Nancy De Simone
About Nancy De Simone
Nancy De Simone is the Lead Risk Adjustment Analyst at EmblemHealth, where she has worked since 2015. She specializes in risk adjustment and reconciliation for government programs and has a background in data analysis and financial reporting.
Current Role at EmblemHealth
Nancy De Simone currently holds the position of Lead Risk Adjustment Analyst (SSP) at EmblemHealth. She has been in this role since 2015, contributing to Government Programs Risk Adjustment and Reconciliation for nine years. In her current position, she performs complex analyses and reporting of risk adjustment submissions and responses for various government programs, including APD, MEDS, HIX, and RAPs.
Previous Experience at EmblemHealth
Prior to her current role, Nancy De Simone worked at EmblemHealth as a Senior Hyperion Systems Administrator from 2012 to 2015. During her three years in this position, she focused on Budgeting and Investor Relations. This experience provided her with a strong foundation in financial reporting and data analysis.
Technical Expertise and Training
Nancy De Simone develops technical expertise in data analysis within her division by serving in the role of 'train the trainer.' This involves sharing her knowledge and skills with colleagues, enhancing the overall analytical capabilities of her team. She is recognized as a subject matter expert for EmblemHealth's Enterprise Health Data Warehouse (EHDW) functionality.
Education Background
Nancy De Simone studied at Middlesex University. Her educational background has contributed to her analytical skills and understanding of complex data systems, which are essential in her current role in risk adjustment analysis.
Financial Reporting Support
In her role at EmblemHealth, Nancy supports MMCOR financial reporting by identifying root causes of variances between financial reporting and encounter data submissions. This function is critical in ensuring accuracy and compliance in financial reporting processes.