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Click here or scroll down to respond to this candidateMichael LouricasP: PHONE NUMBER AVAILABLE E: EMAIL AVAILABLE Brooklyn Park, MNSUMMARYDedicated Analyst and Data Specialist with experience in analyzing and manipulating both small and large datasets for Financial, Utilization and Statistical purposes in the form of data comparison, analysis, and presentationExperience with Unit trend pricing and querying large data sets (millions of records, Medical., Rx and Eligibility claims, EMR/EMH records, etc.) to evaluate savings trendsExperience analyzing Pricing information based on VBC and Fee For Service contracting with providers and payers, analyzing metrics including STARS and other VBC/HEDIS MetricsReport automation using VBA in excel and macros in SAS (PROC SQL) to create various BI presentationsSkills and Expertise: SAS, SQL, Python, R, DataBricks, Snowflake, Teradata, Power BI, Tableau, Automation, Excel, VBAEXPERIENCE9/2023 4/2024Elevance HealthcareProv Contract/CofC ConsultantWriting Complex queries to do deep dive analytics into Medicare Health Trends in Risk and Shared Savings ArrangementsDelivering Medicare Reconciliation reporting for internal and external stakeholdersSuccessfully Transitioned Data from a Teradata warehouse, using SQL/SAS over to Snowflake9/2022 5/2023Molina HealthcareLead Data Analyst Medical EconomicsDeep dive analytics into Population health Trends in all LOBsCompleted a MHSA/BH report using grouper and different codes such as Dx, CPT, HCPCS, Charlson and Chronic conditions to help advance production and of UM/CM programsCreate complex data queries using Python/SQL/PySpark, pulling data from multiple sources, and delivering Health Care Economics reporting for internal and external stakeholdersOptum Rx 9/2021 9/2022Sr Data AnalystProviding clinical analytic support to Clinical Consultants, developing innovative analytical solutions to address clients changing needs, and generating trend analyses and insights to support custom requests.Creating Rx reporting deliverables by creating an Excel/PPT template, writing and updating SAS/SQL queries, Macros and Loops in SAS EG creating output that automatically populates the template. Then have a one button VBA Macros written to auto-populate the PPT template with the goal to continually automate reports that can be scalable across the organization.Adhoc reporting requests involving deep dive analytics stretching across our IDW containing Pharmacy claims and Member Eligibility data, using Join(s) (Inner, Left, Full Outer, etc.) from Product, Provider, Transaction, and Xwalk reference tables etc.Work directly with OptumRx Sales, Account Management, and Clinical Teams departments to understand the requests for model/reporting developmentImplemented our constant Data Quality Assurance checks. Data QAd by comparing to specific LOB Benchmarks, Internal reporting matches/within tolerance.Minnesota Oncology 6/2020 4/2021Sr. Medical Data AnalystAnalyze multiple types of Provider datasets including EMR, EHR and McKesson to measure and report Provider Performance Metrics and make sure we met our Value Based Contract Guarantees.Crete and automate Multiple Ad-Hoc report requests from Internal and External Stakeholders using Medical Claims data provided by McKesson for financial/trend reportingData querying using Crystal and other reporting software; i.e. CVP, Practice Insights, external locationsReport and Data automation using VBA, Excel, Access, CrystalCVS Health 3/2015 4/2020Advisor, Data AnalyticsAnalyze multiple types of Health Plan and Payer claims datasets for potential clients by creating financial/savings opportunity analysis using different modeling methodologies and techniques including grouping/mapping Diagnoses and studying Optum grouped data sets with SRx Pharmacy drug productsSuccessfully managed my team in delivering accurate outcomes reporting and was the Point of Contact for the Site of Care/Drug Benefit Alignment programWorked closely with account executives and clients to answer reporting questions and/or create ad-hoc reportsBuilt, maintained and transitioned the Medical Benefit Management drug list database, an Exclusive specialty and other outcomes reports to other team membersOverseeing the entire process of obtaining and quality checking Optum and a nationally representative external data extract for Book of Business and trend bench marking for Specialty Marketing presentations and modelsSuccessfully developed and manage regular reporting and presenting activity for Generic Combination Therapy, Chronic Conditions and the Immune Deficiency Drug ClassesCreating data maps for different types of coding and internal mapping roll-upsThoroughly QAd 100s of million record data sets by checking initial control totals, completeness/cleanliness of fields, made sure the data made sense (i.e. Units, Diag. Codes, Spend for a specific drug had to be within range), Mapped data to our process, auto-populated reports, then checked against Internal BOB and National BenchmarksWork with SAS and SAS EG: creating queries, manipulating queries, pulling data, transforming data, creating tables based on certain criteria, Ranked Drugs/Drug classes by spend and/or savingsWork with SQL Server: creating queries, manipulating queries, pulling data, transforming data, creating tables based on certain criteria, Ranked Drugs/Drug classes by spend and/or savings. Used SQL to create daily reports and transferred the data into some of the SSRS packagesWork with Tableau, by connecting to SQL/Teradata/ODBC data sources and creating dashboards for clients. Used R to do high level control total checks as well as data transformation/manipulation.Work directly with Marketing, Sales, Account Management, Clinical, Underwriting and other departments for model development, Marketing/Client presentations and deliverables; Pilot programming modeling, and Data mapping.Allina Hospitals and Clinics 6/2011 3/2014Sr. Financial/Data AnalystQuarterly analysis of generic versus brand name prescriptions from large datasets and created insightful reports for Pharmacy stakeholders to make beneficial organizational decisionsBegan grouping and working with data to create new TCOC, VBC, and Other method to group claimsLead analyst within the ACO department and created a variety of financial reports for the various populationsAnalyze different payers claims and report utilization statistics to ensure efficient, quality care at the lowest possible costsSuccess in analyzing large datasets and developing utilization statistics and affordability measurements that upper level management and executives have supported and made strategic decisions onWorked with Reimbursement and Payer Relations to build Bundled Payment Models determining payment estimations across providersAnalyze value of generic medications versus brand name prescriptions and found many ways for physicians to increase efficiency.Have created complex physician rate and forecasting revenue modelsProficient with working in the Enterprise Data Warehouse and using Advanced Microsoft SQL Server programming skillsMinnesota Institute of Public Health 10/2007 6/2011Statistical AnalystProvide statistical expertise to design, define and execute analysis and interpret statistical results for epidemiological data substance use patternsAnalyze epidemiological data for various projects, including a site dedicated to substance use patterns.Developed programs where SPSS is used to automate datasets, in turn saving man hours and company dollarsEfficiently provide accurate, statistically appropriate outputs included in protocols, statistical analysis plans, study reports and regulatory submission documents required by SAMHSA and the Evaluators groupUsed Excel and SPSS to analyze many types of data sets including surveys and many other alcohol, tobacco, and other drug statisticsEDUCATIONJohns Hopkins University - 6/2017 3/2019General Certificate - Data Science & Machine LearningSouthern New Hampshire University - 9/2015 3/2017Master of Business Administration - LeadershipUniversity of Minnesota Duluth - 9/1999 12/2004Bachelor of ArtsMajor: Economics - Minor: Mathematics/statisticsSKILLS AND EXPERTISESAS, SQL, Teradata, Snowflake, DataBricks, Python, R, Power BI, Tableau, Excel, VBA, Automation |
