Mary Grace Quismorio
@marygracequismorio
Experienced healthcare data analyst with a focus on cost savings.
United StatesWhat I'm looking for
I am a seasoned data analyst with over 15 years of experience in the healthcare industry, specializing in clinical and finance analytics. My extensive background includes working with SQL relational databases, healthcare data, and a solid understanding of medical terminology and claims billing practices. I have successfully managed projects that resulted in significant cost savings, including over $35 million in savings from 2024 to date at LA Care Health Plan.
Throughout my career, I have developed and analyzed critical reports for various healthcare initiatives, collaborating with IT and leadership to streamline processes and improve operational efficiency. My expertise in SQL, Tableau, and data analysis has enabled me to automate reporting tasks, reducing workload significantly and enhancing decision-making capabilities within organizations. I am passionate about leveraging data to drive improvements in healthcare delivery and outcomes.
Experience
Work history, roles, and key accomplishments
Data Analyst III, Business Insights, Advance Analytics Lab
LA Care Health Plan
Jul 2024 - Present (1 year 4 months)
Managed cost savings projects exceeding $35 million for Medical Cost Driver and Special Investigation Unit initiatives. Utilized advanced analytics to identify and implement financial efficiencies within the healthcare system.
Data Analyst, Continuity of Care, Medical Strategy
Kaiser Permanente
Jan 2024 - Present (1 year 10 months)
Developed and analyzed out-of-network provider and member reports for DHCS inquiries, ensuring seamless member transitions. Collaborated with IT and leadership to automate reporting processes, reducing weekly work hours significantly.
Data Analyst III, Business Insights, Advance Analytics Lab
LA Care Health Plan
Jan 2019 - Present (6 years 10 months)
Achieved over $20 million in cost savings through project management for Medical Cost Driver and Special Investigation Unit projects. Developed a comprehensive Claims Universe using SQL Server to support KPI, Compliance, and Audit Dashboards.
Technical Report Analyst, Enterprise Shared Services
LA Care Health Plan
Jan 2018 - Present (7 years 10 months)
Developed SQL reports to implement claims regulations and business rule updates for QNxt configuration. Supported Project Managers by creating reports to test updates to documented process changes and new business rules.
Senior Report Writer/Analyst, BPI/EDSA
LA Care Health Plan
Jan 2014 - Present (11 years 10 months)
Interpreted and analyzed claims-related data, generating ad-hoc and recurring compliance reports for various stakeholders. Optimized SQL queries, reducing run-time by over 98% and improving schedule constraints.
Healthcare Analyst, MHC Provider Network Strategy
Molina Healthcare of California
Jan 2012 - Present (13 years 10 months)
Collected, interpreted, and analyzed Provider Network data, developing monthly and quarterly reports on government contracts. Created ad-hoc reports for regulatory agencies and internal departments, including claim sweep reports for payment errors.
Education
Degrees, certifications, and relevant coursework
Saint Paul University Quezon City
Bachelor of Science in Commerce, Information Technology
Completed a Bachelor of Science in Commerce with a major in Information Technology. This program provided a strong foundation in business principles combined with essential IT skills.
Long Beach City College
Certificate Program, Cisco Networking Systems/Computer Business Information Systems
Obtained a certificate in Cisco Networking Systems/Computer Business Information Systems. This program focused on networking fundamentals and business information systems.
Downey Adult School
Certificate Program, Medical Terminology/Coding and Billing
Completed the Certified Professional Coder AAPC Certificate Program. This included comprehensive training in Medical Terminology, Coding, and Billing practices.
Coursera
Certificate Programs, Tableau and MySQL
Completed certificate programs in Tableau and MySQL through Coursera. These programs enhanced skills in data visualization and database management.
Availability
Location
United StatesAuthorized to work in
Job categories
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