Experience

GuideWell

• United States
• Wellness and Fitness Services
• 300 - 400 Employee

• Director - GuideWell Health Analytics

  • Apr 2020 - Present



Florida Blue

• United States
• Insurance
• 700 & Above Employee

• Senior Manager - Value Based Analytics

  • Dec 2019 - Apr 2020

• Senior Manager - Risk Adjustment

  • Mar 2018 - Dec 2019

  Manage Medicare Advantage submissions to the Risk Adjustment Processing System (RAPS) and Encounter Data Processing Systems (EDPS).Coordinate across multiple areas of the company including Medical Management, IT, Provider Network, and Actuarial to develop solutions that increase revenue and lower spend.

• Risk Adjustment Consultant I

  • Mar 2016 - Mar 2018

  • Design complex value-stream projects, including the identification and acquisition of appropriate data required for projects. • Research, validate, and analyze data for monitoring and reporting, strategic & tactical support, and research & development projects.• Represent division and department at decision-making meetings and balancing department’s perspective with those of other areas to ensure that the company’s goals are achieved.• Recommend new ways of performing work tasks or projects, applying research and/or additional benchmarks to generate solutions; manages creative thinking, imagination, and innovation within the team.• Prepare final versions of reports and exhibits; make presentations to senior and executive management.• Propose new analyses, when appropriate, to deepen and broaden the department’s capabilities; make recommendations that comply with laws and regulations, and support division and company goals; assist Senior Manager in development of standards to ensure quality• Supervision of junior Risk Adjustment Specialists on a project basis, a Specialist III – Risk Adjustment on an ongoing basis, or Intern on a temporary basis. Show less

• Specialist V - Risk Adjustment

  • May 2014 - Feb 2016

  Creates SAS/SQL programs for the purpose of performing medical and data analysis. Mine data to detect trends, develop profiles, create predictive models and perform statistical analysis.Creates custom reports, programs and databases to address identified issues with sophisticated solutions to acquiring needed information.Researches, extracts, analyzes, validates, reconciles, prepares and interprets data for medical cost initiatives.Creates statistically valid saving analyses with the ability to justify financial impact.Performs research and analysis of complex healthcare data, applying business experience and knowledge of data analysis.Evaluates, writes and presents reports and makes recommendations based on relevant findings.Perform value-stream research, measurement, and model-building; develop strategies for and calculations in support of RPM operations; and review the work of peers.Research, validate, and analyze data for monitoring and reporting, strategic & tactical support, and research & development projects.Design standard value stream projects, including the identification and acquisition of appropriate data required for projects and setting time lines.Recommend new ways of performing work tasks or projects, applying research and/or additional benchmarks to generate solutionsPrepare reports and exhibits; make presentations to RPM leadership.Represent department at decision-making meetings and balancing department’s perspective with those of other areas to ensure that the company’s goals are achieved.Supervision of junior Risk Adjustment Specialists on a project basis, or Intern on a temporary basis. Show less

• Specialist IV - Risk Adjustment

  • May 2013 - May 2014



Florida State University

• United States
• Higher Education
• 700 & Above Employee

• Graduate Teaching Assistant

  • Aug 2011 - May 2013

  Lead recitation for entry level Biostatistics courses. Help administer and grade assignments Lead recitation for entry level Biostatistics courses. Help administer and grade assignments



Stanton College Preparatory School

• Chemistry Teacher

  • Aug 2007 - Jun 2011

  Taught college-level chemistry to Advanced Placement and International Baccalaureate students at one of the nation’s most demanding magnet high schools. Hold a Professional Teaching Certificate in both Chemistry (6-12) and Mathematics (6-12) in the state of Florida. Communicated efficiently with students and parents. Maintained accurate and current student records in accordance with state, district, and school regulations using internet and computer based databases. Taught college-level chemistry to Advanced Placement and International Baccalaureate students at one of the nation’s most demanding magnet high schools. Hold a Professional Teaching Certificate in both Chemistry (6-12) and Mathematics (6-12) in the state of Florida. Communicated efficiently with students and parents. Maintained accurate and current student records in accordance with state, district, and school regulations using internet and computer based databases.