SUMMARY:

• Over twenty years spent creating value and insight with actionable predictive models, and creating and implementing data science and analytics strategies in the US Healthcare, Insurance, and Analytics Consulting industries.
• Twenty years of experience programming in SAS, and also experienced in writing and implementing R language scripts in SAP HANA database environment, and the Python language.
• Population Health Management - network, provider, patient and facility analytics
• Financial forecasting, actuarial trend analysis and consulting for Confidential
• Hospital readmission predictive models implemented in a 12-Facility US hospital system
• Analysis of the economic and chronic disease management aspects of the US Confidential population's health trends
• Detailed RFP written responses for many large-scale analytics projects at the Private, State and Federal (CMS) levels.
• Telecom-Banking fraud detection algorithms
• Retail sales advanced analytics forecasting models
• Customer sentiment natural language models
• Customer churn predictive models
• Vehicle fleet management predictive maintenance models

WORK EXPERIENCE:

Data Scientist

Confidential

Responsibilities:

• Data Scientist responsible for key aspects of operational analytics pertaining to Confidential 's role as a CMS Risk-Adjustment Data Validation (RADV) consulting contractor.
• Product development consultant for reporting and analysis proposals.
• CMS proposal response writer for Confidential ’s responses to data architecture, data science and advanced analytics TO responses.

Senior Consultant

Confidential

Responsibilities:

• Data Analytics Consultant playing key role in team responsible for building provider web portal, to measure and visualize provider performance as measured by patient health gaps, quality outcome benchmarks, enrollment patterns, and financial performance.
• Role includes extensive development in the SAS and JavaScript programming languages.

Manager, Corporate Analytics

Confidential

Responsibilities:

• Data Scientist responsible for measuring, analyzing, understanding, predicting and communicating all key findings related to patient health measurement outcomes and associated costs, for Major Mid-Atlantic Confidential associated with one of Maryland’s largest Hospital networks.
• Work included quarterly reporting of primary care outcome measures to Confidential 's Joint Operating Committee, extensive role in forecasting provider financial performance and incentive target results by group practice, payer and care categories including Risk Adjustment factoring and Medical and RX IBNR estimation across a variety of contractual assumptions; as well as lead in developing Population Health Management COPD and opioid patient program evaluation studies.

Senior Consultant/Decision Science Analyst

Confidential

Responsibilities:

• Responsible for end-to-end project management as well as analytic and technical work for advanced analytics and statistical consulting engagements in US industry, including statement of work language, RFP responses, project documentation and sub-contractor onboarding, as well as the analytic and technical functions such as model building and validation, model programming code (primarily in R, Python and SAS), data visualization (primarily with R and SAP Lumira), machine learning algorithm selection and implementation, forecasting methods, queuing theory models, fraud detection modeling, database implementation of predictive models, and communication of results to C-level executives.
• Experienced user of SAS, R/RStudio, Python Statistical and Data Science applications; Microsoft Azure; and SAP HANA Cloud, SAP Predictive Analytics software, and related SAP products and services.
• Led and managed the building of a predictive model applied within a large hospital system database, which accurately predicted readmission likelihood for patients, enabling measurably more efficient patient aftercare resource allocation.
• Co-developed a predictive model of disability claim allowance likelihood, and discovered Social Security Administration disability claimant appeal resolution time and case outcome drivers. Used the scored predictions to design priority queuing system built from the scored predictions, with estimated reduced claimant wait times, allowing processing of over 100,000 more cases per year.
• Co-developed operational prototype to calculate a patient health score, i.e., a credit score-like measure of member’s health, for one of the 3 largest health insurers in the US. The new approach proved many times faster than prior method of calculation, and allowed the client to being making the calculation in-house for the first time.
• Developed end-to-end customer churn analytics environment for one of the largest satellite internet service providers in the US. This work generated a variety of actionable insights into customer and competitive data, resulting in the customer reaching their annual churn reduction goal in the 1st quarter of the year, and creating bottom line impact to revenue growth.
• Various roles: mentorship of Confidential - Confidential ’ global analytics team in Gurgaon, India, including software demonstration webinars and co-authorship of analytics software materials; creation of use case demonstrations of SAP’s Predictive Analytics product for large corporations in the Health Care, Telecommunications and Oil and Gas industries.

Manager

Confidential

Responsibilities:

• Developed innovative method to estimate actionable in-year Confidential CMS Confidential rating measure rates for major national health plans.
• Evaluated and analyzed health outcomes program effectiveness and financial impact to our customers of Confidential Disease Management products
• Improved existing IBNR calculation methodology by creating innovative method directly leading to renewal of a large account
• Innovations in data integrity analysis and sales commission models

Decision Support Consultant

Confidential

Responsibilities:

• mortality predictive modeling, ‘Senior’ member unreported morbidity identification regression analysis matched cohort studies of health impact of Highmark Wellness program and dental coverage elasticity of Pharmaceutical demand calculation assisting in the development of a regression model used in the online marketing of Highmark’s commercial products for senior members
• SAS programming logic and calculation, and report generation of client financial results, including ROI and trend reduction, for financial performance guarantees created for Highmark’s chronically ill patient management program.
• Act as lead for departmental projects and consultant to co-workers for SAS programming and statistical analysis.