For those who’ve worked with inpatient claims data, how do you handle vendor data that doesn’t line up with what you know internally or just fails the gut check? I understand penetration and utilization gaps, but some numbers seem far off (for example, a very small hospital showing three times the volume of a much larger one). How do you approach adjusting or validating data when you see discrepancies like that?

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Probably source dependent. MEDPAR is 100% of discharges but commercial / MA data sets have sampling issues from the clearinghouse / you may have to use scalers.

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U find a proof point

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Love that you’re using FB for an actual work question 🤓

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I think I would start looking at the top: Are we double counting claims? Do we have incorrect claim codes? Are the claim codes too broad? Is it a programming / sql counting error? Does this get replicated with another disease area as well?

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All claims data goes through a clearinghouse and various vendors get different proportions of the claims in the claims universe.

If a subset of hospitals sends its claims through a clearinghouse that's better represented in your vendor's data, then you may not have an equal distribution. Look for patterns in your data to see if this is true. Indeed you may need different scales.

But, like others have mentioned, there may be other reasons. Do you really need claims, or are patients the right count? If claims, are you looking at the final one? Is there a reason the smaller hospital could actually be doing more of said procedure (they have more doctors in that department, it's their specialty area, they happen to have a high volume clinician)?

Claims data is as much art as it is science. Think of it as a puzzle to solve :)

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^ only MCO claims, FFS claims do not but I agree with your statements on the clearinghouse challenges

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Interesting. Let’s see if the uptick In cases continues to drive an uptick in hospitalizations and then in fatalities. Depends on how many of the cases are incidental or in very young people not prone to severe cases. But either way, look at the hospital capacity utilization figures! This is the untold story. Were we bending the curve to avoid unnecessary deaths due to overcrowded hospitals, or were we bending the curve to buy time for treatments and vaccine, or just to slow fatalities?

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What is the longest you have seen someone with less than 50% utilization stay in a firm?

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We stay until 8 or 9 everyday and then at the end of every week my manager tells me to book only 40 hours. It sucks ass and now I have to explain to my counselor why my utilization is so pedestrian...

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How is utilization calculated? What happens if we are on the bench?

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Hello, I am looking to make a career change that starts at a minimum 75K salary. The economy is tough right now and I can no longer afford to stay in my current role. I have a bachelors degree in Sociology with experience in managed care, utilization management, & clinical admin.. Does anyone have any suggestions for a possible higher paying career that I would be qualified for based on my background?

I think hospitals would benefit tremendously from hiring designers to help facilitate better space utilization, communication, etc.

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Controversial question - what are some roles/functions to avoid at Google for ex-management consultants, in terms of potential under-utilization of skills and limited career progression? Common exit opps tend to be in StratOps, PMM, PgM/Solutions Consultant, roles in Sales; would anyone not recommend any of these roles?

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What is the target utilization for a Senior 2? Or number of chargeable hours goal? Is this ever hard to meet?

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My browser history is failing me and hope y’all can help! I recently stumbled upon a website where some ad folks had compiled a bunch of idea/conceptual thinking approaches and if you clicked through there were past spots that had utilized that idea / way of thinking. I wanted to share it with a mentee and can’t track it down. It was a simple layout: grid of images w/headline naming the idea … Sound familiar?

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I am curious how other inclusion teachers are being utilized when the school is doing remote learning. I find that I am sitting in the zoom class and have very little opportunity to contribute. I am having discussions with my teachers on ways that I can better support them and the students when remote.

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How does it feel to earn less than US Consultants while also struggling for utilization

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In the last PDM town hall, they said they were going to lower utilization targets for those that work on projects with capped hours. For those people, have you seen your utilization target lowered? I haven’t seen shit change for me.

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Has anyone ever worked at an agency in which the project management department was properly utilized? I traditionally was brought up in my career where PM type tasks were handled by lower level AMs. I have observed separating AM and PM tasks into two separate departments just causes communication issues and lazy account people. Account people should have a good understanding of how much effort and time goes into a project. Project Managers are missing a lot of context so blind leading blind.

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Promoted to SSE with 25% hike and VP as 9% . I had received ACE award in Q3 . I have also maintained utilization report 100% still I got less VP. Can I ask manager to revisit the component

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I wish admin utilized Tier 1 supports with teachers. Smiles, appreciations and acknowledging ones efforts would do a great deal to boost morale and climate. I just don’t understand what that is so hard to do.

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What other performance factors are considered for PDM besides utilization?

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Anyone working in Wholesale Credit (Corporate Banking) at JP Morgan can give insight on what’s the best way to get your resume into the right hands? Trying to lateral with a speciality and it’s hard to find openings.

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Does anyone knows about Virtusa ? They are offering me considerably high offer compared to others but I am not sure as I don't know much about the company or anyone who works there ? Project is Legato Healthcare.

Any help will be appreciated.
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YOE- 6
Skill - Dot Net Full Stack

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Need to know how is the Citibank project in Larsen & Toubro Infotech in terms of work life balance, work culture, technology used

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