Mary Gao
About Mary Gao
Mary Gao serves as the Lead Medical Economics Analyst at EmblemHealth, where she has worked since 2021. She possesses extensive experience in healthcare analysis, specializing in risk adjustment and program evaluation.
Work at EmblemHealth
Mary Gao serves as the Lead Medical Economics Analyst at EmblemHealth, a position she has held since 2021. In this role, she focuses on healthcare analysis, specifically in areas such as HCC gap analysis, ROI analysis, and program evaluation. Her responsibilities include evaluating the effectiveness of healthcare programs and analyzing financial data to support decision-making processes within the organization.
Previous Experience in Healthcare Analysis
Prior to her current role, Mary Gao worked at several notable healthcare organizations. She was a Senior Healthcare Analyst at Healthfirst for 9 months in 2018. Following that, she served as a Risk Adjustment Analyst at Horizon Blue Cross Blue Shield of New Jersey from 2018 to 2020. Additionally, she worked as a Risk Adjustment Analyst at HealthTeam Advantage from 2020 to 2021. Her diverse experience has equipped her with a comprehensive understanding of healthcare analysis across various sectors.
Education and Expertise
Mary Gao earned her Master's degree in Statistics from Ball State University, where she studied from 2003 to 2005. Her educational background provides her with a strong foundation in quantitative analysis, which she applies in her work. She specializes in MA and ACA risk adjustment and possesses extensive knowledge of risk factoring methodology, enabling her to effectively analyze healthcare data.
Healthcare Analysis Skills
Mary Gao has extensive experience in analyzing various aspects of healthcare, including claims, networks, providers, clinical, and financial data. She is familiar with key healthcare analysis metrics such as Allowed $ PMPM, Net $ PMPM, Member Share $ PMPM, Unit Cost, Utilization, Completion Factor, MLR (MER), and Trend. Her expertise also extends to provider networks, network pricing, benefit pricing, and manual rate analysis.
Knowledge of Government Healthcare Programs
Mary Gao possesses in-depth knowledge of government healthcare programs, including the Affordable Care Act (ACA), Medicare Advantage (MA), Medicaid, and the Children's Health Insurance Program (CHIP). She is also knowledgeable about employer large group plans and prescription benefit structures, which enhances her ability to conduct thorough analyses in the healthcare sector.