Scott Thomas Duce has over 20 years of experience in healthcare analytics and quality improvement. He currently works as a Senior Manager of Clinical Analytics at Healthfirst, where he has led initiatives to improve star ratings and health outcomes. These initiatives include creating programs for prenatal visits, osteoporosis testing, diabetes education, well-child visits, and access to care. He also manages a team of clinical analysts and has experience in finance analytics.
New Ways for Predictive Analytics and Machine Learning to Advance Population ...Edifecs Inc
The team at University of Washington’s Center for Data Science and Edifecs have collaboratively built predictive tools that use machine-learning to identify patterns in morbidity progress and health status.
Learning Objectives
Hear how other industries are using the latest in predictive analytics and how this experience can be applied to healthcare
Discuss why healthcare needs machine learning and how it compares to traditional analytics
Explore the Data Tsunami and what the future holds for our industry
With Attune’s Business Intelligence Solution for Hospitals, by harmonizing your operations data from billing, cash, remittance, procurement to clinical performance, you can now monitor and forecast financial and operational performance more effectively. Mobile dashboards allow your executives to stay in touch with recent developments in the revenue cycle at all times.
Data Quality Assessment Pilot Highlights Focus on Improving HMIS Data Quality...HFG Project
Dr. Vishnu Kant Srivastava leads the Statistics Division at India’s Ministry of Health and Family Welfare (MoHFW). Having managed statistical initiatives at different departments and levels of the government, Dr. Srivastava recognizes the value of quality data for effective decision making. He spoke with USAID’s Health Finance and Governance (HFG) project on the findings of the data quality assessment pilot the HFG team conducted.
Late Binding: The New Standard For Data WarehousingHealth Catalyst
Join Dale Sanders as he explains the concepts behind the Late-Binding (TM) Data Warehouse for healthcare. In this webinar, Dale covers 5 main concepts including 1) The history and concept of "binding" in software and data engineering, 2) Examples of data binding in healthcare, 3) the two tests for early binding (comprehensive and persistent agreement), 4) the six points of binding in data warehouse design (including a comparison of data modeling and late binding), and 5) the importance of binding in analytic progressions (including the eight levels of analytic adoption in healthcare).
MEASURE Evaluation’s Health Information System Strengthening ModelMEASURE Evaluation
This PowerPoint presentation provides an updated overview of MEASURE Evaluation’s Health Information System Strengthening Model, or the HISS Model. The slides describe the purpose of the model and each of the model’s areas and sub-areas.
New Ways for Predictive Analytics and Machine Learning to Advance Population ...Edifecs Inc
The team at University of Washington’s Center for Data Science and Edifecs have collaboratively built predictive tools that use machine-learning to identify patterns in morbidity progress and health status.
Learning Objectives
Hear how other industries are using the latest in predictive analytics and how this experience can be applied to healthcare
Discuss why healthcare needs machine learning and how it compares to traditional analytics
Explore the Data Tsunami and what the future holds for our industry
With Attune’s Business Intelligence Solution for Hospitals, by harmonizing your operations data from billing, cash, remittance, procurement to clinical performance, you can now monitor and forecast financial and operational performance more effectively. Mobile dashboards allow your executives to stay in touch with recent developments in the revenue cycle at all times.
Data Quality Assessment Pilot Highlights Focus on Improving HMIS Data Quality...HFG Project
Dr. Vishnu Kant Srivastava leads the Statistics Division at India’s Ministry of Health and Family Welfare (MoHFW). Having managed statistical initiatives at different departments and levels of the government, Dr. Srivastava recognizes the value of quality data for effective decision making. He spoke with USAID’s Health Finance and Governance (HFG) project on the findings of the data quality assessment pilot the HFG team conducted.
Late Binding: The New Standard For Data WarehousingHealth Catalyst
Join Dale Sanders as he explains the concepts behind the Late-Binding (TM) Data Warehouse for healthcare. In this webinar, Dale covers 5 main concepts including 1) The history and concept of "binding" in software and data engineering, 2) Examples of data binding in healthcare, 3) the two tests for early binding (comprehensive and persistent agreement), 4) the six points of binding in data warehouse design (including a comparison of data modeling and late binding), and 5) the importance of binding in analytic progressions (including the eight levels of analytic adoption in healthcare).
MEASURE Evaluation’s Health Information System Strengthening ModelMEASURE Evaluation
This PowerPoint presentation provides an updated overview of MEASURE Evaluation’s Health Information System Strengthening Model, or the HISS Model. The slides describe the purpose of the model and each of the model’s areas and sub-areas.
I am a financial industry professional with over eighteen years of experience specializing in improving the operational and financial effectiveness of the unit; preparing and extracting financial data from various accounting and information systems; performing moderately complex statistical, cost and financial analysis of financial reports and data, and preparing subsequent narrative analysis for management. Expert communicator able to forge solid relationships with partners and build consensus across multiple organizational levels. Proven leader ensuring high-quality and optimal profitability.
Clinical Operations Manager with vast array of experience amidst rapid growth-state healthcare startup.
Opportunity to wear multiple "hats" within current role has allowed project management skills to be highly developed - Disciplined Agile Scrum Master PMI Certification in progress!
Eager to learn new skills & grow professional community.
Don't hesitate to reach out via LinkedIn, email, text, or call.
Thank you!
The Entity chosen was Baptist Healthcare South Florida for years 201.docxtodd701
The Entity chosen was Baptist Healthcare South Florida for years 2017,2018,2019 the stats are online
The course project will require students to select a
healthcare
organization and review its financial operations based on data available from various sources. The entity may be a individual hospital, medical group practice, managed care organization, or government agency delivering healthcare services. Once the group has selected a healthcare entity, it will obtain three years of financial statements to analyze along with appropriate literature reviews about the entity or similar entities. The final paper will be submitted in a case study format, which includes the following sections:
Background
Issues/problems identified
Analysis utilizing ratios and other financial analysis tools
Recommendations
Implementation plan
Monitoring methodology
References demonstrating graduate-level research (only references of the highest quality grade will be accepted)
The page count for this assignment is at least seven (7) pages plus references and title pages. Your paper needs to be submitted in APA 6th format and must have a minimum of 10 current resources four (4) of them from current peer-reviewed articles. The final group assignment paper is submitted Canvas with each team member sharing equally in the development of the group project.
Rubric
Written Grading Rubric (AW) (1) (1)
Written Grading Rubric (AW) (1) (1)CriteriaRatingsPtsThis criterion is linked to a Learning OutcomeIntroduction25.0 pts
This criterion is linked to a Learning OutcomeAccuracy25.0 pts
This criterion is linked to a Learning OutcomeRelevance25.0 pts
This criterion is linked to a Learning OutcomeReference List25.0 pts
This criterion is linked to a Learning OutcomeIn Text Citations and Paraphrasing25.0 pts
This criterion is linked to a Learning OutcomeCritical Thinking25.0 pts
This criterion is linked to a Learning OutcomeCreative Thinking25.0 pts
This criterion is linked to a Learning OutcomeOrganization25.0 pts
Total Points: 200.0
Previous
So far this is whats done but I am only responsible for the Monitoring Methdology Part
Baptist Health South Florida Financial Operations Case Study
Background
Baptist Health South Florida is the biggest healthcare organization in the region, with 11 hospitals, approximately 23,000 employees, more than 4,000 physicians and more than 100 outpatient centers, such as urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. Baptist Health was founded in 1960 and it is well known for having centers in different areas of health care such as cancer, cardiovascular care, orthopedics, sports medicine and neurosciences, which attracts patients from all over the U.S., the Caribbean, and Latin America. It is a not-for-profit organization committed to their faith-based generous mission of medical excellence. Also, Baptist Health has been recognized by Fortune as one of the 100 be.
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.