Compliance & Healthcare Data Analyst Leader

Noel Park MPA, PMP, PMI-ACP

Queens, NY 347-***-**** ********@*****.***

PROFESSIONAL EXPERIENCE

CareDesign New York, NY

Compliance Manager May 2021 – Present

• Audited Care Managers’ records to ensure preventive measures are placed and regulations set by CMS are met. o Reported error rates across various documentation types and sections, and supplied targeted recommendations based on the identified trends.

• Designed and implemented a dashboard to monitor daily citations issued by the Department of Health and the Office for People with Disabilities, providing clear insights into regional compliance performance.

• Investigated care managers for suspected fraud and gathered evidence to support corrective actions. Business Analyst June 2018 – April 2021

• Report care gap rates for prioritized HEDIS measures to evaluate intervention outcomes, establish SMART goals for assessing vendor ROI, and determine effective methodologies for broader implementation.

• Integrate and standardize data sources while synchronizing tracking systems to generate key performance indicators (KPIs).

• Streamline medical record requests for ongoing initiatives and clarify their structure, boosting provider response rates and member adherence.

• Validate provider data submitted through claims and SuDs against CMS tech notes to confirm gaps are addressed.

• Directed the design and deployment of system enhancements to streamline procurement processes and facilitate the review of medical documentation, ensuring adherence to CMS regulations and timelines.

• Optimized provider’s Prior Authorizations (PA) reviews to prevent incorrect billing and coding. o Corrected PAs that were improperly submitted as bundled codes, achieving significant cost savings. Northwell Health Manhasset, NY

Project Coordinator January 2017 – June 2018

• Collaborated with the privacy officer to review provider handling of social security numbers, medical records, and claims history, mitigating risks of fraud and preventing significant financial losses.

• Spearhead a database enhancement initiative that reduced processing time and standardized the review of claims received from the Department of Financial Services (DFS) relating to appeals and billing disputes by 80%. Outreach Coordinator April 2016 – December 2016

• Evaluated members' eligibility for the NY Health Home Program and recorded their status in the Medicaid Analytics Performance Portal (MAPP) to coordinate scheduling with social workers for chronic condition management.

• Integrated effective components from established outreach templates, which led to improvement in appointment scheduling rates.

TECHNICAL SKILLS

Proficient in Excel, Power BI, Visio, and SQL query development EDUCATION

Long Island University Brookville, NY

Master of Public Administration in Health Care Management May 2015 St. John’s University Queens, NY

Bachelor of Science in Health Care Administration May 2011 CERTIFICATIONS

• Google Data Analytics Certificate May 2021

• Project Management Professional (PMP) 2790915 August 2020

• Agile Certified Practitioner (PMI-ACP) 2901242 December 2020

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