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Financial Analysis Specialist Resume

Cool Valley, MO

SUMMARY:

  • Proven analytical skills to generate concise results from very large and detailed data sets to further operational goals
  • Outstanding verbal and written communications skills with internal and external customers at all levels
  • Meticulous organizational and project management proficiencies for a complex project environment
  • Demonstrated ability to build diverse teams across disciplines to translate and communicate results
  • Dynamic community service and charity leader, with proven results and ability to grow programming & engagement

PROFESSIONAL EXPERIENCE:

Confidential, Cool Valley, MO

Financial Analysis Specialist

Responsibilities:

  • Lead a cross - functional specialty margin SWAT team which identified and facilitated resolution of specialty pharmacy pricing issues, including $60M total client recovery over 2½ years, coordinating the work of a direct employee and loaned talent in IT, finance, accounting, and audit contributors and completing project management and analytical responsibilities. Drafted and made bi-weekly VP-level reporting and maintained an online project plan. Significant projects include:
  • Pricing changes and adjustments for an exclusive specialty drug originally sold by legacy Confidential as mail/specialty, and by legacy Medco as retail/non-specialty. Identified the results of mispricing for legacy Medco clients and returned those clients to retail rates, then worked across teams and restored proper specialty pricing for legacy Confidential and more clients who were set up with 0% discount on the drug by implementing a novel pricing mechanism. Simultaneously corrected an error by which the dispensing subsidiary was not being paid the same amount billed to clients, as intended, increasing SDS revenue by $1.5M in 2017
  • Identified significant clients who were not being charged for specialty drugs. Worked with technology resources to determine the root cause was a long-forgotten hard code, had it removed, then engaged with impacted account teams to communicate the error and complete the adjustment, including $1.7M in recovery from one client.
  • Detected specialty claims invoicing to clients at $0, and coordinated with revenue cycle management to develop a process for secondary review of free claims. Monitored the monthly recovery and trend outcomes to assess variances and predict totals. Resolution of zero-dollar invoices recovered $7.6M to date in 2017, $6.0M in 2016, and $3.2M in 2015.
  • Partnered with internal technology and operations teams to develop a new process to reprice adjudicated specialty claims not yet scheduled by contact with the patient but after a manufacturer price increase, called “layaway.” Estimated the value of repricing all claims, then refined the estimate after a management decision not to reprice scheduled but unshipped claims. Repricing raised $6.6M to date in 2017 and $3.5M in 2016 in incremental revenue opportunity for already adjudicated claims, and additionally accelerated the adoption of new pricing for future claims.
  • Identified and coordinated with internal partners to determine the root cause of a mispricing across specialty for a client insurer, who migrated specialty incorrectly to POS. Worked with the account team and with PBM billing to complete the adjustment before year end 2015, recovering $7.7M from the client.
  • Coordinated work by the specialty SWAT team to apply credit prepaid client balances to the correct open invoices and send patients statements for patient pay fractions, which were incorrectly halted.
  • Maintained continuity for specialty SWAT through several director and VP-management changes.
  • Utilized various analytical strategies to address issues across the entire breadth of Confidential ’ billion claim database to research and resolve identified issues and bring critical data to the top of sometimes lengthy extracts.
  • Found and systematically leveraged SQL to connect claims across specialty and PBM systems for integrated clients and patient balances
  • Identified, collaborated with technology and revenue cycle management to find the root cause, and extracted credits data to uncover and validate the correction of a mismatch between patient assistance between two systems, the resolution of which recovered an additional $1.7M in patient assistance.
  • During migration of clients to the post-Medco adjudication system, developed code and refined mathematics to compare claims pre- and post-migration, discriminating between AWP, volume and discount drivers in revenue, cost, and margin changes, apportioning multiple-factor-driven variance components, and identifying many small setup errors from among thousands of client-drug pair migrations. First applied this strategy to comparing a client’s post-hire claims actuals with expectations from the setup process. Identified a total of $40M in revenue variances.
  • Estimated the value of migrating a subsidiary to the new, unified F14 plaform, improving margin on some products but exacting mail discounts from non-specialty drugs. Analysis therefore required estimating the revenue impact to existing clients, specialty drug business to specialty rates, imposition of mail pricing on all legacy Medco client non-specialty volume, and the additional revenue of retail specialty volume moved to specialty rates. Projected net impact at $7M per year.
  • Rapidly retrieved client-level data showing claim volumes and billing totals for a specialty drug, supporting reconciliation of manufacturer rebates, after the drug was improperly classified on legacy Medco systems, resulting in $17.2M in additional ingredient cost.
  • Demonstrated the marginal value of a small patient access program, with $1,241 of revenue in 2013, confirming an absent financial imperative for future investment.
  • Applied statistical techniques, sometimes for the first time, to estimates of future volumes and financial values, communicating the accuracy of these estimates and presenting on their sensitivity to uncertain model inputs.
  • Created a new estimate and uncertainty model for price increases on adjudicated claims that included data-driven predictions of variability in drug price increases and claims in layaway by day of week.
  • Modelled the impact of discontinuing mail service for delinquent individual PPACA policy holders, who would have been required to fill any claims at 100% copay at a retail provider. Using insurer, consultant and internal estimates for enrollment, delinquency, mix, and financials, showed the sensitivity of the model to various inputs, and calculated $40M revenue loss sufficient to support building alternative capability.
  • Participated twice as the finance leader for an internal innovation competition, developing and presenting a finalist-selected presentation for utilizing technology to improve the company’s member outreach and profitability.
  • Incub8 finalist in 2016 for a team project to leverage text messaging to convert retail to mail fulfillment. Representing finance, developed the net present value, including determination of the text messaging cost.
  • Seconded to the adjustments team after the F14 migration in 2014, accurately estimated the impact of client claim changes by direct recourse to warehouse claims, and increased by person throughput by leveraging these warehouse data to correctly constrain the claims extract. Contributed directly to 179 client adjustment tickets in the PBM space in five months.
  • During the Medco systems migration, organized a cross-functional meeting of technology, finance and accounting stakeholders for both legacy Medco and legacy ESRX systems to increase understanding of how the new, integrated, mostly-Medco-based, systems and data warehousing would work. Invited speakers, maintained meetings and minutes, and facilitated speaker requests and questions from the team.

Senior Strategy Analyst

Confidential

Responsibilities:

  • Developed strategy proposals to executive leadership for future treatment of orphan and fertility drugs, forecasting of commercial drug pipeline approval timelines and first-year sales, impact of patent expiry, patient assistance, and others.
  • Created and maintained REMS drugs database, new drug approvals, and specialty drug pipeline in support of product and business development, and drafted documents to Confidential manufacturers in support of business development up sells.
  • Assembled sales and volume data from proprietary and commercial databases in support of strategy and program development.
  • Drafted briefing documents for drugs, disease states, and manufacturers to inform account managers of necessary background prior to time-critical sales contacts, and wrote client-side documents presenting initial views of Confidential ’ REMS compliance business.

Confidential, Chesterfield, MO

Senior Scientist

Responsibilities:

  • Expert in the analysis of aggregation in large molecule protein drugs, including monoclonal antibodies and hematopoetic drugs. Frequently utilized tandem LC-MS, RP- and SEC-HPLC paired with static and dynamic light scattering, and SDS-PAGE to quantitate and describe aggregate products of accelerated drug stability. Additionally, an expert in BIAcore / surface plasmon resonance, and PEGylated protein conjugation. Distilled many large data sets to summarize actionable findings.
  • Supervised and evaluated outsourcing of glycan analysis to a partner academic lab in Ireland, including currency effects. Determined in-house analysis was $10k cheaper per sample, or $420k per year.
  • Managed project team of 36 project-based analytical R&D scientists in the characterization activities for two monoclonal antibody compounds with potential blockbuster status. For a late stage development project, built a bottom-up work breakdown structure to estimate line FTEs, then applied the model to task estimates across projects. Responsibilities include generating GMP reference standard characterization and product comparability prior to a phase III IND filing, drafting analytical portions of regulatory filings and coordinating with internal customers. Enabled successful initiation of phase I and pivotal phase III clinical trials for these two compounds.

Scientist / Senior Associate Scientist

Confidential, Jefferson City, MO

Responsibilities:

  • Appointed to the Committee, which oversees the Missouri Organ Donor Registry and recommends expenditures from the related Organ Donor Fund, in 2006 by Confidential Matt Blunt. Re-appointed in 2011 by Confidential Jay Nixon.
  • Leveraged data from the 2009 implementation of a new registry system to bolster original research, combining registry results with national 2010 census data, to generate new findings that donor designation rates in Missouri were driven more by poverty than by race, which informed partner programs to engage with license offices in demographically diverse but poor areas.
  • Increased donor designations from 2.4 M to 3.1 M, fund donations from $152 thousand to $308 thousand per year, and the fund balance from $147k to $603k, in my term as chair.
  • Personally wrote and coordinated grassroots support for second-year passage of an individual income tax check-off to support the Organ Donor Fund - one of only nine explicitly shown on individual income tax forms - significantly supplementing fund revenue above the predominant channel of $1 fee office contributions, unchanged since the fund was created. The check-off was made permanent in the 2017 legislative session.
  • Initiated an annual state organ donation awareness day at the State Capitol and began the tradition of holding it on the second Tuesday in April, part of Donate Life Month nationwide. The third floor Capitol rotunda is open to public groups, and I led the Committee in a tradition of using this space to provide donor designation registration opportunities and build awareness for organ donation, expanding the awareness day to eye and tissue donation. Increased traffic by partnering with organ procurement organizations to provide donate life cookies, and moved outside the third floor space by reserving parking on the Capitol circle drive for a partner member’s Donate Life float. Subsequently leveraged relationships formed and sustained by Rotunda Days in support of the Committee’s legislative recommendations.
  • Simplified the Committee’s bylaws and organizational structure by drafting and leading Committee agreement and Department of Health and Senior Services (DHSS) approval of new bylaws, reducing the bylaws from a multi-page document to a single page, simultaneously providing the Committee with greater latitude to explore its impact opportunities and creating leadership term limits to refresh the Committee with new ideas. These bylaws are still in effect, with only minor revisions.
  • Organized the annual proclamation of April as Donate Life Month in Missouri via gubernatorial proclamation, including a public signing ceremony of the proclamation by Governors Blunt and Nixon. The public proclamation signing was picked up by news services and pictures of the event communicated to news media and used in partner media to promote organ donation awareness. The Donate Life proclamation signing continues under the new chairperson.
  • Created a program in cooperation with DHSS and the Missouri Department of Revenue to reward the best performing and most improved license/fee offices for donor designation rate and fund contributions rate, and designed the hand-delivery of cheap winner certificates by donation partners, including donees and families, donor families, and partner agencies, to communicate the critical importance of license offices and engender competition which bolstered donor designation and donation rates. This program continues quarterly, with certificates displayed in winning offices.
  • Presented to community groups, radio, and television, and on social media, about organ donation and the registry process.

Confidential, St. Louis, MO

Navigator, Saint Louis Assembly

Responsibilities:

  • Elected to this office (Assembly president) a year in advance of the regular progression.
  • Reversing declines of 298 families over the two prior years, of members leaving the Assembly by engaging each of the thirty member Councils (generally Catholic parishes), personally attending individual Council meetings to promote Assembly membership and programming, establishing teams led by the Assembly’s leadership to outreach personally to members on their birthday and joining anniversary, and creating 1:1 leader - Council partnerships to identify and nurture potential leaders and members. Only two members have departed since my term began in July, offset by one returning member.
  • Leveraging an existing program for college councils to create a faith-building movie series for the Assembly, partnering with prospect-rich Councils to host a screening of each movie in the series and invite members and prospects for the film and a discussion of its faith-related questions in the context of current events. Ongoing.

Confidential

Activities Director

Responsibilities:

  • Applied supply chain principles to Christmas gift inventory for Santa to present at the State Council’s annual Christmas party. Used incomplete data on prior year attendance and current year registrations to predict the required safety stock, and decided that no new Christmas gifts needed, freeing precious charity funds for other purposes. Safety stock remains for the current year Santa visit.
  • Wrote and directed the widely-praised inaugural performance of a Christmas play to replace a long-standing but much derided Christmas children’s choir concert at the State Council’s winter meeting.
  • Organized the availability, registration, and attendance of families on a state Capitol tour during the summer State Council meeting, augmenting the existing but sedentary activity schedule for older ladies (and not families) during afternoon meetings for members, and a subsequent dinner & movie for children during the evening banquet so that parents could attend the evening program together. These events doubled the attendance of mothers during the weekend, who typically stayed home for the weekend with their families, and built relationships between the moms who attended.

Confidential

Activities Director

Responsibilities:

  • Managed the affairs of activities of four councils in seven parishes, with over 700 families, $300 thousand in charitable contributions, and 26,000 hours of community service. During my tenure, two of my Councils partnered and raised significant funds to purchase and equip a mobile RV ultrasound clinic, in cooperation with the state’s “ Confidential ” and headquarters “Ultrasound Initiative,” an effort which today claims hundreds of lives saved from its usual position across from St. Louis’ Planned Parenthood Clinic. Earlier, in 2006 - 2007, managed six councils with 424 families.
  • Supervised the re-activation of a Council at St. Ambrose (“On the Hill”), a parish in a traditionally Italian-American and strongly Catholic neighborhood in St. Louis. This parish, then inactive, now has grown to an important parish group and to 35 families, with leadership cultivated during my term.

Adult Leader

Confidential, Chesterfield, MO

Responsibilities:

  • Organized 20 den meetings and 18 den (“field trip”) activities over the course of the nine month Tiger program year, with some boys in the den earning all 19 Tiger adventures and several additional awards.

Softball Coach

Confidential

Responsibilities:

  • Head softball coach for my daughter’s team of a dozen kindergarten, then first grade, girls
  • Engaged with opposing coaches to model and teach good sportsmanship and resiliency
  • Developed softball skills, and taught the importance of teamwork and active lifestyle
  • No experience playing softball, but my daughter wanted to play and there were no other coach volunteers
  • Guest judge for a local science competition sponsored by the University of Missouri - St. Louis science departments and office of science education, for high school students, generally seniors, presenting the science research performed as a capstone project of their high school science careers. Students made fifteen minute oral presentations and I served on a panel of judges in a concentration subject, generally in general biology.

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