Ankit Gupta
Healthcare Manager @UnitedHealth Group
Signup · Get unlimited contacts
WORK HISTORY
Healthcare Manager @UnitedHealth Group
Researched on both Inpatient Admissions as well as Outpatient Visits with the intent of Analyzing expense per condition with analyzing 30 days, 60 days and 90 days Readmissions post Inpatient Admissions.• Studied New York University algorithm for identification of Avoidable Emergency Visits and implemented the algorithm into United Health Group Medicare population to identify the Emergency Visits that can be classified as Avoidable and can be routed to Alternative and Cost-Effective sites of Care. In addition to that, Study was also performed by analyzing Avoidable Emergency visits through a Hybrid model more suited to United Heath Group Disease Pattern. Also researched on prevalence and percentages of Emergency Visits that were Avoidable in different areas of USA based on Area Deprivation Index (ADI) of the Area. • Compared and analyzed the percentage of dollars Paid in Avoidable Emergency visits and Trend Analyzed the same KPI with respect to frequency of Emergency Visit in the respective year. Compared the Average Paid amount between Avoidable Emergency Visits vis-a-vis Real emergency Visits. Looked for Outliers that were resulting in inflated Cost of Care during Emergency Visit and analyzed their impact on Average Paid dollars. Also looked at the impact of Weekend, when PCP offices are closed, on the Avoidable Emergency Visits.• Analyzed CDO PMPM, Utilization per k and Amount per Utilization for different Prior Authorization Lists for Durable Medical Equipment in different Place of Services and for different providers. Focused on usage of Rental DME v/s New Equipment, Expenditure on Prosthetics, Oxygen equipment. Looked for YOY trends in the before mentioned KPIs to understand the impact of Prior Auth List on Total and Average expenditure.• Was a part of Financial Validation Project which was focused on reducing Monthly Variance for different Care Delivery Organizations by removing inconsistencies in the underlying Clinical, Membership and Provider Data.
EDUCATION
Mewar Institute
Advance Legal Studies , Advanced Legal Research/Studies, General
Amity University
Bachelor of Technology - BTech, Data Analytics
SKILLS
ABOUT ANKIT GUPTA
11+ Years of Total Experience with 4+ years of Experience in Healthcare…
This profile is compiled from publicly available professional sources. Unifers is not affiliated with or endorsed by LinkedIn. Request removal of this profile.