Ariel Caplan Email & Phone Number

Louisville, Ky, Us

Louisville, Kentucky, Us

Lead and manage team of credentialed actuaries in the Office of the Chief Actuary (Planning & Analysis) to analyze Medicare policy, and assess performance of Medicare Advantage plans compared to Traditional FFS Medicare, and manage model development supporting formal research and publication. 8 years leadership experience, growing talent to enable success for department and team development. Pioneered the development of formal research and publications within the Office of the Chief Actuary to advance Humana’s brand as a thought-leader in holistic care for Medicare members.  Analysis of Medicare value-based care picked up by major media – Forbes & Medicare industry publications Brought in as subject matter expert, advising inside & outside counsel as they developed legal arguments affecting billions of dollars in annual revenue. Developed novel methods for modeling consumer lifetime value, allowing financial leaders to quantify the dollar value of improved member retention and managing disease progression. Oversaw development of modeling and analytical capabilities for a team of 10 associates to advance team productivity and implement best-practices for predictive modeling. Spear-headed inter-departmental collaboration with medical, financial, corporate communications/marketing, investor relations, and senior management to break down organizational silos and foster efficiencies.

Louisville, Kentucky, Us

Louisville, Kentucky, Us

Managed a team of actuarial analysts and interns in the Clinical Insight & Analytics department, to provide clinical trend analysis that informed financial forecasting. Analyzed clinical subpopulations to model drivers of claims and utilization. Responsible for data management to support department reporting and analysis needs.  Constructed core data sets for member demographic, financial and utilization – still in regular use today Developed methods and performance benchmarking for hospital admission/readmission and HEDIS reporting. Implemented and designed changes to data warehouse related to Rx reinsurance, improving accuracy for pricing.

Louisville, Kentucky, Us

Louisville, Kentucky, Us

Responsible for member/claims/revenue/risk experience reporting to support Medicare bid development and pricing. Implemented process for assessing month-over-month restatements, improving efficiency of monthly reconciliation by 30%

Louisville, Ky, Us

Created a tech startup that developed an innovative online music collaboration and education platform utilized in schools, universities and private settings. Contributed to the product development/design in the launch phase, in addition to managing the intellectual property, accounting, and general business administration. Led fundraising, investor-pitches, and development of short/long-term strategic plans, financial forecasts and marketing plans. Raised over $500,000 in investment capital, at a maximum company valuation of $5 million Company grew to six employees and customers in 10 states

Bachelor Of Science - Bs, Statistics, Actuarial Science, And Economics

Associate'S Degree, Business Administration And Accounting