Randall Tran
Senior Clinical Analyst at Health Plan of San Joaquin- Claim this Profile
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English Native or bilingual proficiency
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Vietnamese Native or bilingual proficiency
Topline Score
Bio
Credentials
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Share Data Through the Art of Visualization
CourseraFeb, 2022- Oct, 2024 -
Analyze Data to Answer Questions
CourseraJan, 2022- Oct, 2024 -
Prepare Data for Exploration
CourseraJan, 2022- Oct, 2024 -
Process Data from Dirty to Clean
CourseraJan, 2022- Oct, 2024 -
Foundations: Data, Data, Everywhere
CourseraSep, 2021- Oct, 2024 -
Ask Questions to Make Data-Driven Decisions
CourseraSep, 2021- Oct, 2024
Experience
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Health Plan of San Joaquin
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United States
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Hospitals and Health Care
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200 - 300 Employee
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Senior Clinical Analyst
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Mar 2023 - Present
• Analyzes and interprets clinical data and metrics to identify impacts, risks, opportunities, trends, variances and other insights. • Proactively identifies potential data and analytical needs to support management and performance monitoring requirements. • Collaborates with business partners to understand business priorities and strategic initiatives and develop effective and timely analytic solutions. • Fosters a data-driven culture through exploratory analytics, experimentation, and in-depth research into business data. • Makes recommendations regarding use of medical informatics including medical data mining, EMR, and decision support systems. • Assists end users in identifying and defining data needs, interpreting data validity and accuracy, analytic and/or reporting needs, and developing self-reporting capabilities. • Compiles, develops, and submits complex reports with written summaries and recommendations to management. • Collaborates with external and internal stakeholders to maintain the availability, validity, and integrity of data sources. • Maintains appropriate and required data, records, and other operational and regulatory report documentation. • Supports internal and external audits, and assists in the preparation of recommendations, responses, and reports. • Identifies and implements process improvements. Show less
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MemorialCare
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United States
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Hospitals and Health Care
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700 & Above Employee
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Managed Care Analyst
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Dec 2022 - Feb 2023
• Depending on reporting area(s) assigned, some or all of the following: - Participate in financial statement audit by providing requested reports and answering inquiries. - Complete and distribute monthly reporting packages for JOCs • Assist and collaborate with senior team members and other departments to design and run queries and reports based on external reporting requests, ensuring data integrity and timeliness. • Provide data support to other departments to support various modeling. • Responsible for encounter processing • Provide analysis of medical expense fluctuations to leadership • Ad hoc reporting and analysis, as needed. • Prioritize and multi-task Show less
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CalOptima
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United States
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Hospitals and Health Care
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700 & Above Employee
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Data Analyst
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Apr 2022 - Dec 2022
• Generates P4V reports on defined schedule; models new P4V metrics or changes in methodology. • Participates in Quality Analytics department and Pay for Value team meetings. • Coordinates with Finance to facilitate approval of payment for earned P4V incentives. • Prepares reports and findings; evaluates reports for accuracy of data, including the application of standardized analysis, and assists in the timely production of reports. • Analyzes data trends compared to industry standards and recognized benchmarks. • Provides technical expertise to staff, other CalOptima departments, and agencies working in conjunction with CalOptima. • Supports Quality Improvement (QI), CalOptima Community Network (CCN), and OneCare Connect (OCC) workgroups and other committees working on quality improvement activities. • Assists in the implementation of integrated strategies to improve data collection and data integration to the business intelligence application. • Assists in the pay for value allocation and calculations for the Behavioral Health P4V program. • Collaborates with systems staff to ensure functional effectiveness of the interactions between operations and information systems. • Maintains thorough knowledge of CalOptima's data warehouse and the move to the Business Intelligence software. Assists in providing feedback to Information Technology Services (ITS) to resolve data integrity issues and to support reporting requirements. • Refers complex data integrity issues to the Data Analyst, Sr. and/or the P4V Manager for further evaluation and action as needed. • Completes ad-hoc analyses, and special projects. Show less
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Prospect Medical Holdings, Inc.
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United States
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Hospitals and Health Care
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300 - 400 Employee
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Disease Management Program Coordinator
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Sep 2017 - Mar 2022
Pull patient data from various sources and compile it into reports for claims and office visits, on behalf of this organization that manages 401,000 members across 24 different health plans. Create and maintain trackers in Excel for COPD, heart failure, diabetes, and chronic kidney disease. Confirm diagnoses in Aerial, ICD-10 codes and doctors’ notes. Use Essette for case management, uploading documents, and adding patients to trackers. Conduct monthly statistical analysis of trackers. •ESRD Revenue Recovery - Use Alexandria (Internal Data) to build flow lanes, trackers and pivot tables. Successfully identified over $2.4 million in revenue recovery from contracted health plans. •Population Health - Train new managers and coordinators on disease data management. Conduct training on the use of the system, access to file share points, tasking, and triage. •Expansions - Processed new members/enrollments in San Diego, RI, TX, and AZ. Act as liaison with teams. •Collaborate with vendors on health tech products. Worked with vendors in uploading data into various systems for case manager review. Show less
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Magellan Health
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United States
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Hospitals and Health Care
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700 & Above Employee
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Care Worker
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Nov 2016 - Sep 2017
Served as a contractor for Cal Optima Behavioral Health. Received a high volume of inbound calls from patients and family members. Administered screening questionnaires, such as CAGE-AID and PHQ-9. Identified community, county and psychiatry/therapy resources that patients could use under assigned health plans. Coordinated interdisciplinary Care Team meetings with different health networks and managed individualized care plans. Developed trackers in MS Office for use by coordinators and behavioral health providers. Worked closely with IT in setting up a new office to serve patients in Orange County. Show less
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Intern
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Sep 2016 - Nov 2016
Brokered liaison services between MD’s, patients and the IDA Health Network in both English and Vietnamese. Organized meetings for doctors in all specialties. Participated in community Health Fairs. Developed Excel documents to track both questionnaire/doctor responses and monthly/yearly medical spending. Brokered liaison services between MD’s, patients and the IDA Health Network in both English and Vietnamese. Organized meetings for doctors in all specialties. Participated in community Health Fairs. Developed Excel documents to track both questionnaire/doctor responses and monthly/yearly medical spending.
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Va Health Care Systems
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United States
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Medical Practices
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1 - 100 Employee
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Intern
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Feb 2016 - May 2016
Developed weekly reports to track the progress of various PC programs, such as Transitional Care. Created SHARPS disposal guides for homebound vets. Coordinated schedules for homebound nursing visits. Developed weekly reports to track the progress of various PC programs, such as Transitional Care. Created SHARPS disposal guides for homebound vets. Coordinated schedules for homebound nursing visits.
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Education
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2013 - 2016
California State University-Long Beach
Bachelor’s Degree, Health/Health Care Administration/Management -
2010 - 2013
Golden West College
Associate of Arts - AA, Business and Technology
Community
