Manvendra Pratap Singh

Responsibilities:

Ops Reoprt: Description:

The role involves generating Prospective Operations Reports to track progress against organizational goals related to risk adjustment and patient engagement. These reports provide actionable insights by consolidating and transforming healthcare data into structured dashboards and performance metrics. The reports include key operational KPIs, patient prioritization data, and performance analytics at multiple hierarchical levels, such as patient, practice, provider, and TIN.

The reporting framework consists of multiple tabs, like Dashboard, Patient Roster, TIN, Practice, and Clinician, offering a comprehensive view of progress and helping stakeholders allocate resources effectively. The work involves advanced SQL development for data extraction and transformation, as well as Python scripting for automation, and structured data delivery into required report tabs.

Data Pipeline and Transformation

• Develop end-to-end SQL pipelines to extract, join, and transform large-scale healthcare data.
• Apply multi-layered logic to compute patient and suspect-related metrics.

Metrics Development.

• Build and maintain patient KPIs, such as Attributed Patients, Addressed Rate, and Assessed Rate.
• Develop suspect-level metrics, including Total Suspected Conditions, PCP Confirmed Rate, and Suspect Points in Claims.
• Track key dates like Max Claim Paid Date and Suspect Generation Date.

Report Design and Structure.

• Design multi-tab reports with sections like Dashboard, Patient Roster, TIN, Practice, and Clinician for various performance views.

Automation and Integration.

• Use Python to automate data loading and organize outputs into structured report tabs.
• Ensure timely, accurate delivery of insights for decision-making.

Agent Quality Dashboard: Description: Reports MS Applications, Sales, Inforce, Lapsers, Plan Changers, MA/PDP Sales, Switchers with New Business, Inforce Loss Ratio for all selling agents that were active.

Responsibilities: Creating the detailed design document, and writing SQL code to measure the performance in Tableau.

Golden Eye: Description: The objective of this project is to provide a unified and concise set of metrics to help business leaders make better-informed decisions and to harmonize the scattered data in the legacy system. Developed below tranches for commercial insurance to provide insights to make better business decisions, compare the performance across products and brands, and identify the growth opportunities: volume and premium, customer experience, leads and opportunity management, and claims.

Responsibilities:

• To write PostgreSQL queries for transforming policy, complaints, quotes, claims data based on certain criteria provided by the client (e.g., Brand, Product, State, Policy Number, Claim Number, Complaint Idetc.)

• The data was extracted from Aginity workbench using PostgreSQL queries to derive the metrices (e.g., Policy in Force, Risk in Force, Active Claims, Complaints etc.) and designed Dashboard on tableau using extracted data.