Data Analyst Specialist

Michael Louricas

P: 763-***-**** E: ad5ntm@r.postjobfree.com Brooklyn Park, MN

SUMMARY

·Dedicated Analyst and Data Specialist with experience in analyzing and manipulating both small and large datasets for Financial, Utilization and Statistical purposes in the form of data comparison, analysis, and presentation

·Experience with Unit trend pricing and querying large data sets (millions of records, Medical., Rx and Eligibility claims, EMR/EMH records, etc.) to evaluate savings trends

·Experience analyzing Pricing information based on VBC and Fee For Service contracting with providers and payers, analyzing metrics including STARS and other VBC/HEDIS Metrics

·Report automation using VBA in excel and macros in SAS (PROC SQL) to create various BI presentations

·Skills and Expertise: SAS, SQL, Python, R, DataBricks, Snowflake, Teradata, Power BI, Tableau, Automation, Excel, VBA

EXPERIENCE

9/2023 – 4/2024

Elevance Healthcare

Prov Contract/CofC Consultant

Writing Complex queries to do deep dive analytics into Medicare Health Trends in Risk and Shared Savings Arrangements

Delivering Medicare Reconciliation reporting for internal and external stakeholders

Successfully Transitioned Data from a Teradata warehouse, using SQL/SAS over to Snowflake

9/2022 – 5/2023

Molina Healthcare

Lead Data Analyst Medical Economics

Deep dive analytics into Population health Trends in all LOB’s

Completed a MHSA/BH report using grouper and different codes such as Dx, CPT, HCPCS, Charlson and Chronic conditions to help advance production and of UM/CM programs

Create complex data queries using Python/SQL/PySpark, pulling data from multiple sources, and delivering Health Care Economics reporting for internal and external stakeholders

Optum Rx 9/2021 – 9/2022

Sr Data Analyst

Providing clinical analytic support to Clinical Consultants, developing innovative analytical solutions to address clients’ changing needs, and generating trend analyses and insights to support custom requests.

Creating Rx reporting deliverables by creating an Excel/PPT template, writing and updating SAS/SQL queries, Macros and Loops in SAS EG creating output that automatically populates the template. Then have a one button VBA Macros written to auto-populate the PPT template with the goal to continually automate reports that can be scalable across the organization.

Adhoc reporting requests involving deep dive analytics stretching across our IDW containing Pharmacy claims and Member Eligibility data, using Join(s) (Inner, Left, Full Outer, etc.) from Product, Provider, Transaction, and Xwalk reference tables etc.

Work directly with OptumRx Sales, Account Management, and Clinical Team’s departments to understand the requests for model/reporting development

Implemented our constant Data Quality Assurance checks. Data QA’d by comparing to specific LOB Benchmarks, Internal reporting matches/within tolerance.

Minnesota Oncology 6/2020 – 4/2021

Sr. Medical Data Analyst

Analyze multiple types of Provider datasets including EMR, EHR and McKesson to measure and report Provider Performance Metrics and make sure we met our Value Based Contract Guarantees.

Crete and automate Multiple Ad-Hoc report requests from Internal and External Stakeholders using Medical Claims data provided by McKesson for financial/trend reporting

Data querying using Crystal and other reporting software; i.e. CVP, Practice Insights, external locations

Report and Data automation using VBA, Excel, Access, Crystal

CVS Health 3/2015 – 4/2020

Advisor, Data Analytics

Analyze multiple types of Health Plan and Payer claims datasets for potential clients by creating financial/savings opportunity analysis using different modeling methodologies and techniques including grouping/mapping Diagnoses and studying Optum grouped data sets with SRx Pharmacy drug products

Successfully managed my team in delivering accurate outcomes reporting and was the Point of Contact for the Site of Care/Drug Benefit Alignment program

Worked closely with account executives and clients to answer reporting questions and/or create ad-hoc reports

Built, maintained and transitioned the Medical Benefit Management drug list database, an Exclusive specialty and other outcomes reports to other team members

Overseeing the entire process of obtaining and quality checking Optum and a nationally representative external data extract for Book of Business and trend bench marking for Specialty Marketing presentations and models

Successfully developed and manage regular reporting and presenting activity for Generic Combination Therapy, Chronic Conditions and the Immune Deficiency Drug Classes

Creating data maps for different types of coding and internal mapping roll-ups

Thoroughly QA’d 100’s of million record data sets by checking initial control totals, completeness/cleanliness of fields, made sure the data made sense (i.e. Units, Diag. Codes, Spend for a specific drug had to be within range), Mapped data to our process, auto-populated reports, then checked against Internal BOB and National Benchmarks

Work with SAS and SAS EG: creating queries, manipulating queries, pulling data, transforming data, creating tables based on certain criteria, Ranked Drugs/Drug classes by spend and/or savings

Work with SQL Server: creating queries, manipulating queries, pulling data, transforming data, creating tables based on certain criteria, Ranked Drugs/Drug classes by spend and/or savings. Used SQL to create daily reports and transferred the data into some of the SSRS packages

Work with Tableau, by connecting to SQL/Teradata/ODBC data sources and creating dashboards for clients. Used R to do high level control total checks as well as data transformation/manipulation.

Work directly with Marketing, Sales, Account Management, Clinical, Underwriting and other departments for model development, Marketing/Client presentations and deliverables; Pilot programming modeling, and Data mapping.

Allina Hospitals and Clinics 6/2011 – 3/2014

Sr. Financial/Data Analyst

Quarterly analysis of generic versus brand name prescriptions from large datasets and created insightful reports for Pharmacy stakeholders to make beneficial organizational decisions

Began grouping and working with data to create new TCOC, VBC, and Other method to group claims

Lead analyst within the ACO department and created a variety of financial reports for the various populations

Analyze different payers claims and report utilization statistics to ensure efficient, quality care at the lowest possible costs

Success in analyzing large datasets and developing utilization statistics and affordability measurements that upper level management and executives have supported and made strategic decisions on

Worked with Reimbursement and Payer Relations to build Bundled Payment Models determining payment estimations across providers

Analyze value of generic medications versus brand name prescriptions and found many ways for physicians to increase efficiency.

Have created complex physician rate and forecasting revenue models

Proficient with working in the Enterprise Data Warehouse and using Advanced Microsoft SQL Server programming skills

Minnesota Institute of Public Health 10/2007 – 6/2011

Statistical Analyst

Provide statistical expertise to design, define and execute analysis and interpret statistical results for epidemiological data substance use patterns

Analyze epidemiological data for various projects, including a site dedicated to substance use patterns.

Developed programs where SPSS is used to automate datasets, in turn saving man hours and company dollars

Efficiently provide accurate, statistically appropriate outputs included in protocols, statistical analysis plans, study reports and regulatory submission documents required by SAMHSA and the Evaluators group

Used Excel and SPSS to analyze many types of data sets including surveys and many other alcohol, tobacco, and other drug statistics

EDUCATION

John’s Hopkins University - 6/2017 – 3/2019

General Certificate - Data Science & Machine Learning

Southern New Hampshire University - 9/2015 – 3/2017

Master of Business Administration - Leadership

University of Minnesota – Duluth - 9/1999 – 12/2004

Bachelor of Arts

Major: Economics - Minor: Mathematics/statistics

SKILLS AND EXPERTISE

SAS, SQL, Teradata, Snowflake, DataBricks, Python, R, Power BI, Tableau, Excel, VBA, Automation

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