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.