Mikaylah Wycoco-Rutter

About Mikaylah Wycoco-Rutter

Born and raised in a suburb outside of Cleveland, OH and moved to Pittsburgh, PA post-graduation. I received my undergrad from Ohio University \'22 in Healthcare Administration along with a minor in Marketing. Throughout my undergraduate curriculum I found a passion and high level of interest in the health insurance industry. I started my professional career as a health insurance agent for Humana. Specializing in all things Medicare. At Humana, I was exposed to the terminology, financial aspect, and operations of Medicare. Fast forward one year, I fell upon a \"Provider Reimbursement Analyst\" role at Medical Mutual of OH. Here at MMO, I am exposed to the utilization trends between Institutions and Providers in-network. I\'m able to analyze and observe payer cost, management, financial models, and quality assurance. As an analyst I am exposed to copious amounts of raw data that lead into decision making.I am currently pursuing my MHA at Cleveland State University and plan to graduate December of 2025.

Experience

1. Provider Reimbursement Analyst Ii

   Medical Mutual

   Jul 2024 — Present

   Negotiate Professional Provider and Ambulatory Surgical Center reimbursement rates or methodologies• Model current and proposed impacts for Professional Providers, Ambulatory Surgical Centers and Hospital Providers • Identify high POC providers and negotiate fixed pricing through APC, ASC, or provider specific carevouts• Analyze multi-product agreements or amendments by reviewing rate methodologies• Observe payer value-based contract opportunities, including pay for performance, gain or risk sharing, bundled payments, and other emerging payment models to support the organizations drive toward alternative payment models• Work on various projects related to the analysis of claims, clinical and financial data, with a focus on improvement of financial and/or clinical outcomes• Analyzes contracted rates to assist with determining appropriate rates for provider contracts• Perform APC, DRG, MCI, and ARM recalibrations for institutional providers varying on contract language

Education

• Ohio University

  Bachelor's degree, Health/Health Care Administration/Management

  2018 — 2022

• Cleveland State University

  Master's degree, MHA