Carlos Batista

Sr Manager Data Analytics @Optum

San Diego, US

Ensure end-to-end revenue cycle integrity across charge capture, coding accuracy, billing, collections, and reconciliation for commercial payors.• Translate revenue cycle performance into financial risk insights, aligning billing, coding, and collections outcomes with VBC contract profitability and shared savings projections.• Evaluate tiered incentive model performance for a regional ACO, leading to a 15% increase in shared savings payout accuracy and improved downstream contract terms.• Design contract models in Optum ONE and Strata’s Axiom platform that simulate impacts of PMPM rate changes, carved-in/-out service lines, and utilization variability.• Apply regression, time-series, and causal inference techniques to evaluate the financial impact of risk-adjustment programs, VBC clinical initiatives, and care-management interventions.• Partner with actuarial teams to support annual CMS bid submissions, integrating forward-looking utilization, RAF trends, HEDIS compliance scores, and STARS projections.• Present quarterly financial and operational insights to VP and senior leadership across Payor Strategy, Finance, and Network Contracting teams.

Utah State University

Master of Business Administration (M.B.A.), Business Administration, Management and Operations

Instituto Tecnológico de Santo Domingo

Bachelor of Arts (B.A.), Economics

Healthcare Financial Management Association

Certified Healthcare Financial Professional, Finance, General

Utah State University

Business Administration

University of California, Irvine Division of Continuing Education

Data Science Certificate Program, Information Technology