Kory is with the Value Transformation team with more than 20 years of healthcare experience. He brings extensive background in data analytics; data management, programming experience, IT business analysis; member, provider, and claim payment system configuration; and health plan daily operations. He is at the forefront of all client data submissions between actuarial and technical consulting firms, such as Myers and Stauffer and DXC, to ensure seamless transitions into Guidehouse data systems and infrastructures. Kory has worked extensively with the Medicaid, Medicare, and commercial membership and claim data from numerous agencies.
Kory is responsible for leading the actuarial data team in all data validation and visualization work, performing client bulk data transfers, data loading, SQL coding, processing, and output preparation. He prepares risk-adjustment models using licensable software, such as CDPS+Rx and John Hopkins ACG, from client datasets for actuarial use in capitation rate setting of managed care organizations (MCO) participating in state Medicaid programs to calculate risk-adjusted capitation rates that are budget-neutral to the state. He performs DRG client repricing exercises using 3M’s core grouping software for DRG assignment, APC assignment, and Medicare inpatient / outpatient fee schedule pricing.
He works with Guidehouse’s IT to maintain system readiness, compliance, and functionality. He is a key contact for clients in responding to detail data questions, issues, and resolution, along with handling any advanced analytic projects.