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Pradeep Kalmat

@pradeepkalmat

Healthcare strategy and operations leader at eSimplify Enterprises who achieved 3X ROI by pairing population health analytics with RCM automation.

United States
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At eSimplify Enterprises, I advise health system executives and population health leaders on service and operating-model strategy. I lead Care & Case Management and navigation pilots, and achieved 3X ROI within 12 months across client initiatives by pairing population health analytics with RCM automation.

I designed analytical models combining population health risk data with EDI claims data to track total cost of care, identify patient leakage, and evaluate value-based contract performance. I also deployed a Medicare Risk calculator using the V28 HCC RAF model.

At Bill My Claims, I built and led a healthcare operations practice spanning billing, coding, contract auditing, and revenue strategy. Earlier, at Aon Hewitt (now Alight), I led enterprise implementations and managed a team of 50+ directly and indirectly, with a $10M+ team budget.

Experience

Work history, roles, and key accomplishments

EE
Current

President/CEO, Healthcare Technology & Strategy

eSimplify Enterprises

Oct 2021 - Present (5 years 1 month)

Advise health system executives on service and operating-model strategy, translating pain points into initiatives and roadmaps. Lead Care & Case Management operational testing and own business readouts for population health initiatives.

BC

Founder, Director of Strategy & Revenue Operations

Bill My Claims

Oct 2015 - Jun 2022 (6 years 8 months)

Built and led an end-to-end healthcare operations practice delivering billing, coding, contract auditing, and revenue strategy. Managed a cross-functional team of 15 and streamlined operations through pre-submission audits and workflow automation.

Education

Degrees, certifications, and relevant coursework

AAPC logoAA

AAPC

Certified Professional Coder (CPC), Medical Coding

2017 - 2021

Certified Professional Coder (CPC) certification from AAPC, held from 2017 to 2021.

AAPC logoAA

AAPC

Certified Professional Biller (CPB), Medical Billing

2016 - 2021

Certified Professional Biller (CPB) certification from AAPC, held from 2016 to 2021.

Bangalore University logoBU

Bangalore University

Bachelor of Technology, Technology

Bachelor of Technology degree from Bangalore University, India.

Tech stack

Software and tools used professionally

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