ESTHER KOH

Los Angeles Metropolitan Area 714-***-**** ad45t1@r.postjobfree.com

Landmark Health (merged with Optum Services Inc/UnitedHealth Group April 2022) Senior Healthcare Economics Consultant August, 2017 - Present Calculated client's settlements worth 2M+, membership and financial restatements, Successfully computed and communicated with Market leaders Medicare CMS Risk Adjustment model scores for their patient population. Consistently found market opportunities for delivering higher quality care with a return in healthcare savings.

Utilized expertise in acuity adjustment, utilization adjustment and models to identify higher mortality or incidence of outliers.

Developed high visibility company-wide reports on performance metrics, costs and actuarial (IBNR triangle, completion factor, seasonality) reports. Trained and guided other analysts on reporting and coding problem-solving. LA Care Health Plan

Clinical Data Analyst August, 2016 - March, 2017 In addition to the regulatory and ad hoc reports responsible as a data analyst, developed an operational scoreboard for Medical Group/IPA performance. Included medical utilization, member access to primary care provider or specialist, selective HEDIS ratings, and encounter timeliness.

Took on responsibilities for external collaboration projects such as Quality improvement with HSAG.

Create and run internal and external production/ad hoc reports using medical, pharmacy claims, and membership eligibility files. Developed patient medication adherence query that was adopted by the pharmacy and analytics team to support all Rx operations. Exercised ability to identify data aberrations and investigate source or cause; working with other cross-functional teams. Worked on reports and data regarding the Health Risk Assessment (HRA), CG-CAHPS, QHP-ESS surveys, Compliance, and provider data. Masters in Public Health - Biostatistics / Epidemiology University of Southern California

Statistics, Risk modeling, Data Mining/Analysis, Tableau, Data visualization Language: SQL, SAS, Python, Korean

Interests: Personal finance, cooking, piano, reading books unrelated to my field Data Analyst November, 2014 - July, 2016

WORK EXPERIENCE

EDUCATION

SKILLS & INTERESTS

University of Missouri - Columbia

Bachelor of Science - Biological Sciences

SCAN Health Plan

HEDIS and STAR Analyst March, 2017 - July, 2017

Successfully supported HEDIS season: HEDIS rate tracking, audit support, issue log resolution, MRRV collaboration, PLD validation, and IDSS submission. Programmed and cleaned STAR measure (SUPD) report/code. Provided organization-wide production reports. Researched improving our member experience using survey data (CAHPS, HOS, GLS/PLS).