract reconciliations.* Develop operational reports, measures and performance metrics for other departments.* Assist with the identification and implementation of technology solutions company-wide.* Manage and maintain oversight of daily activities of the Client Decision Support department and provide staff development. Provide analytic support to all other departments. Show less

• Supervisor, Client Decision Support

  • Feb 2013 - Present

  * Supervised all aspects of reporting and analytics for Client Decision Support. Managing, training, mentoring and coordinating workload for department and staff.* Managed healthcare reporting, development and analytics for all service contracts.* Defined, analyzed and proposed reporting solutions based on the business needs to rework, enhance or develop additional components for reporting packages. * Developed standardized reporting tools/methods for clinical, case or administrative management, such as: ER frequent visits; Medicaid savings analysis; inpatient and outpatient surgery trends and distributions; RVU health risk trend.* Incorporated industry standard methods and tools into daily analyses and reporting, such as clinical classification, procedure grouping and use of RBRVS components for risk trending and assessment. * Analyzed and determined IBNR (incurred by not reported) reserves for each client on a monthly basis. Provided periodic forecasts for healthcare expenses to be used to set yearly budgets/allocations for state/local clients.* Presented standard reporting and associated analyses to clients monthly. Increased significantly, content, value and stakeholder satisfaction with standard reports, trend analyses, outcomes analysis and other analytics.* Presented standard and ad hoc reports and analyses to internal client work groups. Presented additionally at a national corrections conference [NCCHC].* Utilized a combination of BI tools--Excel, SQL, SSRS, Crystal Reports--to develop and manage reporting. Show less



Anheuser-Busch InBev

• Westlake Village, California

• Promotions Manager

  • Jul 2011 - Apr 2012

  • Successfully transition existing promotion plan at yearly price increase time. Reviewed existing and proposed discount arrangements. Analyzed EDLP versus Pulse strategies. Determined applicability of outliers in price pack curve. Analyzed appropriateness of vertical—brand segment-price relationships. • Managed project to analyze and implement high end (brand) quantity discount promotions in various states • Compiled ROI analyses of existing and proposed discounts to determine promotional efficiency within the 3-tiered distribution network—brewer, wholesaler, retailer. • Developed sales segmentation analysis for Las Vegas market to prepare for implementation of channel pricing; heavy use of IRI syndication data for elasticity and segmentation reporting • Analyzed detail forecast elements—allowance rate, investment volume rate, forecast volume—to enhance accuracy of promotional investment Show less



Extreme Networks

• Senior Pricing Analyst

  • May 2008 - Jul 2011

  • Implemented a data centric approach to pricing incorporating economic value assessment. Applied technique to determine significant tangible and intangible aspects of product pricing to identify appropriate premium or discount off competitive price for new product introductions. • Developed a contribution margin assessment model to identify true profitability of existing product lines. • Successfully priced significant new and innovative ethernet networking and wireless products and services. • Regularly engaged appropriate resources (e.g. product marketing, sales, operations and finance) to deliver best possible pricing solutions for new product introductions or to support existing customer purchases. • Gathered and disseminated competitive list and street pricing for all current products. Estimated competitive discounting to inform various constituent group—finance, sales operations and marketing. • Compiled detailed and accurate analysis of market sizing and segmentation based on syndicated data. • Periodically evaluated existing business metrics; benchmarking key stats such as discount and street price. • Gained operational efficiency by converting 30+ separate price lists into one tool and reducing the total applied lists to minimized human error. Transformed the published price list to a set format. • Consulted with Sales and IT staff to develop system requirements, use cases and testing scenarios to enhance pricing systems. • Managed manual and automated price loads and modifications to Oracle/Siebel Show less



Express Scripts

• Senior Business Analyst

  • Jan 2007 - Apr 2008

  • Supervised staff of two business analysts; managed day to day work load; developed performance management plans and tracking metrics; compiled and delivered periodic reviews. • Developed an incremental gross margin forecast model (VE or Value Enhancement) to facilitate management of provider contracting planning and programs development; worked with multi-disciplinary group to develop appropriate inputs and supporting analyses for the model. • Detail claims analyses related to network contracting and management; ad hoc activities supporting the claims audit function. • Analyses of AWP price change impact on overall book of business to support re-contracting of client and provider contracts • Analyzed impact of provider performance guarantees • Supported data warehouse development efforts through planning committee activities • Supported MAC pricing activities and linear programming inputs Show less



Kaiser Foundation Health Plan

• Pricing Specialist

  • Jul 2004 - Oct 2006

  • Medicare product strategy, benefit design, competitive bid development for A/B and Part-D. • Rate Setting: Analysis of price adequacy for KP existing and prospective healthcare products. Comparing target revenue requirements based on market conditions to projected costs, analyzing subsequent revenue gap and developing strategies and actions to close the gap. Includes trend analysis of external costs and actuarial analysis of benefit changes at a global level. • Reserve Analysis: Analysis of current reserves for the healthplan. Presentation of recommendations to internal finance and actuarial staff. • Budgeting: Facilitate the development of the healthplan budget with respect to membership projection, revenue projection and adequacy, expense development, etc. • Participated in the development of a revised national Rx fee schedule. Helped to develop strategic positioning and the resultant pricing formula. Show less



McKesson

• Program Pricing Manager

  • Jul 2001 - Jun 2004

  P&L responsibility on $100M/month. Set pricing for products in McKesson's premier generic pharmaceutical program to meet corporate performance goals and objectives. Lead pricing while program grew from 45M to 100M per month in 3 years. • Analyze product pricing and sell margin for the McKesson OneStop Generics (retail) and Network Net (institutional) Programs to effectively compete in the market place. • Track and trend financial impact of program pricing decisions to optimize sell margin. • Develop/Modify pricing models and assumptions due to changing market conditions or pharmaceutical group goals and objectives. • Retrospectively negotiate acquisition cost with suppliers due to changing market conditions. • Facilitate negotiations on acquisition cost for new products to market. Also, provide support for yearly program re-bid project as required. • Research pricing systems related issues. • Compile ad-hoc data mining and analysis requests. Show less



PacifiCare Health Systems

• Priciple Financial Analyst

  • Sep 1995 - Aug 2000

  Accountable for healthcare related contractual reimbursement analyses--risk analysis of shifting contracts--and special projects. Also responsible for reporting and analysis of healthcare information and health cost and utilization budget development. • Compiled numerous health cost projections of HMO related contracts shifting from capitation to fee-for-service (FFS) reimbursement methodologies. • Developed a FFS tracking tool, which tracks current contractual cost and utilization factors, by provider, and compares to similar budgetary factors. Tracking tool is utilized for: definitive source of health cost projections for IBNR analyses; the calculation of deterioration of budgeted gross margin; FFS membership projections; the calculation of gross margin impact of utilization control programs; etc. • Developed provider level utilization and cost tracking tool for Northern California network management. Show less