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  #1  
Old 05-26-2018, 09:00 AM
Leopold Stotch Leopold Stotch is offline
 
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Default health insurance company that has no internal predictive modeling staff

Interviewed with a regional health insurance company this week.

Asked the VP about their predictive analytics capabilities and how such techniques are used in the company.

Other than some off the shelf risk adjustment software used in the quality and care management departments, and a few tasks outsourced to vendors (e.g. fraud, waste, abuse department), they don't use these techniques anywhere, and have no staff dedicated to building/improving models. Actuarial teams focus on reporting and traditional actuarial work (report loss ratios, claim triangles, trend reporting, rate filings, etc.). IT has a BI group building reports/dashboards in tableau, but it's entirely reporting the news/explaining the past, not forward looking.

"We are not competing on analytics" was an exact quote.

Would this be a red flag to you in a job hunt?
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Old 05-26-2018, 09:02 AM
TDH TDH is offline
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It depends what you want out of the role. If you want to do predicative analytics then yes it's a major red flag. If you want to one day lead the actuarial team of a regional health insurance company then perhaps it isn't.
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Old 05-26-2018, 01:52 PM
Fracktuary Fracktuary is offline
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Quote:
Originally Posted by Leopold Stotch View Post
Interviewed with a regional health insurance company this week.

Asked the VP about their predictive analytics capabilities and how such techniques are used in the company.

Other than some off the shelf risk adjustment software used in the quality and care management departments, and a few tasks outsourced to vendors (e.g. fraud, waste, abuse department), they don't use these techniques anywhere, and have no staff dedicated to building/improving models. Actuarial teams focus on reporting and traditional actuarial work (report loss ratios, claim triangles, trend reporting, rate filings, etc.). IT has a BI group building reports/dashboards in tableau, but it's entirely reporting the news/explaining the past, not forward looking.

"We are not competing on analytics" was an exact quote.

Would this be a red flag to you in a job hunt?
I can give you a little perspective from the life side.

You might have a company that sells simplified products through saturated distribution channels. The company aims for volume. This type of company would benefit greatly from increasing their net response rate from 6 to 7 per thousand. This is an example of a company that has decided to "compete on analytics" but not product.

Another company might sell complicated financial/estate planning products through sophisticated distribution channel and have some use for predictive models, but not enough to justify a large staff. The company can be described to be competing on product design.

There are better oppo's for data scientists at the first company. There are better opportunities for actuaries at the second. Both companies could do well and exist side by side in the market place. Which is better for you would depend on wether you want to be a data scientist or an actuary.
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Old 05-26-2018, 06:36 PM
This is my Alt This is my Alt is offline
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Why are you under the impression that complicated predictive modeling is essential to a successful company in the first place? Out of curiosity - what do you think the predictive capability of these health models is like?

Short answer: no, I wouldn’t consider it a red flag.

It sounds like you are early in your career and reacting to some buzzwords you don’t understand
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Old 05-26-2018, 07:25 PM
Leopold Stotch Leopold Stotch is offline
 
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Originally Posted by This is my Alt View Post
Why are you under the impression that complicated predictive modeling is essential to a successful company in the first place? Out of curiosity - what do you think the predictive capability of these health models is like?

Short answer: no, I wouldn’t consider it a red flag.

It sounds like you are early in your career and reacting to some buzzwords you don’t understand

fairly early. some reasons:

* the most successful companies seem to be embracing it everywhere they can (check out job postings from the largest health insurers in the country)

* the soa is pushing these skills hard in the education system

* I worry about not acquiring skills that will eventually become table stakes for being employable

*It seems obvious that employing modelling well would give a competitive advantage in areas like marketing/member retention, risk stratification and member engagement for health management/quality, risk adjustment coding improvement, etc. and from what I heard this place doesn't do much of it in those spaces.

* looking at job postings nationally many of the more successful health insurers seem to be all in on analytics (uhg, aetna, wellpoint, hcsc, humana, kaiser, etc.)
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Old 05-26-2018, 07:57 PM
clarinetist clarinetist is offline
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The answer is really this: you need to decide what your focus is.

From my experience as a data analyst, I can tell you that the majority of companies rave all about analytics yet have no idea what they're doing. There are a few exceptions I've seen, but these exceptions have extremely high standards for hiring.

As a side note, be careful when trying to bring analytics onto a new company which knows nothing about it, particularly if you're not a manager who can make budgetary decisions.
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Old 05-26-2018, 08:03 PM
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Colonel Smoothie Colonel Smoothie is offline
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As a side note, be careful when trying to bring analytics onto a new company which knows nothing about it, particularly if you're not a manager who can make budgetary decisions.


Somebody in senior management needs to know that they're doing. I've seen too many bad decisions being made by people due to a lack of knowledge/experience.
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Old 05-26-2018, 08:05 PM
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As a side note, be careful when trying to bring analytics onto a new company which knows nothing about it, particularly if you're not a manager who can make budgetary decisions.
Are you done building those GLMs in Microsoft Access yet? The people on my team are familiar with the technology so that's the program I want you to use.
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Old 05-26-2018, 08:52 PM
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Quote:
Originally Posted by Leopold Stotch View Post
fairly early. some reasons:

* the most successful companies seem to be embracing it everywhere they can (check out job postings from the largest health insurers in the country)

* the soa is pushing these skills hard in the education system

* I worry about not acquiring skills that will eventually become table stakes for being employable

*It seems obvious that employing modelling well would give a competitive advantage in areas like marketing/member retention, risk stratification and member engagement for health management/quality, risk adjustment coding improvement, etc. and from what I heard this place doesn't do much of it in those spaces. One of the nice things about being involved in predictive modeling is that if things don't work out in health care for some reason, those skills are transportable.

* looking at job postings nationally many of the more successful health insurers seem to be all in on analytics (uhg, aetna, wellpoint, hcsc, humana, kaiser, etc.)
Responding to your bullets in order:
  • This is not a good reason, as explained by clarinetist
  • soa is also pushing their GI tract. And CERA. And a lot of really dumb stuff.
  • This is a good reason IMO, but of course you're assuming these skills become table stakes. Could just as easily become some version of illegal to do this stuff in health for political reasons.
  • Not so obvious IMO and again political stuff.
  • clarinetist, again

Overall, not sure where you are in career, but you will hit a career point where you decide what kind of actuary you're going to be - business side, modeling, multi-disciplinary, non-traditional. Maybe you're there. +1 on it's not obvious this company is missing anything, maybe they just have a different business model; and maybe that works for you maybe it doesn't.
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Old 05-27-2018, 02:25 AM
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whoanonstop whoanonstop is online now
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Not a red flag. A red flag is a company that says they are competing in predictive analytics and nobody even knows what that entails.

Which is why there are half a billion data science platforms trying to sell to Banks and insurance companies.

-Riley
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