Mika Nagamine
Senior Research Consultant Data Scientist, Healthcare and Pharmacy Benefit Management @UnitedHealth Group
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WORK HISTORY
Senior Research Consultant Data Scientist, Healthcare and Pharmacy Benefit Management @UnitedHealth Group
Irvine, CA, US
Integrate and analyze both medical and pharmacy data and present comprehensive understandings about total cost of care. Develop models and analytic methods for estimating cost / savings associated with specialty drugs. Support clients and stake-holders in making decisions for mitigating high cost specialty medication use by patients. Provide and analyze both medical and pharmacy data, and perform consultative services to internal teams and external clients.• Discovered an unexpectedly low prescriber adherence to the drug treatment guideline for the Rheumatoid Arthritis. Potential savings were $2-3 million per year if the adherence improved.• Identified low adherence rate of Asthma patients to a new drug treatment regime. The result triggered pharmacists to investigate causes and perform corrective actions.• Enhanced existing SAS programs to increase efficiency in data extraction from multiple databases; real time of extracting data decreased by 90%.
EDUCATION
Otterbein University
Bachelor's degree, Sociology
The Ohio State University
Master of Social Work (M.S.W.)
Yokahama National University , Japan
Master of Education (M.Ed.), Specializing in Psychology
Rikkyo University, Japan
Bachelor of Arts (BA), Psychology
University of Minnesota
Doctor of Philosophy (Ph.D.), Social Work; Minor: Epidemiology in the School of Public Health
SKILLS
ABOUT MIKA NAGAMINE
Mika N••••••••@gmail.comPossesses expertise in managing complex databases & leading multi-disciplinary / multi-location teams for successful results. Thrives on taking on challenging situations, planning & executing in-depth analyses to discover meaningful, relevant information that leads organizations to address their greatest challenges & make informed business decisions. Recognized as a subject matter expert for medical claims, revealing & thorough investigation of longstanding or potential issues, develops accurate analyses & consistently provides resourceful, effective solutions. Displays critical thinking, an analytical mindset, a creative & ethical approach to solving problems & a collaborative leadership style. • Plans and implements data analyses, identifies analysis methods, problems, patterns, trends, and solutions.• Analyzes and manages large datasets (claims, encounter, provider, membership, patients, hospitals), and statistical analysis. Conducts literature review and develops algorithms to detect unusual patterns.• Develops analysis plans and algorithms, and constructs stories from data; authors reports, and informs customers on most critical healthcare issues. Communicates, documents, and presents findings.• Tools: SAS SQL, Python, Power BI, Excel, Word, other MS Office Products• Databases: Databricks, Teradata, SAS, SQL, DB2, IBM NetezzaAssures the quality of data & accuracy in analysis methods & findings & solves issues arising during analysis & data preparation. Presents & communicates results with senior management & business customers using reports that use concise & easy to understand terms, charts & graphs. Recommends solutions while staying current with industry regulations & trends. Healthcare Data | Medical Claims Analysis | Pharmacy Claims Analysis | Data Analytics | Data Management | Observational Studies | Statistical Methods | Research Methods | Database Development | Fraud Investigation
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