Alan Baldwin Email & Phone Number

Eden Prairie, MN, US

• Provide analytics vision, support and leadership for Optum Health’s population health products and clinical programs serving 103 million Medicare, Commercial, Medicaid members, 4 million patients in value-based.
• Lead an advanced analytics organization with a $23M annual budget of 130 statisticians, researchers, data scientists and data analysts focused on identifying trends, creating analytical insights, using machine learning.
• Secured $2M in funding to create a dedicated Health Equity analytics team focused on refining the analytic methods and combined the clinical data assets to evaluate Optum Health’s products and clinical programs for.

Indianapolis, Indiana, US

• Integrate predictive models, clinical rules and specialty population analytics to enable clinical programs to better target members, drive behavior change and improve care outcomesElevance Health, STAFF VICE-PRESIDENT.
• Led a 77 person clinical consulting team responsible for developing clinical program member targeting strategies using advanced analytics; predictive modeling, clinical gap in care rules and behavioral models.
• Drove $15M in cost of care by improving member targeting for hospital readmissions, opioid abuse, diabetes, end of life and inappropriate ER use clinical programs.

Indianapolis, Indiana, US

• Primary Responsibility: Analytic support Leading and driving medical and pharmacy cost improvement strategies across the Medicaid enterprise through the influential delivery of actionable analytics.
• Lead a national team focused on modeling, identifying, tracking, valuing and reporting on Medicaid cost of care initiatives.
• Provide insights on medical expense trends and provide analytic support to Medicaid enterprise leaders in developing, evaluating and monitoring programs and initiatives focused on optimizing the delivery of care to.
• Team supported Anthem Medicaid Government Business unit which significantly exceeded its 2013 and 2014 Cost of Care goals.

US

• Structure, integrate and analyze online engagement metrics with survey and claims data to measure educational impact, learning gaps and readership intelligence
• Develop statistical analysis and methodological studies evaluating how different online content formats impact reader engagement, clinician learning and ultimately impact clinician practice behavior

Raleigh, North Carolina, US

• Analytic support for clinical trial study feasibility including country, site and patient identification
• Developed innovative analytic solutions using secondary health data including a 100 million patient claims database and publically available data from FDA, CDC, WHO, OECD, UN and AHRQ
• Developed study specific patient recruitment models designed to predict patient recruitment rates and inform drug sponsors on high-recruiting investigators and recommended study countries using epidemiologic data.

US

• Served as lead for clinical trial analytic activities and principal representative for the enterprise
• Worked in partnership with scientific, business, operational, clinical and technology areas to jointly manage projects and initiatives focused on protocol feasibility and investigator identification
• Integrated United Health 10 year, 55 million life claims database with other proprietary and public databases in support of clinical trial analytics projects

US

• Lead consultant on 4 year multi-million annual engagement to provide analytics for 3 regional hospital-based HMOs
• Led consultant team of programmers and business analysts responsible for delivering customized analytic and reporting solutions
• Developed and presented health plan business, medical cost trends and drivers to senior management
• Provided health plan ad-hoc, contract support, physician fee-schedule, medical cost and utilization analyses
• Analytic support for health plan disease management programs including ROI analysis and population identification

US

• Developed decision support tool enabling clients to identify statistically derived aberrant providers using proprietary clinical rule based metrics.
• Constructed multiple regression model measuring key MCO demographic, provider, financial and utilization attributes impacting client revenue.
• Met with large MCOs and physician practice groups to understand internal data processing and payment policies to implement Bloodhound’s signature ClaimsGuard product.

Bloomfield, CT, US

• Supervised Quality Management Department with nine direct reports.
• Wrote service and clinical QI studies for NCQA site-visit.
• Led HEDIS Analytic Team responsible for calculating quality and provider measures reported to NCQA.

Oakland, California, US

• Developed study demonstrating how diabetic glycemic control affects inpatient, ambulatory, lab and pharmacy costs.
• Measured how increased Ace Inhibitor, Beta-Blocker and Aspirin use among patients with a recent major cardiac event impacted claims cost.
• Defined outcomes measures and supplied data for nationally published population outcomes studies.

• Identified outlier physician practice patterns and worked with those physicians to better manage utilization.
• Developed provider profiling reports using control charts to track physician utilization and financial performance indicators.
• Created reports summarizing cost and utilization information for BCBSME managed care products

Master’S Degree, Public Policy, Planning And Management

Bachelor'S Degree, Political Science And Government