Healthcare SQL Comprehensive Guide
Language: English
Published by Omkrust Press, 2026
- Softcover
- New
Seller: PBShop.store US, Wood Dale, IL, U.S.A.PBShop.store US
AbeBooks seller since April 7, 2005
Condition: New
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Seller Inventory # L0-9781971447193
- Title
- Healthcare SQL Comprehensive Guide
- Author
- Urmi K Doshi
- Publisher
- Omkrust Press
- Publication year
- 2026
- Condition
- New
- Binding
- PAP
- Language
- English
- ISBN 10
- 1971447196
- ISBN 13
- 9781971447193
- Item weight
- 649 grams
Healthcare Analytics: Comprehensive Guide is the definitive desk reference for data professionals working in managed care, health plans, and population health programs. With 31 chapters and over 100 real-world analytics scenarios, it bridges the critical gap between programming syntax and the deep domain knowledge required to produce results that actually hold up in front of a CFO, a quality director, or a CMS auditor.
Structured around the STAR methodology (Situation, Task, Action, Result), every scenario teaches not just how to write the query — but why the data looks the way it does, what the business rule actually requires, and what the number means to the organization.
What you will master:
- Claims and Enrollment Fundamentals — Inpatient vs. outpatient billing, claim adjudication gates, member months, coordination of benefits, continuous enrollment logic, voids and reversals.
- Quality and Population Health — HEDIS measure construction from denominator to rate, CMS Star Ratings end-to-end pipeline, 30-day readmission prevention, and risk stratification models that identify rising-risk populations before costs escalate.
- Risk Adjustment and Regulatory Compliance — CMS-HCC RAF score calculation, RAPS/EDPS encounter submission, retroactive payment cycles, and RADV audit preparation.
- Financial and Network Analytics — PMPM medical cost trend decomposition, MLR calculation, Value-Based Care shared savings, fee schedule analysis, and out-of-network leakage detection.
- Advanced Domain Analytics — Pharmacy adherence (PDC), PBM spread pricing detection, oncology cost decomposition, maternal care episodes, and behavioral health parity analytics.
- Data Architecture and Advanced SQL — Star schema design, SCD Type 2 joins, claims lag management, window functions, recursive hierarchies, and query optimization for enterprise-scale datasets.
This guide gives you the framework, the logic, and the confidence to turn raw claims data into defensible, actionable answers
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PBShop.store US
Wood Dale, IL, U.S.A.
AbeBooks seller since April 7, 2005
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