Structure the market
Built a Databricks claims-intelligence framework across 3B+ records.
SELECTED WORK / 02 / Doral Health & Wellness
The data lake becomes useful at the next decision.
Turn claims, utilization, geography, provider behavior, and payer economics into named accounts, referral corridors, and service-line priorities.
Business Account Executive · 2025
- claims records
- 3B+
- modeled leakage opportunity
- $125.9M
- referral increase in three months
- 163%
THE CONSTRAINT
Which demand can the organization actually capture—and what must change first?
A multispecialty organization needed to distinguish total market leakage from plausible capture. The task was to connect demand intelligence to capacity, strategic accounts, reimbursement, and field execution.
Claims-to-account decision architecture
A reconstructed exhibit showing how analysis informs field priorities. No patient-level data or employer-confidential records are included.
- 01Claims + utilization
- 02Leakage + geography
- 03Capturable demand
- 04Account priorities
- 05Referral + capacity
Review conversion, access, economic value, and exceptions → adjust the next operating decision.
WHAT I BUILT
Prioritize the field
Translated leakage, procedure utilization, geography, and provider relationships into account and network strategy.
Connect growth to economics
Supported negotiation and implementation of $3.2M+ value-based agreements and service-line capacity decisions.
Expand the delivery model
Designed RoadL and HouseCalls growth architecture linking home-based services to health plans, ACOs, IPAs, hospitals, and provider groups.
REPORTED OPERATING OUTCOMES
What changed.
- Established 1,362 provider relationships.
- Linked access redesign to approximately 4,000 activated patients.
- Identified an estimated $22M downstream lifetime-value opportunity and $240K in savings opportunities.
THE EXECUTIVE DECISION
Executive decision brief
CEO question
What system did this work make more launchable, fundable, or scalable?
Operating answer
Claims analytics becomes valuable when it changes commercial action: which accounts to pursue, which services to launch, and where referral leakage can be captured.
Proof to inspect
The leakage signal matters because it was connected to action: claims-record context, service-line focus, provider targeting, activated patient flow, and downstream value logic.
Scope & source
$125.9M is modeled leakage, $22M is an estimated downstream lifetime-value opportunity, and $240K is identified savings—not realized cash. The 4,000 figure describes activated patients, not physicians.
Read the source résumé