More Related Content
What's hot (20)
Viewers also liked (17)
Similar to Scott Duce - 2016 (20)
Scott Duce - 2016
- 1. Scott Thomas Duce 209 Clinton Avenue #5A Brooklyn, NY 11205 (646) 734-3562 scooternyc@gmail.com CAREER SUMMARY Data-driven, results-oriented Senior Analytics Manager with over 20 years of healthcare experience. A skilled collaborator comfortable working across key functional business areas, creating, communicating and implementing analytical insights around quality improvement opportunities. EMPLOYMENT EXPERIENCE Healthfirst, New York, NY (1/07 – Present) Senior Manager, Clinical Analytics (5/12 - Present)  Integral in leading Healthfirst to 4 Stars in Medicare and 5 Stars in Medicaid by providing HEDIS, QARR and Medicare Stars analytics to internal business units in order to create and drive a focused outreach strategy to targeted populations to improve individual measure rates and overall health plan quality scores.  Designed and implemented a comprehensive OB database in order to create a member outreach program to improve prenatal and postpartum visit rates. Used SAS for data mining to identify members early in their pregnancy and Access for front-end data input by a team of outreach coordinators and backend report generation.  Improved Osteoporosis Management rate by 15% in one year (taking the measure from 0 to 4 Stars) by creating a program for in-home testing for eligible members. Created an outreach plan for member education and managed specific data transfers to the technical team for testing.  Collaborated with Healthfirst Medical Management department to create, implement and monitor a yearlong HbA1c education program to reduce the number of members in poor control. The program successfully reduced the poor control sample population by 14% by year-end 2015 and the program was expanded for 2016.  Created a program for early outreach to parents in order to improve Well Child and Childhood Immunization rates. Both measures have shown 2-4% improvement for the last 2 reporting years.  Worked with Healthfirst Product Management department to create a member outreach program to improve Access to Care rates to create member engagement and increase overall member retention.  Implemented a project tracking system to improvement efficiency and team productivity.  Interacted with other departments (including Pharmacy, Medical Management, Ancillary and Behavioral Health) to explain Medicaid, Medicare and Commercial quality trends.  Manage a staff of 3-5 clinical analysts of varying experience and skill sets.  Currently using SAS/SQL, Access, Excel, Crystal Reports, PowerPoint and Word. Manager, Finance Analysis (1/07 - 5/12)  Spent 5+ years in Finance as Analytics Manager focusing on provider financial / quality reporting.  Created financial and quality performance reports and presented them, along with Healthfirst senior management, to the network of Healthfirst owner hospitals.  Developed, using SAS, Excel and Crystal Reports, a suite of performance reports that the provider network could access via an on-demand portal, giving them access to specific individualized performance data.  Managed staff of 3 financial analysts. CIGNA Healthcare,Jersey City, NJ (12/04 – 12/06) Financial Analysis Specialist  As a dedicated regional analyst, I helped improved reimbursement rates and overall competitive position for the entire Ohio market through comprehensive contract analyses.  Created yearly unit cost trends for the market and then worked to meet (or beat) these trends, monitored progress with monthly management reports. AmeriChoice,New York, NY (4/03 – 12/04) Sr. Medical Cost Analyst  Responsible for medical expense trend analysis for New York, New Jersey and Rhode Island plans.
- 2.  Prepared monthly expense lag schedules as well as yearly health plan budgets and bi-monthly plan v. actual updates for senior management. Saint Vincent’s Catholic Medical Center,NewYork, NY (10/98 – 4/03) Reimbursement Specialist  Assured appropriate financial reporting through ongoing analyses of patient revenue.  Supported contract negotiations with managed care companies through detailed financial analytics.  Contributed to the completion of the yearly Institutional Cost Report. Prudential HealthCare,Kansas City, MO Information Services Supervisor 7/96 - 10/98  Supervised staff of two analysts and one data technician in order to supply timely and accurate utilization reports for all health plan departments for Kansas City, Topeka and Wichita healthcare networks (approximately 100,000 members).  Produced yearly physician bonus payout and analysis for over 320 primary care physicians  Active members of NCQA Quality Improvement committee helping to develop and perform studies for focused review of health plan practices. Technical lead for yearly HEDIS data collection efforts. CIGNA Healthplan of St. Louis,Clayton, MO Financial Analyst 12/90 – 6/96  Prepared and monitored yearly health plan budget. Analyzed actual vs. plan results throughout the year for medical and administrative cost variances, surfaced issues; devised and implemented solutions to these problems.  Acted as liaison with corporate accounting department for month-end financial reports and statutory filings.  Compiled and presented quarterly employer group profitability analyses for health plan General Manager and Sales Manager. EDUCATION University of Missouri – Columbia, earning a BSBA degree with an emphasis in Finance & Banking.