Open-source FHIR-native digital quality measure engine with AI care-gap closure layer. Codename "Pramana." This shows up in search results.
Medicare enrollment trends, plan type breakdowns, and geographic penetration rates across all US states and counties.
In this end-to-end data project, I will clean and analyze Medicare Prescription Drug cost data and develop a composite score system to decide which medications incur the most losses on insurance policies.
Data-driven intervention to reduce avoidable emergency department visits in a Medicare Advantage population using NYU-EDA and operational workflows at Mendez Medical Center.
Medicare Advantage payer analytics on CMS DE-SynPUF: Snowflake + dbt medallion warehouse, HEDIS-style 30-day readmission measure, chronic condition cohort analytics (CHF/COPD/CKD/IHD/diabetes), deployed Streamlit dashboard. Public synthetic data only.
Payer-contract simulator for mission-driven digital health
Reproducible contract-level structural modeling pipeline for Medicare Advantage Star Ratings with threshold-based opportunity targeting (Python + DuckDB).
Catch Medicare Advantage E/M downcoding on 835 remittances and draft CMS/AMA-cited appeal packets. Self-hosted, no cloud required.
Universal American was a health insurance holding company that focused on providing Medicare Advantage and Medicare prescription drug benefit plans to seniors.
Triple-S Management Corporation is the largest managed care company in Puerto Rico in terms of membership, providing health, life, and property and casualty insurance. A subsidiary of GuideWell (parent of Florida Blue), Triple-S operates as an independent licensee of the Blue Cross Blue Shield Association for Puerto Rico and the U.S.
DaVita HealthCare Partners is the legacy name for the combined entity of DaVita and HealthCare Partners following their 2012 merger. The HealthCare Partners group operated medical groups and physician networks managing Medicare Advantage and other coordinated care patients before being divested by DaVita in 2019.
Independence Blue Cross
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