Data Scientist Reporting Analyst
Resume:
SUMMARY
SKILLS
EXPERIENCE
RICHARD
BOUNDS
WWW: https://bold.pro/my/richard-bounds
WWW: https://www.linkedin.com/in/richard-
bounds-b4026217a/
*******@***.***
Waveland, MS 39576
Data Scientist with considerable experience using Provider, Claims and Contract Reimbursement data. Metrics and reporting Analyst with extensive experience at a leading Fortune 500 insurance company. Strong analytical and attention to detail skills applied to analyze trends in large datasets, leading to actionable insights and informed decision-making. Business intelligence professional focused on enhancing productivity and efficiency in task execution. Proven track record in developing and managing client relationships to drive collaboration across organizations.
• Agile Management (JIRA)
• SAS
• Microsoft Office Suite
• Oracle Database
• UNIX operating system
• SQL programming
• Python development
• AWS and Databricks
DATA SCIENTIST / DATA REPORTING ANALYST 04/2017 to Current Cigna
Developed and managed SQL queries in SAS and Microsoft Access to extract Provider Managed Care information from Oracle, UNIX, and AWS repositories.
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Proactively identified and analyzed complex data discrepancies, initiated comprehensive investigations of these areas, and recommended corrective action plans.
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• Mined and managed information from large, complex data sources.
• Analyzed data for trends supporting or disproving business assumptions. Created control and equivalency reports to identify data inaccuracies, automating recurrences to maintain accuracy in multiple large volume Provider databases.
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Proactively mitigated conflicts or data errors by participating in team meetings and offered data analysis expertise.
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Worked across multiple teams to identify problems and offered solutions to issues not yet identified.
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Coached and trained team members to enhance skills and foster a collaborative environment.
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Produced accurate, comprehensive, metrics-driven reports in an easily understood format within given timelines.
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Created and managed Microsoft Access Database to catalog department work volumes. This tool allowed the entire department to leverage and reuse existing code, improve efficiency by reducing duplicate reports, and define a library of reports available for future use.
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EDUCATION
AWARDS
REFERENCES
COMPETITIVE INTELLIGENCE/UNIT COST ANALYST 04/2008 to 04/2017 Cigna
Monitored competitor activities through comprehensive research and collaboration with internal and external competitive intelligence peers.
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Consolidated competitor information and data into actionable reports to aid strategic decision-making.
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Analyzed competitor claim payments by benchmarking against Cigna contracted rates and provided objective insights to Sales and Contracting Directors on competitiveness.
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• Produced membership data models to support Pricing and Sales initiatives. Conducted in-depth physician network reviews using GeoAccess and Zip Code analysis to promote network parity with competitors.
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• Extracted and developed reporting in support of executive decision-making. DATA REIMBURSEMENT ANALYST 04/2000 to 04/2008
Cigna
Conceptualized, constructed and maintained Access Fee Schedule Database to track reimbursement levels for network providers.
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Interpreted provider contracts, generating compliant fee schedules based on stipulations.
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• Audited reimbursement dollars across all claim platforms.
• Updated fee schedules to ensure adherence to HIPAA regulations. Acted as liaison to department leads, delivering reports and interpreting statistical information on claim payments.
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Served as subject matter expert on financial models assessing impacts of provider reimbursement changes.
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Grand Canyon University - Phoenix, AZ
Bachelor of Science
Applied Business Management, 05/2015
Dean's List, Grand Canyon University, 05/2015
References available upon request.
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