Gabriel Tomkowicz

ady33i@r.postjobfree.com

802-***-****

Experienced Healthcare analyst with history of report development utilizing IBM Cognos, SSMS, and Oracle to generate, validate, extract and process data. Primary focus on the financial areas of the healthcare industry including billing and claims, with clinical data mining used for aggregation, presentation, process improvement and business analysis. Extensive history utilizing data to improve decision making across various organizations.

PROFESSIONAL EXPERIENCE:

Centene March 2023-Present

Financial Analyst IV (Contract Position)

Remote Position:

Contributed to month end close process, specifically around Inpatient Validation to assist in monthly accrual for unpaid Medicaid claims for Delaware First Health

Created monthly claims and membership reports

Maintained and produced ad hoc State of Delaware Medicaid required reporting on a monthly, quarterly and annual basis.

Report automation to update processes to streamline reporting functions for the Finance department in MicroStrategy

Assisted with Data Analytics team to review SQL code and validation steps for Finance reporting

Surest December 2022-March 2023

Senior Financial Analyst (Contract Position)

Remote Position:

Contributed to month end close process, including creating journal entries to close paid claims process for employer contracted Medical and Pharmacy claims

Created monthly invoices to send to clients

Balanced 834 and 820 files to source warehouse system to ensure ad hoc reporting is based on accurate data using Looker,

Ad hoc reporting

Health Catalyst

Implementation Specialist, Sr. April 2022 – November 2022

Remote Position:

Contributed to the success of deployments of our Regulatory Measures product (MeasurABLE), specifically around HEDIS, MIPS, CMS/UDS, and eCQM measures

Improve and update data models and visualizations that meet project requirements and comply with our design standards and principles

Interacted with the client Operations and Clinical teams on a regular basis throughout the engagement

Managed technical client projects by providing technical oversight; ensure assigned projects are executed efficiently and according to project requirements and timelines

Managed data validation tests to ensure the quality of deliverables

Worked with client data architects to train and mentor on Health Catalyst tools and methodologies

Kept up to date on the regulatory measures landscape as they change

Financial Value Analysis Specialist September 2020-April 2022

Remote Position

Identified operational, financial, population health, revenue cycle and clinical/quality for the value architect team for prospects or clients

Used publicly available data and/or client data to analyze and find potential opportunities for improvement for Health Systems, Hospitals, Payers or ACOs

Developed financial models for repeatable analysis to identify areas of improvement

Created analysis for sales team members to highlight prospect opportunities where a Health Catalyst solution would bring value to the prospect

UPMC Health Plan

Manager HEDIS Data Quality and Analysis

Pittsburgh, PA April 2019-August 2020

Responsible for year-round HEDIS, CAHPS and State of Pennsylvania performance measure reporting and utilizing quality improvement processes to improve and optimize performance

Build and maintain process documentation for data validation, quality control process and measure analysis

This includes working with IT and other business owners to generate, analyze and audit administrative, supplemental, and medical record data. It also includes working with various departments, vendors, agencies, and providers on initiatives to evaluate and close data and care gaps

The position is responsible for meeting all HEDIS reporting requirements and deadlines, including those leading to successful data integrity audit, medical record review validation and state submissions

Implementation of Vendor Product to replace inhouse HEDIS Engine, creation of new input files, input controls for validation of claims data sent to vendor. QC process to validate output data to inhouse data. Ensure that claims processed properly from 834 files to EDW to Vendor

Oversees the day-to-day work for seven database analysts

Allegheny Health Network:

Sr. Financial Analyst October 2017-April 2019

Pittsburgh, PA

Analyzed financial data by collecting, monitoring, and creating financial reports for decision support. Improve financial status by analyzing results; monitoring variances; identifying trends; recommending actions to management

Creation of monthly Profit and Loss Statements for the Network, Hospitals and Institute level for business units and senior leadershi

Report migration from Excel outputs to Tableau using Alteryx

Data Validation of the Enterprise Data Warehouse to the source billing systems

Ad Hoc reporting requests utilizing claims and in house billing data

The University of Vermont Medical Center:

Programmer Analyst Staff/Business Intelligence Analyst October 2011- October 2017 Burlington, VT

Created various financial and clinical reports used throughout the organization ranging from day-to-day operation to providing regulatory auditing reports

Balanced the data warehouse back to the source billing system (GE, formerly IDX) to ensure all financial reports balance to the accounting GL systems as well as the claims data sent via electronic formats as well as on paper

Created, maintained and taught a course curriculum for end users that access the data warehouse to allow them to be self-sufficient in pulling reports (13 separate courses for roughly 75 end users)

Upgrade/Migration from Cognos 7.4 to Cognos 10.xx, involving report conversions, new server installation, data validation of all claim and clinical data loaded into the warehouse properly and balances

Upgraded from Cognos 10.2 to Cognos 11, involving report conversation and data validation

Creation of report templates with optional parameters for ease of use and customization

Proficient in the EPIC Ambulatory and Inpatient modules

Crystal Report development and validation

Revenue Cycle Analyst August 2007-October 2011

Creation of Professional and Facility reports at the Health Care Service level

Creation of Health Care Service Dashboards for summary of the health of the service on a monthly and rolling trend basis

Balancing of payer claim batches

Creation of Physician Compensation reports for year-end RVU Comparison, a component for year-end compensation bonuses

Maintained CPC Certification for this role.

TD Bank:

Credit Exchange Specialist II September 2005-August 2007 Williston, VT

Provided Commercial Loan customers with credit rating for third party lines of credit

Reviewed Commercial Loan agreements

Examined checking, savings, and lines of credit balances for Commercial Customers

Wire Room Specialist August 2003-September 2005

Processed commercial and personal wire exchanges

Audited daily government exchanges between the Federal Reserve and TD Bank

Exception Processor January 2002-August 2003

Processed all exception checks for commercial and personal customers to verify signatures/endorsements, checking account numbers and NSF/Closed Account checks.

Balanced batch files back to the source financial system to ensure all accounts balanced to what deposits or withdrawals from customer accounts.

EDUCATION:

Saint Michael’s College Colchester VT

Bachelor’s Degree in Business Administration and Management

LinkedIn Profile;

linkedIn.com/in/gabriel-tomkowicz/

ADDITIONAL SKILLS:

Expert in the Office Suite of products

Financial Analysis

Data Analysis

Business Development and Process Improvement

KPI/Dashboard creation

Expert in IBM Cognos Platform

oDashboard Training and Course Curriculum

Tableau Dashboard visualizations

Medicare Cost Reporting

Data Validation experience

Business Plan experience

EPIC Clinical and Revenue Cycle Platforms

ServiceNow and Workday data extraction/report development

HEDIS Regulatory Submissions

Intermediate SQL comprehension

SQL Server

Oracle Toad

Data Management and Governance

Change Control/GitHub

Power BI Reporting

Looker Reporting

MicroStrategy Reporting

Data Story Telling

Leadership

Health Insurance/Health Plan Analysis

oPMPM

Contact this candidate