1. Natalia Korina
215 Skokie Blvd, Wilmette, Il, 60091
(224) 715 4989
nkorina@hotmail.com
Professional Summary:
 Performing clinical analysis based on a variety of Episode Groupers such as Optum, MEG, SG2
Grouper
 Extensive experience managing, interpreting, cleansing, normalizing, linking together, and analyzing
exceedingly large and complex medical claims, pharmacy claims, and eligibility data sets from
prominent health plans, employer groups, insurance and pharmaceutical companies. Solid knowledge
of hospital data.
 Experience with EMR programs.
 Extensive experience working with and analyzing many independent BlueCross and BlueShield plan
medical claims data sets.
 Over 20 years of experience with increasing responsibilities in the medical and pharmaceutical
industries, including medical data analysis and validation using:
Languages / DBMSs: Visual Basic, SQL Server, PL/SQL, Oracle, MS Access,
Excel.
ASP, Seagate Crystal Reports, SQL Server, HTML, Java Script, SAS, DB2
Power Point, Vertica.
Professional Experience
BHI
Senior Clinical Analyst
(November 2012 – current)
Performed clinical analysis for Walmart, KCI, URMBT, Axial, KPMG, Horizon, others
Providing clinical support for the Blue Distinction (bariatric, cardiology, knee and hip replacement, disc/laminectomy, spina
fusion)
and Exchange Advisor projects (head injury, rare kind of cancer, chronic vs acute conditions, mental health, diabetes, etc.)
TEG implementation and testing
ICD9 to ICD10 conversion program
Allscripts
Senior Implementation Consultant
(2012)
Implementing Sunrise Analytic (EMR):
Sunrise Clinical Analytics™ is an advanced clinical intelligence solution that allows organizations to
effectively track and measure clinical performance and identify how clinician actions impacts patient’s
outcomes and clinical costs.
 Performed clinical analysis of the client database in order t to meet the face on ARRA measure requirements

2. defined by the Joint Commission, Centers for Medicare and Medicaid (CMS), core measures,
quality measures, and hospital acquired complications and other quality initiatives.
 Compliance implementation of stroke (stk-10), VTE and ED requirements
 Training nurses and doctors to work with SCA applications, providing clinical support for users
 Creating custom reports for clients such as 30 days readmission report
SG2
Senior Data Manager/ Analytic Consultant
(2010-2011)
Analysis of actual inpatient market for the strategic planning process based on procedures, service lines
and diagnostic codes combination.
Thomson Reuters Healthcare
Senior Data Manager/ Analytic Consultant
(2009 – 2010)
 Created an algorithm of the Life Masters process for the HCSC Opportunity Score predictive model,
working with a cross-functional team
 Created Opportunity Score trend reports against the Health Status Report values for the HCSC
analytic team.
 Worked with ICD9 to ICD10 conversion programs
 Detailed analysis of variety of hospital data (all aspects) Worked with external clients such as
HCSC, Liberty, Mayo.
American Imaging Management, Inc.
Medical Economics Department
Senior Analyst
(2005 – 2009)
 Participating in creating Clinical Script to determine medical necessity of requests using company
guidelines and client-specific health plan medical policy.
 Analysis of case reviews for the variety of diagnostic imaging study requests.
Worked closely with internal Marketing and Sales Department management, as well as with prospective
and existing clients’ technical and business staff to ensure that data files are sufficient to perform required
analytics and support implementation.
 Created and managed client’ data
 Normalized and warehoused extremely large medical claims and eligibility data sets.
 Performed all aspects of health plan radiology imaging management pre-program
benchmark and program performance analytics: network, products type, and line-of-
business historical and projected costs, trends, and savings on a pmpm, utilization per
1,000, and provider and hospital basis, including reimbursement comparisons and trends
Created final presentations and present findings to prospective and current clients
Created new and updated existing organization fee schedules based upon State and County-specific
CMS physician fee schedules.
Blue Cross, Blue Shield
Business analyst
(2004 -2005)

3. Validated accuracy of medical claims data and then performed analyses to support internal client
business needs. Testing the data of EDW and creating test plans.
SMG Marketing Group, Inc.
Medical Data Analyst
(1998-2003)
 Collected, analyzed and generated reports of medical data for major pharmaceutical companies (Bayer,
Sankyo, etc.).
 Analyzed patient data for chain clients and for physician group practitioners.
 Developed and supported web-based application allowing remote users to generate reports. Designed,
developed and prepared project specifications and flow charts for controlled tests and made
recommendations to management based on test results.
 Modified and documented SAS programs and macros used in generating tables, listings, and graphs.
Industrial Medical Center
Data Analyst/ Office Manager
(1992 –1997)
Supervised and trained staff, maintained medical and administrative inventories
Performed medical coding and billing to insurance companies dealing with workman’s compensation plans.
Clinical Hospital N 9 , Minsk, Belarus
Attending Physician
Neurology department
(1987–1991)
Education:
Community College, Glenview, IL
Computer Science
(1995 –1997)
Visual Basic 4.0 and 5.0, Oracle 7.*, MS Access 2.0 and 97, SQL, PL/SQL.
Medical School, USSR
Residency of neurology
(1986-1987)
Medical School, USSR
(1978 –1986)
Doctor of Medicine