Marc Chiang
Marc Chiang plays a key role in the San Diego Health IT Practice, which provides healthcare analytics and health claims auditing services to its clients. Marc is a senior member on the team and his expertise is implementation, end user training, and monthly management of data warehouse and reporting technology, including Milliman's enterprise level MedInsight platform. Using MedInsight, Marc has worked closely with numerous large health plans who manage millions of lives. Marc’s notable projects include developing custom quality metrics software to support alternative provider payment methodologies for clients in the Oregon Health Alliance. He is also responsible for overseeing several staff members who manage MedInsight tools, servers, and data analysis for clients in commercial and federal markets across the country. Recently, Marc played a key role in the MedInsight implementation and ongoing consulting services for the Massachusetts Group Insurance Commission (GIC) – a commercial health plan with nearly half a million lives. The focus of his work with the GIC has been population migration analysis, key metrics adherence, and Medicare re-pricer reporting.
Marc's broader healthcare experience also includes market research for major pharmaceutical manufacturers and reimbursement support for healthcare providers. Within the pharmacy industry, Marc has worked in several roles, providing clinical, prior authorization, and claims appeal support for medication prescribers. In addition, Marc is part of the San Diego claims auditing group that performs electronic and on-site audits of medical, dental, and vision claims. Marc has audited health claims for clients in the private and public sectors, both on-site and virtually.
He also contributes to business development efforts by delivering MedInsight demos to prospective clients, writing proposals, and presenting at finalist meetings. Marc has leveraged his professional expertise to win additional consulting projects with new and existing MedInsight clients, including a multi-year consulting contract with Santa Clara’s Valley Health Plan. Marc has also worked on a variety of internal initiatives, such as establishing the San Diego Health IT consulting practice QRM adherence guidelines and filing procedures.
